Training Programs
The Johns Hopkins Medicine Simulation Center offers several different training programs to meet your specific training needs.
- Mannequin-based Simulations
- Standardized Patient (SP) Program
- Teaching Associate Programs (including the Genitourinary Teaching Associate Program (GTA) and the Physical Exam Teaching Associate Program (PETA)
Mannequin-Based Simulations
Residents practice surgery on mannequins
Mannequin-based simulations use high fidelity simulators, mannequins that breathe, with breath sounds, heart tones, and palpable pulses. In addition, the mannequin has a monitor that can display EKG, pulse oximeter, blood pressure, arterial wave forms, pulmonary artery wave forms, anesthetic gases, etc. Procedures can be performed on the simulators such as bag-mask ventilation, intubation, defibrillation, chest tube placement, cricothyrotomy and others.
Using mannequins in clinical simulations allows future and current physicians to ‘practice on plastic’ first. The reality of mannequin-based simulations allows for virtual feedback using computers that regulate the mannequin's compressors, mimicking pulses and chest raising.These life-like mannequins simulate heart tones and other vital cues that when connected to monitors, provides real-time information to students. By practicing true clinical skills in a safe and regulated environment, future physicians learn permanent and excellent evaluation and treatment techniques.
Standardized Patient Program
Dr. Betsy Hunt teaches a student about the appropriate way to examine a patient
Standardized patient simulation involves the use of individuals trained to portray the roles of patients, family members or others to allow students to practice physical exam skills, history taking skills, communication skills and other exercises.
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Experiential Learning
A Standardized Patient (SP) is a person carefully recruited and trained to take on the characteristics of a real patient thereby affording the student an opportunity to learn and to be evaluated on learned skills in a simulated clinical environment.
During an interaction with a student the SP may:
- present case history in response to questioning by the student
- undergo a limited physical examination at the student's direction
- assist students in developing their communication and clinical skills
- assist students in working through difficult emotional situations in a safe environment
Learning to give necessary medical news
Other projects are formulated around psychosocial issues using Standardized Patients to assist students in developing communication skills or in working through difficult emotional situations in a safe environment.
Training to be a Standardized Patient
People from the community who are interested in contributing to the development of health care professionals may be chosen to work as SPs. These individuals are carefully recruited and trained.
Once Johns Hopkins University School of Medicine faculty or staff selects cases for an event, Standardized Patients are matched with the cases using specific criteria such as age, gender, race, etc. Each simulation is designed to be as realistic as possible to enhance the learning experience.
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The Standardized Patient (SP) Program at Johns Hopkins originated in the Clinical Education Center (CEC) which was instituted in 1991 to serve Johns Hopkins’ medical and nursing students, as well as students from a consortium of area medical schools, by assessing their clinical and interviewing skills in exams which are administered when students complete a specific medical learning experience.
The CEC was selected by the National Board of Medical Examiners (NBME) as a site for researching the efficacy of using Standardized Patients for licensure examinations. The CEC was also selected by the Education Committee for Foreign Medical Graduates (ECFMG) as a site for research and development of their own SP examination procedures prior to their opening facilities in Philadelphia.
More psychosocial experiences have since been added as teaching tools in response to society’s increased awareness of:
- End of life issues in pediatric and adult medicine
- Organ donation
- Domestic Abuse
- Emotional impact on caregivers
- Discussion of life-sustaining treatments
- Breaking bad news
- Disclosing Medical Error
The main components of these programs are designed to develop the medical professional’s communication skills.
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The educational process for medical professionals is experiential learning through the interaction with Standardized Patients (SPs), Physical Exam Teaching Associates (PETAs) and Genitourinary Teaching Associates (GTAs). Because SPs are trained to mimic the realism of medical exams or tense communication scenarios, medical professionals become trained to communicate and respond better to patient needs.
At the Johns Hopkins Medicine Simulation Center, our SPs, PETAs and GTAs undergo a rigorous training process.
Typical Learner Interactions with a Standardized Patient:
- At our Facility, we have twelve exam rooms. Each is equipped with the medical equipment you would find in any standard exam room throughout the Johns Hopkins Hospital.
- Monitors who are trained as SPs watch through video monitors and assist in maintaining quality control
- Typically, a medical student will enter the exam room with the SP waiting, just as a doctor would enter an exam room with the patient already present.
- The exams are conducted as though they are real, and not simulations. The SPs are trained to present with a certain set of symptoms. During an interaction with the student the SP may present the case history in response to questioning by the student and undergo a physical examination at the student’s direction.
- SPs typically complete a checklist after the encounter focusing on history taking, physical exam and communication skills.
- In some formative exercises, the SP may also deliver feedback to the learner, focusing on interpersonal skills.
- After the exam, the video can be reviewed by faculty with the medical student to evaluate the interaction and give feedback about where modifications should be made in the future.
Teaching Programs
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Two teaching programs geared toward training medical professionals in the areas of physical exam skills are provided at the Johns Hopkins Medicine Simulation Center.
