The Role of Standardized Patient Programs in Promoting Equity, Diversity, and Inclusion: A Narrative Review

Yılmaz, Derya Uzelli; Azim, Arden; Sibbald, Matthew

doi:10.1097/acm.0000000000004447

Cited by 8 publications

(9 citation statements)

References 37 publications

(217 reference statements)

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“…Recruitment focused on those who had active roles in supporting EDI oriented curriculum involving SPs, including corresponding authors identified in a recent narrative review, 10 speakers at international SP conferences on EDI‐related issues in the last 5 years and leads involved in the delivery of EDI SP curricular from SP programmes identified through centre collaborations. We recruited using published email addresses in literature sources, conference materials and our internal lists for national SP programmes.…”

Section: Methodsmentioning

confidence: 99%

“…We purposefully sampled different content domains, curricular approaches, institutional contexts and health care training environments. Our a priori review of the literature 10 identified 17 key literature sources with corresponding author information, review of conference material revealed five key speakers, and internal lists included 10 SP programmes. Guided by our study aims, sampling specificity and analysis strategy, we anticipated requiring 15–20 interviews to reach saturation 21 .…”

Section: Methodsmentioning

confidence: 99%

“…Many questions remain around operationalising SP-based equityseeking educational opportunities. A recent review of the literature 10 revealed multiple ways to work with SPs to meet curricular mandates around equity-deserving groups, including enriching the SP pool with diversity characteristics, [11][12][13][14] construction of cases focusing on equity-deserving populations, 15,16 physical examination sessions with SPs to develop cultural competence 17 and use of diverse SPs as part of an OSCE. 18,19 Studies have shown a promising impact on learner awareness, 8,11,13,15 self-efficacy 11 and competence in trans-cultural care.…”

Section: Existing Literaturementioning

confidence: 99%

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Challenges facing standardised patients representing equity‐deserving groups: Insights from health care educators

et al. 2023

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Introduction: Health professions training programmes increasingly rely on standardised patient (SP) programmes to integrate equity-deserving groups into learning and assessment opportunities. However, little is known about the optimal approach, and many SP programmes struggle to meet these growing needs. This study explored insights from health care educators working with SP programmes to deliver curricular content around equity-deserving groups.Methods: We interviewed 14 key informants in 2021 who were involved in creating or managing SP-based education. Verbatim transcripts were analysed in an iterative coding process, anchored by qualitative content analysis methodology and informed by two theoretical frameworks: sociologic translation and simulation design.Repeated cycles of data collection and analyses continued until themes could be constructed, aligned with existing theories and grounded in empirical data, with sufficient relevance and robustness to inform educators and curricular leads.Results: Three themes were constructed: (i) creating safety for SPs paid to be vulnerable, (ii) fidelity as an issue broader than who plays the role and (iii) engaging equity-deserving groups. SP work involving traditionally marginalised groups risk re-traumatization, highlighting the importance of (i) informed consent in recruiting SPs, (ii) separating role portrayal from lived experiences, (iii) adequately preparing learners and facilitators, (iv) creating time-outs and escapes for SPs and (v) building opportunity for de-roling with community support.Conclusions: SP programmes are well positioned to be allies and advocates to equity-deserving groups and to collaborate and share governance of the educational development process from its outset. SP programmes can support the delivery of curricular content around equity-deserving groups by advocating with curricular leadership, building relationships with community partners, facilitating co-creation and co-delivery of educational content and building safety into simulation.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Existing Literaturementioning

confidence: 99%

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Challenges facing standardised patients representing equity‐deserving groups: Insights from health care educators

et al. 2023

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“…In fact, very few studies examining the role of simulation within DEI training and how to best incorporate simulation for DEI have been published to date. 11,12 Fewer still provide specific guidelines/best practices on the use of simulation for DEI training, including guidance on appropriate debriefing techniques, modalities, 12…”

