August 20, 2018
Chuck Dribin spends a lot of time at the University of Illinois at Chicago College of Dentistry as a patient—but not because he needs dental work. Dribin is a Standardized Patient (SP)—an actor who takes on the characteristics of a real patient to help students develop their ability to communicate.
“I regularly use SPs to help me teach communications skills to first-year to third-year students,” explained Dr. Sheela Raja, associate professor, pediatric dentistry. “The SPs come into class and volunteer students work on simulated cases. We do many kinds of patient cases—how to work with patients who are angry/uncooperative, how to break bad news or deal with an adverse event, how to motivate a patient to quit smoking, how to assess whether a patient has experienced domestic violence, how to calm an anxious patient.”
One of those SPs is Charles (Chuck) Dribin, a former acting and English teacher at Glenbrook North High School in Northbrook, IL. Dribin has worked with the UIC Graham Clinical Performance Center (GCPC) at the university’s College of Medicine since 2007. One of the first performance centers established in the United States, in 1987, the GCPC has served thousands of medical and dental students with simulation training.
Dribin noted that students “interact with a variety of patients who are experiencing emotional distress regarding the care they receive. Often the diagnosis ranges from distressing or annoying to dire or life-changing. Students need specific training regarding strategies for communication skills on how best to resolve the distress being demonstrated.
“Dr. Raja’s classes provide those techniques,” Dribin added. “Patient care needs to provide not just expertise in procedural manners, but also what constitutes ‘bedside manner.’
“Better to be prepared in using learned skills from class, than to first encounter a distressed patient in a medical or dental practice,” Dribin said.
The college also uses SPs in an Objective Structured Clinical Exam (OSCE) in the third year. Students move from station to station and have various individual conversations with the SPs. The conversations are videotaped, and the student has the chance to receive feedback from Dribin and other SPs.
“Chuck is one of my ‘go-to’ SPs,” Raja explained. “I’ve worked with him for many years as one of the actors in the OSCE, and he also has come into countless classes over the years where we use SPs for students to practice how to talk to a challenging patient.”
Through the UIC GCPC, the SPs first worked with medical students. Raja was a volunteer at the College of Medicine, and was so impressed with the talents of the SPs that she worked with Dr. Bill Knight, who was then executive associate dean of the College of Dentistry, to introduce the SPs into the DMD curriculum.
“I write all of the cases in consultation with one of our dentists from the clinic, and train the SPs for my classes and the OSCE exam,” Raja said.
“Chuck’s background as a teacher makes his feedback even more useful to the students,” she added. “Often, students think using actors is going to be silly, but when they see how skilled these SPs are, they are usually shocked. It often feels like a real patient in the room, not an actor. This is why it is called ‘simulation’ and not ‘role play.’”
Dribin became involved with the GCPC several years ago after recovering from mitral valve replacement. During Dribin’s convalescence, his wife, Alice, saw an article in the Chicago Tribune about the UIC GCPC, and suggested that the program might be a good fit for him because it would utilize both his love of acting and his love of teaching.
“It turned out to be a wonderful match-up,” Dribin said. “After encounters with students, a debriefing occurs in which I can discuss specific observations based on performance. It’s the best possible job for a retired performance teacher—acting, a ready audience of one, and then a sharing of what was learned. Perfect.”
In the more than ten years since he was hired by the GCPC, Dribin estimates he has “been through a thousand encounters. I’ve been impressed by the level of proficiency of the students.”
Many medical students have actually discovered Dribin’s heart murmur during the simulations, and when he congratulates them, he often receives an excited fist bump.
Students also often become emotional at conveying bad news to Dribin and other SPs, sometimes even crying. “It’s quite moving for the student to empathize with an adult male in his 50s/60s who’s crying in front of him or her,” Dribin explained. “Many of these students move in to comfort me, hugging me or holding my hand. It really is quite affecting to be so involved during a simulation.”
After a recent simulation in one of Raja’s classes, dental student Patrick Magner approached Dribin. Magner is a Glenbrook North alumnus, and although he never had Dribin as a teacher, he recognized him because many of Magner’s Glenbrook North friends were students of Dribin’s. Magner told Dribin that the college’s dean, Dr. Clark Stanford, was a Glenbrook North alumnus as well. Although Dribin had worked at the College of Dentistry for years, it was only then that he put it together that his former student from the 1970s was now the dean of the College of Dentistry.
Dribin and Raja went over to Stanford’s office, and the teacher and his former student caught up on the intervening 40 years.
“Some students are memorable, and Clark is one,” Dribin said. “He was in my sophomore English class, and was involved in the Glenbrook North drama program. It’s from that program I remember Clark.
“Theater is a highly disciplined endeavor requiring a tremendous amount of time and focus, as well as being part of a team—cast or crew,” Dribin said. “That’s what Clark was like—reliable and willing to work long hours in order to achieve the highest quality of performance. He may have been soft-spoken, but he put out the energy that was needed to get the job done on-stage or off-stage.”
Dribin enjoyed reconnecting with Stanford, and that led him to reflect on the connections he helps foster as an SP.
“An emotional connection leading to a bonding of trust is in order,” Dribin concluded. “Bedside manner is more than a smile and a handshake. ‘White coat fever’ needs to become a thing of the past. Communication skills provide an equal footing. Standardized Patient work helps to prepare students to be the best medical/dental professionals possible.”
Photo caption: Standardized patient Chuck Dribin with his former student, Dean Clark Stanford