A. Fluet is a medical student, University of California, San Francisco, School of Medicine, San Francisco, California.
J. Essakow is a clinical fellow, Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, California.
Acad Med. 2022 Nov 1;97(11S):S29-S34. doi: 10.1097/ACM.0000000000004925. Epub 2022 Aug 9.
Standardized patient (SP) encounters are widely used in health professional education to evaluate trainees' clinical skills. Prior literature suggests that bias can influence the evaluations of student learners in SP-student encounters. Understanding how SPs perceive bias in their work and how they view their role in mitigating or perpetuating bias in simulation is an important first step in addressing bias in the SP-student encounter.
Researchers designed a qualitative interview study and conducted 16 semistructured interviews with SPs at the University of California, San Francisco Kanbar Simulation Center from July through September of 2020. Participants were selected using purposive sampling. The interviews were transcribed and analyzed by researchers using inductive thematic analysis. Researchers met iteratively to reconcile codes and identify themes.
SPs identified bias occurring in multiple directions: SP-to-student, student-to-SP, student-to-character, and SP-to-character. SPs were hesitant to label their own biases and instead used words such as "comfort" or "preference." SPs reported little bias from students, because students were being evaluated and therefore behaving carefully. Additionally, SPs perceived bias in the implementation of health care simulation, which manifests as underrepresentation of certain groups amongst actors and character descriptions. Most SPs felt that they should play a role in mitigating bias in SP-student encounters, including addressing bias that occurs, challenging stereotypes, teaching about cultural differences, and/or being conscious of bias in their assessments of learners.
In the SP-student encounter, bias can occur on many levels and between many individuals, including between the SP and the character they are portraying. Identifying the areas in which bias can exist can help simulation educators mitigate bias.
标准化病人（SP）的接诊在评价医学生临床技能方面被广泛应用于医学专业教育中。先前的文献表明，偏见可能会影响 SP 与学生学习者之间的评估。了解 SP 如何看待他们在工作中的偏见，以及他们如何看待自己在模拟中减轻或加剧偏见的角色，是解决 SP 与学生接诊中偏见问题的重要第一步。
研究人员于 2020 年 7 月至 9 月在加利福尼亚大学旧金山 Kanbar 模拟中心进行了一项定性访谈研究，共对 16 名 SP 进行了半结构化访谈。采用目的性抽样选择参与者。研究者对访谈进行转录，并使用归纳主题分析对其进行分析。研究人员通过迭代会议来协调代码并确定主题。
SP 确定了多个方向的偏见：SP 对学生、学生对 SP、学生对角色和 SP 对角色。SP 不愿将自己的偏见贴上标签，而是使用“舒适”或“偏好”等词。SP 报告学生的偏见很少，因为学生正在接受评估，因此表现得很谨慎。此外，SP 认为医疗模拟实施中的偏见，表现为演员和角色描述中某些群体的代表性不足。大多数 SP 认为他们应该在减轻 SP 与学生接诊中的偏见方面发挥作用，包括处理发生的偏见、挑战刻板印象、教授文化差异知识，以及/或在评估学习者时意识到偏见。
在 SP 与学生的接诊中，偏见可能发生在多个层面和多个个体之间，包括 SP 与他们所扮演的角色之间。确定可能存在偏见的领域可以帮助模拟教育者减轻偏见。
