Tremblay Marie-Laurence, Fournier Claudia
Faculté de pharmacie, Université Laval, Quebec City, Canada.
Clin Teach. 2025 Oct;22(5):e70163. doi: 10.1111/tct.70163.
While people with lived experience (PLE) are increasingly included in health professions education, their role in simulation often remains limited to narrative sharing. This initiative explored how involving PLE throughout the design and delivery of a pharmacy simulation on PrEP (a preventive HIV treatment) and sexual and gender diversity shaped students' learning about inclusive, person-centred communication in consultations involving stigma and marginalisation.
A PrEP-related simulation involving a non-binary patient was integrated into a third-year pharmacy course. Sessions took place in a fully equipped lab replicating a community pharmacy, with 10 stations and professional actors as standardised patients. Six PLE informed learning objectives, scenario design and debriefing. One PLE trained the actors, observed simulations and participated in debriefings. Their involvement supported inclusive, person-centred communication around sexuality, gender diversity and HIV prevention.
A mixed-methods design assessed impact. Survey responses (n = 109) indicated increased confidence in PrEP-related care and strong appreciation for PLE's presence. Most students had little personal and professional exposure to PrEP, and 93% agreed the PLE enriched their learning. Interviews (n = 14) highlighted how PLE involvement helped demystify stigmatised topics, fostered self-reflection and emphasised the value of lived experience. Students noted enhanced realism and psychological safety.
Involving PLE throughout simulation-from codesign to debriefing-helped reduce stigma, promote inclusive communication and enhance scenario authenticity. Students felt better prepared for consultations involving PrEP or sexual and gender diversity. This approach may help amplify the patient's voice in health education and could be adapted to other sensitive or stigmatised health topics.
虽然有实际生活经验的人（PLE）越来越多地被纳入卫生专业教育，但他们在模拟教学中的作用往往仍局限于分享个人经历。本项目探讨了在以暴露前预防（PrEP，一种预防性艾滋病治疗方法）为主题的药学模拟教学的设计和实施过程中，让有实际生活经验的人参与其中，以及性取向和性别多样性如何塑造学生在涉及污名化和边缘化问题的咨询中对包容性、以人为本的沟通的理解。
将一个与PrEP相关的模拟教学纳入药学专业三年级课程，其中涉及一位性别认同非二元性别的患者。教学在一个配备齐全、模拟社区药房的实验室进行，设有10个站点，并由专业演员扮演标准化患者。6位有实际生活经验的人参与了学习目标的设定、情景设计和总结讨论。1位有实际生活经验的人对演员进行培训、观察模拟教学并参与总结讨论。他们的参与促进了围绕性取向、性别多样性和艾滋病预防的包容性、以人为本的沟通。
采用混合方法设计评估影响。调查反馈（n = 109）表明，学生对PrEP相关护理的信心增强，对有实际生活经验的人的参与给予高度评价。大多数学生在个人和专业层面很少接触PrEP，93%的学生认为有实际生活经验的人丰富了他们的学习。访谈（n = 14）强调了有实际生活经验的人的参与如何有助于消除污名化话题的神秘感、促进自我反思并强调实际生活经验的价值。学生们指出，这增强了模拟教学的真实感和心理安全感。
在模拟教学的全过程，从共同设计到总结讨论，让有实际生活经验的人参与进来，有助于减少污名化、促进包容性沟通并提高情景的真实性。学生们觉得自己为涉及PrEP或性取向和性别多样性的咨询做好了更充分的准备。这种方法可能有助于在健康教育中放大患者的声音，并可适用于其他敏感或有污名化问题的健康主题。
