Digital Standardized Patients: Anita Douglas

Anita Douglas is a 72-year-old Black woman who appears in both graduate and undergraduate DCEs. Anita appears in Advanced Pharmacology and Advanced Diagnostics DCEs for graduate students. In the Advanced Diagnostics DCE, Anita has been experiencing fatigue and weakness that has impaired her activities of daily living for a few months and has had her symptoms dismissed as ‘old age’.

As an older patient, students should be mindful of how they interact with Anita to avoid implicit ageism. Ageism in the healthcare setting can impact adequate care, prevalence of health conditions, and healthcare costs (Levy et al, 2018). Additionally, discrimination is even more prevalent among older minority individuals particularly as it relates to delayed care and poor communication (Rhee et al, 2019). In these simulations, students must remain aware of how implicit bias toward race, gender, and age may impact interpretation of a patient’s signs and symptoms throughout the diagnostic process. They must also take potential risk factors into consideration when determining their working medical diagnosis.

In the Undergraduate Leadership DCE, Anita is one of five patients that students manage care for over three consecutive days at Shadow General hospital. Students must apply several leadership concepts, including prioritization, delegation, ethics, change management, and patient advocacy. For Anita, this means evaluating her condition to ensure positive outcomes for patient care. Anita suffers a hip injury and has already been in the hospital for three days. During the morning of the third day, Anita wants to ambulate by herself and maintain her independence. She also requests education on physical therapy and how to avoid future falls. When she asks for an expedited discharge even though her goals have not been met, students will need to consider the best course of action utilizing leadership skills.