“It's Not an Acting Job … Don't Underestimate What a Simulated Patient Does”: A Qualitative Study Exploring the Perspectives of Simulated Patients in Health Professions Education

Abstract

Introduction Simulated patients (SPs) are individuals who have learned to realistically portray patient roles in health professional education. Program recommendations are increasing for simulation programs, and as key stakeholders, SPs' perspectives seem underrepresented. The aim of the study was to explore the experiences, perspectives, and practices of SPs to gain insights on topics of importance to SPs and inform program recommendations. Methods An interpretivist research paradigm and qualitative design were adopted. Eighteen SPs participated in 2 focus groups that were audio recorded, transcribed, and deidentified. Three researchers completed inductive thematic analysis. Institutional ethical approval was obtained. Results Three themes represented the different elements of SP practice: becoming and being a SP, preparing for a SP role, and performing a SP role. Simulated patients identify as educated specialists with unique responsibilities and attributes. Simulated patients are committed to representing the perspectives of real patients, while simultaneously supporting learners and educators. Simulated patients can feel unprepared to perform a role but have innovated responsive strategies. Conclusions Simulated patients considered 3 primary aspects to their practice and shared ways that they might be well supported. Simulated patients represent a community of practice, characterized by mutual engagement, joint enterprise, and a shared repertoire. Ongoing SP input in SP programs may benefit SPs and lead to higher-quality educational experiences for learners.

‘It’s the ultimate observer role…you’re feeling and seeing what’s happening to you’: students’ experiences of peer simulation

“…Experiences of physical discomfort while portraying a patient role (see subthemes 1.3 and 3.3) appear similar to those reported in the wider SP literature. 23 26 However, instances of psychological disturbance from portraying a patient role were less prevalent in this study compared with those reported by professional SPs. 25 26 The most challenging components of peer simulation for students appeared to be related to acting as the peer-therapist.…”

“…23 26 However, instances of psychological disturbance from portraying a patient role were less prevalent in this study compared with those reported by professional SPs. 25 26 The most challenging components of peer simulation for students appeared to be related to acting as the peer-therapist. This may have been because the patient roles were not psychologically or emotionally complex.…”

“…Students had completed a peer simulation programme that comprised 8 hours of online learning activities across SBE activities. Guidelines for successful SP programmes 11 26 36 were used to inform programme design, which occurred across 2016–2017.…”

“…23 24 Increased confidence, empowerment, improved health literacy, in addition to physical discomfort, psychological distress, shame and anxiety are reported. 23 25 26 Prior knowledge of health conditions, and familiarity of fellow students may amplify or reduce these impacts. Of particular interest is whether student portrayal of patients’ roles leads to greater learning related to empathy for patients’ perspectives.…”

Asynchronous pediatric caregiver simulation in a virtual setting during the COVID pandemic

“…Patient simulation has been used widely in health professions education. [1][2][3] The University of North Carolina at Chapel Hill (UNC-CH) Adams School of Dentistry has embraced patient simulations as a core component of student assessment. Students complete in-person interviews with standardized patient (SP) actors to practice interviewing skills and develop deeper diagnostic reasoning and critical thinking.…”