Adolescent females showed no adverse effects when used extensively to portray risk-taking SPs. The focus groups provided the adolescents with an opportunity to debrief together. The adolescent SPs reported benefiting from this study but requested unanimously that they come "out of character" when giving feedback to the medical students.

Few medical schools integrate adolescent simulators into their regular teaching curricula, although the use of adult simulators has become common practice. 1±4 One reason may be that it is not known whether training adolescents to simulate illness may adversely affect their psychosocial development. There may also be a concern that the commitment by the adolescent to regular simulations will interfere with their school work or extra curricular pursuits.We are undertaking a study which uses adolescent girls as simulated patients in a training project for fourth year medical students. This project includes psychosocial assessment of the adolescent participants. A number of important ®ndings have emerged from our preliminary work. This information may be helpful to others wishing to recruit adolescents in medical training programmes. Recruiting and screening adolescentsApproaching the schools Two local private schools, chosen for their proximity to where simulations would take place, were approached to recruit adolescents. We sought girls, aged 13± 15 years, who would be interested in participating and whose academic performance would not be expected to suffer from the time commitment involved. Initial selection and information sessionIn total sixteen girls were selected, eight girls were selected as simulators and eight girls as controls, matched for age. The selected simulators and their parents met as a group with the project co-ordinators to further explain the purpose of the project. Questions regarding time commitment and ®nancial remuneration were addressed. Initial interviewAn interview was performed with each adolescent individually, in order to screen for characteristics which might potentially pose problems for adolescents in simulated roles. The girls were asked detailed questions about their medical histories, including whether they had any of the illnesses that they might be asked to simulate, or a history of any chronic medical condition. In addition, questions about their psychosocial history were asked, including stresses within the past two years, family functioning, academic record, self-perceptions of sociability and their comfort-level with their own doctors.The interview included two structured questionnaires. The Youth Self-Report 4 assesses the degree to which adolescents display certain behaviours or characteristics typical of a wide range of internalizing and externalizing problems. The Piers-Harris Children's Self-Concept Scale 5 assesses how adolescents feel about themselves in the areas of behaviour, intellectual and school status, physical appearance and attributes, anxiety, popularity and happiness. These will ultimately serve as an objective basis for evaluating the effects of simulations, both by comparing pre-and post-scores and by comparing the changes in the control group within the same period. Training and feedbackAdolescents were paired with their simulated mothers and both trained together in one of four medical roles. Training addressed how to provide feedback to the medical...

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