Model patients. That small sentence almost implies that there is supposed to be an ideal that our patients are working towards, but actually it is more descriptive of part the training medical students receive here at OHSU.
3 times a year in our first two years, we don our professional attire and white coats in order to take histories and perform physical exams on actors trained to portray an illness or injury.
This training emphasizes the ritualistic side of medicine: as we learn to not stumble over introducing ourselves as doctors we also learn to perform the basic acts of the physical examination. Similar to playing a musical instrument, we are practicing putting together all of the necessary elements in our own ways.
And yes, we hit the wrong note sometimes. Close to immediate feedback from the model patients can range from “You don’t need to say sorry so many times” when doing a cardiac exam on a lady, to “You didn’t listen to my heart with the stethoscope bell.” Despite any errors in penitence or technique, everyone has positive things to say as well, which generally makes the experience less daunting.
All of this acting helps us prepare for part of the medical licensing exam in which we will travel to a different city to take histories, perform exams, and generate diagnoses and plans on model patients. It also helps us learn how to take a history and use the physical exam in the context of actually providing care.
So yes, it is important to ask if the abdominal pain has occurred before, and it is important to have your patient turn their head the opposite direction when looking for a jugular venous pressure. And yes, I probably do not have to apologize more than once if the exam calls for bare skin auscultation.