Section: Introductionmentioning

confidence: 99%

“…Nearly all the publications cited before are descriptive ones that portray the use of simulation for very specific topics, such as caring for transgender patients, 10 but they do not clearly define the role of simulation for DEI education. In fact, very few studies examining the role of simulation within DEI training and how to best incorporate simulation for DEI have been published to date 11,12 . Fewer still provide specific guidelines/best practices on the use of simulation for DEI training, including guidance on appropriate debriefing techniques, modalities, 12 logistics, anticipated controversies, or most productive ways to explore the psychosocial contextual aspects of using simulation for DEI education.…”

Section: Introductionmentioning

confidence: 99%

Simulation for diversity, equity and inclusion in emergency medicine residency training: A qualitative study

Nadir

Winfield

Bentley

et al. 2023

AEM Education and Training

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Background The last few years have seen an increased focus on diversity, equity, and inclusion (DEI) initiatives across organizations. Simulation has been used in varying degrees for teaching about DEI topics with emergency medicine; however, there are no established best practices or guidelines on this subject. To further examine the use of simulation for DEI teachings, the DEISIM work group was created as a collaboration between the Society of Academic Emergency Medicine (SAEM) Simulation Academy and the Academy for Diversity and Inclusion in Emergency Medicine (ADIEM). This study represents their findings. Method This qualitative study was conducted using a three‐pronged approach. Initial literature search was conducted followed by a call for submission of simulation curricula. These were then followed by five focus groups. Focus groups were recorded, transcribed by a professional transcription service, and then subjected to thematic analysis. Results Data were analyzed and organized into four broad categories including Learners, Facilitators, Organizational/Leadership, and Technical Issues. Challenges within each of these were identified, as were potential solutions. Select pertinent findings included focused faculty development, a carefully planned approach that utilized DEI content experts and the use of simulation for workplace microaggressions or discriminations. Conclusions There appears to be a clear role for simulation in DEI teachings. Such curricula, however, should be undertaken with careful planning and input from appropriate and representative parties. More research is needed on optimizing and standardizing simulation‐based DEI curricula.

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Exploring the implicit meanings of ‘cultural diversity’: a critical conceptual analysis of commonly used approaches in medical education

Zanting,

Frambach,

Meershoek

et al. 2024

Adv in Health Sci Educ

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Existing approaches to cultural diversity in medical education may be implicitly based on different conceptualisations of culture. Research has demonstrated that such interpretations matter to practices and people concerned. We therefore sought to identify the different conceptualisations espoused by these approaches and investigated their implications for education. We critically reviewed 52 articles from eight top medical education journals and subjected these to a conceptual analysis. Via open coding, we looked for references to approaches, their objectives, implicit notions of culture, and to implementation practices. We iteratively developed themes from the collected findings. We identified several approaches to cultural diversity teaching that used four different ways to conceptualise cultural diversity: culture as ‘fixed patient characteristic’, as ‘multiple fixed characteristics’, as ‘dynamic outcome impacting social interactions’, and as ‘power dynamics’. We discussed the assumptions underlying these different notions, and reflected upon limitations and implications for educational practice. The notion of ‘cultural diversity’ challenges learners’ communication skills, touches upon inherent inequalities and impacts how the field constructs knowledge. This study adds insights into how inherent inequalities in biomedical knowledge construction are rooted in methodological, ontological, and epistemological principles. Although these insights carry laborious implications for educational implementation, educators can learn from first initiatives, such as: standardly include information on patients’ multiple identities and lived experiences in case descriptions, stimulate more reflection on teachers’ and students’ own values and hierarchical position, acknowledge Western epistemological hegemony, explicitly include literature from diverse sources, and monitor diversity-integrated topics in the curriculum.

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The Role of Standardized Patient Programs in Promoting Equity, Diversity, and Inclusion: A Narrative Review

Abstract: Supplemental Digital Content is available in the text.

Cited by 8 publications

References 37 publications

Challenges facing standardised patients representing equity‐deserving groups: Insights from health care educators

Challenges facing standardised patients representing equity‐deserving groups: Insights from health care educators

Simulation for diversity, equity and inclusion in emergency medicine residency training: A qualitative study

Exploring the implicit meanings of ‘cultural diversity’: a critical conceptual analysis of commonly used approaches in medical education

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