Council on Medical Student Education in Pediatrics


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Through the Eyes and Heart of a Standarized Patient

‘The Empathy Exams.’ Jamison L. The Empathy Exams: Essays. Graywolf Press. 2014

“My job title is a medical actor, which means I play sick.” Thus begins this look into the world of suffering from the perspective of a standardized patient (SP) facing sickness, both real and ‘mock.’

What does this essay highlight?
Being empathic is a choice and one that needs courage, and for some, a level of intentionality to practice, which does not make it any less meaningful. This essay highlights the need for humility: “Empathy requires knowing you know nothing…it suggests you enter another person’s pain as you’d enter another country, through immigrations and customs, border crossing by way of query: What grows where you are? What are the laws? What animals graze there?” When practiced with skill, empathy promotes a shared discovery by enabling patients to give voice to their feelings, even the ones they don’t consciously acknowledge.

Implications for educators
This essay calls to question the methods we use to assess professionalism: are we assessing behaviors (using ‘checklists’) or values or does it even matter? Perhaps it is unrealistic and unimportant to expect all learners to appreciate the richness of empathy, especially if one believes that over time behaviors that are repeatedly practiced will get ingrained into one’s character. Another aspect of empathy that is not discussed often enough in education is the need for humility - conveying to learners that people are wondrous beings instead of ‘problems to be solved’, thinking of humans as needing to be explored with reverence and awe. Words that convey a power over others (“that must feel really hard”) should be shunned for those that convey the uniquely personal nature of grief that can never fully be comprehended by others (“I couldn’t even imagine”).

Editor’s note: Obviously not a study, this essay provides valuable insight from an important and often neglected perspective, that of a standardized patient (RR).

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