After giving birth for the first time, Stacie Rearden Hall was exhausted — though not in the way you might expect. "My arms were very sore the next day," she says. "It was quite a workout."
If her account of childbirth sounds odd, perhaps it's because she's an actor in Virginia Commonwealth University's standardized patient program. Working in conjunction with the Center for Human Simulation and Patient Safety, the program allows medical students to practice care giving by using paid actors and simulation machines.
For Rearden Hall, this sometimes means pretending to give birth while pushing a mannequin infant through a fake uterus. She's covered with a sheet while acting; the top half is her, the bottom half is a simulator.
"It looks like two half legs attached to a large, pregnant stomach," Rearden Hall says of the simulator. "It creates a pretty affecting illusion."
In preparation for their roles as pregnant mothers or sick patients with different maladies, the actors undergo an orientation process. Many of them are involved in the local theater scene, and some of the methods used to elicit these performances are similar to ones they use onstage.
"We feel that gives us a more emotional and realistic portrayal," says Ted Carter, a former high-school drama teacher and director of operations for the program. "Trainings we have look a lot like rehearsal for a play."
The sessions are meant to improve a medical student's bedside manner and ability to diagnose illnesses outside of a normal classroom. Students also are taught how to deal with patients who might be alcoholics or victims of abuse.
"Just about any condition that a woman can have, I've had at this point," says Rearden Hall, who will appear in Richmond Shakespeare's "The Tempest" in March. In addition to learning how the body reacts to certain health conditions, actors memorize a detailed case study for each character they're portraying at least two weeks in advance. The case study contains everything from a patient's name and complaint to his or her family history and background.
After studying, actors undergo a training session to fine-tune the details of a scenario. An injured knee might feel all right when turned one way, but hurt when turned the other. The upper left quadrant of the abdomen might feel OK when touched, but the upper right elicits excruciating pain. Once the training is complete, it's show time.
Actors usually portray the same patient for numerous medical students, which can be challenging, depending on the illness. In four different sessions one morning, Rearden Hall had to receive the news that her breast cancer had spread throughout the body.
"All of the students take it very seriously," Rearden Hall says. "Sometimes you look over and you can tell that the students are so invested and concerned. It kind of pulls at your heart strings."
In March, both the patient and simulator programs will move into two stories of the new James W. and Frances G. McGlothlin Medical Center. The $158.6 million, 12-story building was designed by I.M. Pei's renowned architecture firm, Pei Cobb Freed and Partners, and Ballinger architects.
"It brings everything together in one central location," says Aaron Anderson, founder of the program, associate chairman and head of undergraduate studies for the theater department. "It gives us the ability to create greater learning experiences for students."
The facility will offer 16 examination rooms, an actors' lounge and a conference room for instruction. The examination rooms have two-way mirrors and separate entryways for actors and medical students to help maintain the illusion.
The standardized patient program is now used as part of the curriculum with every department of the medical school, and is looking for additional actors beyond its roster of roughly 45.
"[Students] are functioning as physicians the very first day they walk through the door," says Dr. Isaac Wood, senior associate dean for medical education and student affairs. "I know definitively it will be the most technologically advanced medical school in the United States."
But for local actors, the program's benefits go beyond training future doctors. For many, like Rearden Hall, the program helps pay the bills between roles onstage. "This is really a fantastic program," she says. "Other than physically stepping on the stage, this has been the best job I've ever had." S