My heart rate increases, and I feel color coming into my neck and cheeks. I’m not a clinician: I say this phrase inside my head as I take a deep breath, trying to slow my heart, which feels like it might beat out of my chest.
Then I say—this time out loud, to the person sitting across the exam table from me—“I’m not a clinician,” before continuing with, “… but on your physical exam I noticed something out of the ordinary, and I’d like to have one of our physicians take a look at you.” I wait and smile my warmest, most empathetic smile.
Even though I’m not a clinician, I am trained in physical exam and communication skills. I have made a life out of training simulated patients in these skills as a simulation educator. So, during those rare interactions when I discover an actual symptom during a training session, I know the person receiving that news may be startled, scared, or even terrified. I have to say this to my simulated patient, a professional portraying someone else’s symptoms to further the education of our health-care students.
If my simulated patient seems calm and ready to hear what I have to say next, I move on. “I want you to know that finding something like this during training occasionally happens. Because I’m not a clinician, I’d like you to see someone who is as soon as possible. I’d hate for you to worry.”
That sometimes elicits a sigh of relief or a nervous giggle or a blank stare. “If it’s all right with you,” I continue, I’ll see if one of our faculty is available to take a look at you now.” If need be, I find someone to sit with them in the tiny simulated exam room until I can find a faculty member.
I can’t tell you about the kinds of symptoms I’ve found, because simulation educators abide by a strict code of ethics. And because I’m not a clinician.