As reported by The Hartford Courant, January 18, 2007.

With These Hospital Patients, Sickness Is Just an Act

By Korky Vann

Stephanie Klaber has had memory loss, dental anxiety, hypothyroidism, aching joints and a brain tumor. She's endured long periods in the hospital being poked, prodded and diagnosed and fully expects to develop more diseases and conditions in the weeks and months ahead. But in spite of her complaints, the 69-year old retiree doesn't suffer from chronic poor health and isn't a hypochondriac.

She's a "patient/instructor" in the Clinical Skills Assessment Program at the University of Connecticut Health Center School of Medicine in Farmington. She has been trained to portray a person with medical problems. Doing that helps instructors evaluate medical students on bedside manner and communication skills, .as well as their ability to take medical histories and perform physical examiniations.

Call it donating your body to science before you die.

"I'm not a sick person, but I play one on a regular basis," says Klaber, a retired registered nurse who has been a part of the program for about a year. "One week, I had four complete physicals. For anyone interested in medicine, as I am, it's a fascinating part-time job."

One of the earliest patient/actor programs began in the 1960s, when Dr. Howard S. Barrows introduced the idea of training individuals to simulate illnesses in a standardized way at McMaster University in Canada. (Standardized training allows students and faculty to assess each individual's performances in relation to his or her peers.) Within a short time, the idea, also known as "standardized patients," "simulated patients" and "actor patients," was common at medical schools and teaching hospitals around the world.

At UConn, patient/instructors from 18 to 80 are first trained in interviewing and feedback skills and then schooled in the details of the disease they will be portraying. Conditions include migraines, diabetes, chest pain, emphysema, gall bladder problems, joint aches and sexual dysfunction. Participants go through dress (or in some cases, "undress") rehearsals before working with student doctors.

Medical students, who know that the "patients" are role-playing, conduct interviews and physical examinations. Sessions are taped for review by students and professors. Afterward, patient/actors rate the students on their skills and provide other feedback. Through these encounters, says Carol Pfeiffer, one of the program's faculty directors, medical students learn how to communicate with patients in situations that do not require the use of actual patients.

"We like to think of the clinical assessment program as making the world safer for sick people," says Pfeiffer, who helped develop UConn's program almost 20 years ago. "It's a safe, controlled environment for students to learn these essential skills"

Cases become more challenging as students progress through medical school.

"They will learn to convey bad news, deal with end-of-life issues and other difficult situations," says Pfeiffer. "They learn how to do 82-point physicals."

Backgrounds of patient instructors, who are paid $18 an hour, vary. Some are health professionals, some have had acting experience and others are interested in just the intellectual challenge of the work and field of medicine.

"We look for good communicators who are detail people," says Pfeiffer. "We also look for people who have positive attitudes about medicine and doctors and who are comfortable sitting in a johnny and letting inexperienced students poke at them."

Many, like Klaber, learned about the program by word of mouth. Work time varies from one-to- four half-day sessions per week, sometimes for several weeks, at various times of the year. P.I.'s, as they're known, can pick and choose work times and diseases.

"Patient/instructors are an essential part of the education process here," says Pfeiffer. "They allow us to monitor how well we're teaching, what students are learning and how prepared they are to practice medicine."