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These Actors Ply Their Craft for an Audience of Just One

Theater* Performers assume the roles of patients to help medical students develop the empathy crucial to a good bedside manner.

July 23, 2002|LAURIE K. SCHENDEN | SPECIAL TO THE TIMES

Shedding tears and feigning anxiety through 25 consecutive performances is enough to emotionally drain any actor. But in her role as an abused wife, Sarah Blevins feels especially obligated to nail the part.

Her character is based on an actual battered woman who agonized over telling her doctor the truth. "She was too scared to say that her husband was getting more abusive, and she feared he was going to hurt the kids," says Blevins. "Most abused women want someone to know, but they won't come right out and say it. I had to get that across with my emotions."

Between regular acting jobs, Blevins works as a standardized patient for medical schools at USC, UCLA and Western University of Health Sciences in Pomona. Medical facilities nationwide are using actors who portray patients in one-on-one encounters to help medical students develop a better bedside manner.

"Not everyone who becomes a doctor is a people person," says Cynthia Harrelson, a trainer of standardized patients at the Pomona school. "The students know this is a safe place to learn those social skills, and they're not going to kill anybody."

Blevins, a full-time actor who was recently cast in "The Comedy of Errors," opening at the Knightsbridge Theatre in August, is called upon every couple of months to portray a standardized patient. Actors make an average of $15 to $20 an hour for their work. "Rarely do you get paid for theater work you do," she says. "This is my only paying gig as of now."

Harrelson says drolly that her job as trainer is equivalent to the "director, casting director, co-author, set designer and craft services." Actors are natural standardized patients, she says, because they "spend their whole lives studying people." The job is similar to a theatrical production for which an actor performs the same role night after night.

UCLA's School of Medicine uses a core group of about 100 actors in its program, according to program coordinator Liz O'Gara, whose office shelves hold 16 bulky three-ring notebooks filled with hundreds of head shots and resumes, labeled according to age and ethnicity.

"I hire actors like anybody in Hollywood hires actors," she says. "People send in head shots, and we audition them."

The ability to improvise is a plus, since there's no script. "We can't give them dialogue because we have no idea what the students are going to say," O'Gara says. "They have the patient's background and a character bio, what their personality is like, what their attitude is toward doctors, what their expectations are.... By the time they get to the performance, the actor knows the patient intimately, and they'll know what an appropriate response is to just about any question."

Ten years ago, O'Gara was performing with the L.A. Women's Shakespeare Company when she joined a temporary project at UCLA, which evolved into the medical school's year-round standardized patient program.

The idea for using actors as patients came from Stephen Abrahamson, retired head of medical education at USC (which was the first Southern California school to have a standardized patient program). In 1964, he co-wrote the first scientific article on the use of standardized patients. Abrahamson predicted in 1991 that, "by the year 2005 or 2010, almost all medical schools will have [standardized patients] for teaching and evaluation."

Not only was that prediction correct, the national medical boards gave the programs a shot in the arm with a mandate for standardized patient testing to become part of the national boards beginning with the class of 2005.

Currently, "there's no exam for physicians that measures how they interact with patients," says O'Gara. "Almost every school in the country has [a standardized patient] program, but not every school in the country has the resources of actors that we have in Los Angeles."

Cases involving emotional and psychological skills, she adds, are the ones in which "the actors' abilities really are important."

It's crucial that actors are believable, says Christine Sheppard, project director at Western University of Health Sciences, because the students' skills--and grades--depend on it.

"Actors have the skills of memorizing and understand improvisation," she says. "And we're often working within a limited budget, so we need people who are going to pick it up quickly."

Taking on such roles can be a challenge. "You have to be the kind of actor who can come up with those tears over and over, and that's hard sometimes after a long day of crying 30 times," Blevins says.

Still, the rewards can be profound. After portraying the abused woman, Blevins was approached by a medical student. "He said, 'It's OK, my mother went through this and you're going to get through this just fine.' He gave me a big hug, held my hand, and he had tears in his eyes. I thought, 'Oh, my God!'

"I just went on with it like it was real because I thought, why tell him, 'Oh, I'm just an actor'? So I just said, 'Thank you very much.' "

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