Some of us are lucky enough to stumble into a job that we love. That was the case for Gabrielle Nuki. The 16-year-old had never heard of standardized patients until her advisor at school told her she should check it out.
"I was kind of shocked, and I was kind of like, 'Oh, is there actually something like this in the world?' "
Since Nuki wants to be a doctor, the chance to earn $15 to $20 an hour training medical students as a pretend patient was kind of a dream come true. Every six weeks or so, Nuki comes to Maine Medical Center in her home town of Portland, Maine, slips on a johnny, sits in an exam room and takes on a new persona.
Third-year medical student Allie Tetreault knows Nuki by her fictional patient name, Emma. A lot of teens avoid the doctor, so it's important for Tetreault to learn how to make them feel comfortable.
"What kinds of things do you like to do outside of school?" Tetreault asks.
"Um, I play soccer, so preseason is coming up soon."
Nuki preps weeks ahead of time for her patient roles. She memorizes a case history of family details, lifestyle habits and the tone she should present. "I've had one case where I was concerned about being pregnant. That was kind of like the most harsh one, I guess."
As Emma, Nuki's playing just a shy, healthy teen.
"How did school finish up for you this year?" Tetreault asks.
"Um, it was good. Yeah, school's been good. Um, yeah."
Emma's an easy role, Nuki says, but she ups the shyness factor because it poses a classic challenge to the medical student: how to get a teen to open up?
"Each case kind of has what's on paper, but then you can come in and kind of add another level," Nuki says. "Depending on how complex it is, you can add your own twist to it."
After asking Emma about her personal history, Tetreault moves on to the physical exam and listens as Emma takes deep breaths.
Tetreault gives Emma a clean bill of health and the practice appointment is over. But the most important part of Gabrielle Nuki's job is about to begin.
The 16-year old now has to evaluate the adult professional. She's smooth and tactful after lots of training on how to deliver feedback. Nuki tells Tetreault she did a good job making her feel comfortable. "I also liked how you mentioned confidentiality, because for my age group, that's important to touch on," Nuki says. "And I think that maybe you could have had a couple more times where you asked me if I had any questions, but other than that I think you did a really great job."
It's communication skills versus acting skills that really qualify someone to be a standardized patient, says Dr. Pat Patterson, the director of pediatric training at Maine Medical Center.
"A lot of patients want to please their physician," Patterson says. "It's not easy for a patient to say 'That didn't feel right', or 'The way you asked that made me feel bad.' "
Gabrielle Nuki says working with medical students and being forthright about their performance has given her more confidence. In the future, she hopes to take on more complex roles — maybe someone with depression.
But she knows no matter what kind of patient she portrays, this job will prepare her well for when she reverses roles and one day becomes a doctor.