Better communication skills are developed by medical students and professionals by simulating common human interactions that take place every day. How a medical professional conducts an exam is vital to this training, both from a clinical and communication perspective.
These programs include:
- The Physical Exam Teaching Associates (PETA) act as:
- individuals trained to teach the techniques of basic physical examination (abdominal, neurology, cardiovascular and pulmonary)
- patient models, providing students the chance to practice exam techniques, giving feedback from the patient’s perspective
- The Genitourinary Teaching Associates (GTA or GUTA) are individuals:
- who are trained to teach techniques and protocol for performing the gender-specific physical examination to healthcare trainees, using him or herself as a demonstration and practice model
- The Physical Exam Teaching Associates (PETA) act as:
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The Physical Exam Teaching Associates (PETA) act as:
- individuals trained to teach the techniques of basic physical examination (abdominal, neurology, cardiovascular, pulmonary, musculoskeletal, head & neck (aka HEENT) and head-to-toe/multi-system).
- patient models, providing students the chance to practice exam techniques
The educational benefits for the student include:
- humanizing the patient
- providing immediate feedback, reassurance and opportunity for experiential learning
- providing individualized attention and feedback on interpersonal skills, as well as technique
- giving feedback from the perspective of the patient
- learning in a safe and relaxed environment
- training through an open, on demand environment to meet project schedules
- learning through cost effective training technique
Individuals are carefully recruited and trained. Men and women will be selected with emphasis on the following criteria:
- comfortableness with his/her body
- comfortableness in discussing and demonstrating his/her own anatomy with others
- ability to communicate articulately, convey information clearly, and remain professional.
- sensitivity to instructing medical students on how to perform a physical examination and interact with a patient
- interest in education and contributing to the development of healthcare professionals
- sophistication in interpersonal skills
Contact Information
If you are interested in this work or have questions, please contact:
Rose Zaeske, Program Manager at:
410-614-0847 or [email protected] -
The PETA program provides a unique opportunity for students to practice components of the physical exam on teaching associates who have been trained to provide feedback in the elements of the exam. PETA modules will be available for the following exams:
- pulmonary
- abdominal
- cardiovascular
- neurological
- musculoskeletal
- head and neck (aka HEENT)
- Head-to-Toe/Multi-system
Note for students participating in PETA sessions: There is a 24 hour cancellation policy for PETA sessions. If you sign-up for a session and either cancel with less than 24 hours notice or are simply no-show, you may be restricted from signing up for future sessions. Please contact Rose Zaeske, Program Manager, SP & Teaching Associate Programs, at 410-614-0847 if you need to cancel a scheduled session.
The teaching associates are trained in each module based on the exam checklists provided by the Johns Hopkins Clinical Foundations of Medicine (CFM) course. They will provide you with feedback in a helpful and non-threatening fashion using these checklists as a guide. Please note these checklists correspond to the CFM syllabus and reflect what students will be required to know by the end of Quarter I/II.
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A Genitourinary Teaching Associate (GTA or GUTA) is an individual who is trained to teach techniques and protocol for performing the gender-specific physical examination to healthcare trainees, using him or herself as a demonstration and practice model.
The GTA also provides feedback to the students in a supportive environment for skill development and practice. Emphasis is on teaching from the patient perspective. This program involves invasive examination.
Roles of Male and Female GTAs
- A female GTA teaches a basic routine breast, pelvic and rectal examination
- A male GTA teaches a routine male genital-rectal examination
- Both male and female GTAs include physician-patient communication and patient education in their instruction, equipping students with compassionate and caring interpersonal skills for effective patient communication in the genitourinary exam.
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Our basic educational model provides instruction for two or three students with one GTA. The session for male instruction is one hour to one and one-half hours. The session for female instruction is one to two hours in duration.
Individuals are carefully recruited and trained. Men and women will be selected with emphasis on the following criteria:
- Should be comfortable with his or her body and sexuality.
- Should be comfortable in discussing and demonstrating his/her own anatomy with others, and possess a high level of comfort with instruction involving invasive examination
- Should be able to communicate articulately and to convey information clearly and in a professional manner.
- Should be interested in education, and in contributing to the development of excellent health care professionals.
- Should possess sophisticated interpersonal skills.
The educational benefits for the students include:
- The humanization of the patient.
- An understanding of the genital, urinary and rectal anatomy (and breast in the female exam) necessary for effective and sensitive clinical skills is provided in a supportive environment..
- Instructor as the patient provides immediate feedback, reassurance and opportunity for experiential learning.
- Time for individualized attention and feedback.
- Small group size maintains engagement of entire student group throughout instruction.
- Students are introduced to patient education skills in the self-examination.
To supervise the instructional content and revisions necessary to maintain a high standard in the GTA program, Johns Hopkins has enlisted consultants Dr. Nancy Hueppchen, Assistant Professor, Gynecology and Obstetrics and Dr. H. Ballentine Carter, Professor of Urology.
GTA/ GUTA Employment Opportunities
Contact Information
If you are interested in this work or have questions, please contact:
Rose Zaeske
Program Manager