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Actors who portray patients adjust to the new world of virtual medical exams

USC employs hundreds of “standardized patients,” trained actors who help medical students diagnose disorders during exams. Since the pandemic hit, their duties have changed dramatically.

Standardized patients Keck USC
Standardized patient Heldine Aguiluz, top, poses as an adolescent patient receiving her annual checkup from USC nursing student Olivia Anderson over Zoom. (Photos/Courtesy of Daniel Amparan)

In Eve Muller’s line of work, body language and face-to-face interaction are almost imperative. Muller is a standardized patient, a trained actor used for medical exams to provide students with a realistic example of doctor-patient interaction and test their interpersonal skills as well as their medical knowledge.

But just like almost every other line of work, she has been forced to interact strictly online due to COVID-19.

“We all just went, ‘Oh shoot. How is this going to even work, and how are we going to work?’” Muller said.

The result: Less overall work and standardized patients who spend most of their time calling their “doctors” and describing symptoms rather than acting them out.

It really is a privilege to be part of the education of someone who does what these students will one day do.

Eve Muller

Muller — who has been working as a standardized patient since 1990 — said she originally stumbled into the profession. Now, she works part time to train other standardized patients for the Keck School of Medicine of USC. As someone who has been in this line of work for 30 years, she said it entails simulating emotional and psychosocial issues along with physical exam findings while portraying them in a realistic and humanistic way.

“I really love the work that I do, and I’m grateful every day for this opportunity that I fell into accidentally,” she said. “It really is a privilege to be part of the education of someone who does what these students will one day do.”

Standardized patients struggle with lack of face-to-face element

The community of L.A.-based standardized patients is quite diverse, as Muller said schools require patients of varying ages and ethnicities. USC has a pool of about 300 total standardized patients, though not all are active. About 100 of them stay in touch through Facebook, where Muller said they discuss auditions, plan get-togethers and — in the wake of the COVID-19 pandemic — check in on each other.

Connie Nelson has been working as an actor and a standardized patient for over 20 years. She said that, once the safer-at-home orders went into effect in March, many standardized patient opportunities were put on hold.

“This is supposed to be our busiest time because this is when all the schools test,” she said. “What we do has definitely been limited.”

Even the available work comes with its share of challenges. Bob Rumnock has been working as a standardized patient since shortly after he arrived in L.A. 20 years ago to pursue acting. He said standardized patient work has been the ideal job, as it has allowed him to travel the world and strengthen the skills he needs for other roles. As with most acting jobs, standardized patients use more than just dialogue to convey messages.

“Standardized patients have a tendency to really focus on eye contact and facial expressions. Oftentimes it’s difficult, depending on where your camera is, to establish eye contact,” he said.

An example Rumnock gave was a standardized patient experiencing appendicitis. Normally, the patient would verbally and physically communicate where the pain is, then the student would lay the patient back and check where that pain is specifically coming from. Without that physical interaction, the process almost becomes more of an interview.

“It’s really that human element that we focus on, and that’s a whole reason for standardized patients being there,” he said. “Otherwise, you could simply watch a video.”

Despite pandemic, this community grows stronger

Along with the rise in telehealth options, Muller said Zoom has been beneficial in training students to handle remote appointments like pharmacy cases or anything that doesn’t require a physical examination. But other avenues, such as occupational therapy, rely on physical contact.

“The actual greatest loss to me is energy, because I feel like there’s an energy to everything we do,” Muller said.

I feel like there’s an energy to everything we do.

Eve Muller

Despite the shortage of standardized patient work and the adjustments that have been made in order to work remotely, all three of them agree that there are a few bright spots during this pandemic.

As actors, they all understand the struggle of trying to work while also auditioning. It’s why they’ve been able to create such a tightknit community, which has only grown stronger in the last few months. Muller said it has extended beyond checking in on each other to running errands and even financial assistance for those struggling to get work.

“It’s a very powerful thing to be part of a community that helps one another boost their immune system, boost their spirits and stay healthy,” she said, “not just physically but emotionally and mentally.”

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Actors who portray patients adjust to the new world of virtual medical exams

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