Standardization of Standardized Patient Training in Medical Simulation

Standardized Patients (SPs) have been successfully utilized in medical education to enhance simulation-based education (SBE) for both formative and summative learning.  Simulation mode(s) and delivery can vary among academic and clinical settings. SBE includes various modes of delivery: Observed structured clinical exams (OSCEs), the use of manikins ranging from low to high fidelity, or hybrid delivery, which can include manikins, task trainers, and SPs. It is important to note that simulation is a pedagogically sound teaching strategy, usually involving technology, that has demonstrated success in various platforms. As more SBE programs include SPs, a critical piece to programmatic success is a standardization process for SP training. The Society of Simulation in Healthcare (SSH) defines an SP as a person who has been carefully coached to simulate an actual patient (or participant) so accurately that a skilled clinician cannot detect the simulation. SPs can be used to enhance teaching and provide a critical evaluation of performance with feedback during the simulation debriefing. The safe learning environment of simulation provides a potential situation as a way for healthcare learners to prepare before entry into clinical practice. When SBE is enhanced with SPs who are trained to portray patients, family relatives, or healthcare team members, learners remain highly engaged without the added risk of causing patient harm. Also, SPs enhance the learner’s critical thinking and self-efficacy skills, communication skills, and the ability to perform telehealth screenings. For the low-frequency, high acuity events that cannot be planned in the clinical day, simulation with the utilization of SPs has been essential to teach learners how to break bad news, promote affirmative transgender health care practice, and facilitate family decision making at pediatric end-of-life.