Inside the World of UVA's Play-Acting Patients

July 26, 2023
Nursing student practices assisting a patient in labor scenario

Abigael Collins has simulated labor for dozens of nursing students at UVA. (Photos by Christine Kueter, School of Nursing)

Even pretending to give birth is exhausting.

Abigael Collins needs a nap after she simulates labor for students in the University of Virginia’s School of Nursing.

“Even though you’re fake screaming and crying, your body is like, ‘Oh, my God, what’s going on?’ So there’s a lot of adrenaline, and there’s an emotional crash afterwards,” Collins said.

Most of the time, Collins works as a personal assistant. Her flexible hours allow her to participate in simulations for the Nursing School, which she’s been doing since April. Collins doesn’t have a background in medicine or acting; a friend who was also acting in simulations got her interested in being what, in medical terms, is called a “standardized patient.” Collins applied and has been helping medical and nursing students practice treating real, live, human patients for a year and a half.

Collins received a loose script to follow and had watched a couple “really terrible” YouTube videos to prepare. Armed with what felt like so little, she was scared to act out symptoms in a room full of students at first. But then she started having fun.

Class reviews a video to improve knowledge in the field
About half the class watches the birthing simulation, observing what their classmates do well and where they could improve.

“I get really into it. It’s really fulfilling to participate in medical education,” Collins said. “Before that, they interacted exclusively with mannequins,” not real people.

Each standardized patient receives a “case” with the patient’s symptoms and medical history. Sometimes, the case tells the standardized patient what attitude they need to have – perhaps they’re anxious about the appointment, high-strung, or dismissive of a medical professional’s advice. From there, these standardized patients get to decide how they act in a simulation.

The nursing students play their own different roles in simulations. During the obstetrics simulation, for example, some students tend the laboring mother; others play Collins’ partner; and still others are assigned to be the chief nurse alongside faculty members who often “deliver” the “infant” as the chief provider. Afterward, they take assessments to see what they learned and debrief with professors and peers about what went well in the simulation, and how their care and decision-making might be improved in the future.

Twins Grace and Ellie Boitnott agreed that the simulations were fun. The 19-year-olds have been standardized patients since they were in middle school, when their mother, nursing professor Amy Boitnott, asked them to help prepare nursing students for their first clinical rotations. Since then, the sisters have played everything from moody adolescents with asthma to teen moms.

“Neither of us has acting experience, so this is like our little taste of that,” Ellie said.

Play acting patient smiles for the camera
One of the students acts as Collins’ partner, there to hold her hand or bring her ice chips if needed.

The two are in college now (Grace is a rising second-year student at UVA), but continue to act in the simulations a couple times a year. The experience nudged Grace to study biomedical engineering; she still looks forward to each simulation in which she takes part.

Though standardized patients are instructed as to how to answer students’ questions about their maladies, they also must improvise and rely on body language to communicate their symptoms. Grace is one of the few people to say she’s had fun with meningitis.

“You have to do exactly what you would do if you actually had the sickness. We have to keep that in mind, but also not give it away,” Grace said.

Bob Hammel, who participates in simulations with his infant daughter, likes to throw the students he works with for a loop.

“It’s my mission to get my daughter in the arms of the students,” he said.

It’s not just a test for the students, though, who often cycle through multiple simulations in one day. By the time they get to Hammel, some of the students’ nerves are so fried that holding a cute baby is just what they need to feel grounded. That’s especially true since he sometimes plays a difficult patient: a man who wants to leave the hospital against medical advice, for example, or a vaccine-hesitant father.

He gets into character for each simulation, which is sometimes easier than others. During the check-up simulations with his daughter, he often answers questions the same way he does at their actual check-ups.

‘Inside UVA’ A Podcast Hosted by Jim Ryan
‘Inside UVA’ A Podcast Hosted by Jim Ryan

It’s rewarding for Hammel. He gets to help nursing students practice caring for patients, and it’s a special way to spend time with his daughter.

“I get a kick out of it,” he said. “I get to hang out with her all day and show her off to the students.”

Media Contact

Alice Berry

University News Associate Office of University Communications