Integration of Standardized Patients into Simulation
Section snippets
Fundamentals of standardized patient methodology
The SP was introduced in 1963 by Barrows [4], a neurologist and junior faculty member at the University of Southern California. Working with Stephen Abrahamson, who was newly recruited to establish one of the first departments of medical education in the United States, Dr. Barrows sought to improve the evaluation of medical students at the conclusion of the neurology clerkship. He challenged himself to develop a case for which he knew every sign and symptom that could be reproduced exactly for
Advantages and limitations of standardized patients
Multiple applications of SP methodology have been developed in parallel with quality standards for reliability and validity. Advantages of using SPs are shown in Box 1.
SP methodology is limited in that multiple patient encounters may be needed for broad-ranged training or testing. The number of cases a learner sees during an objective structured clinical examination (OSCE), for example, typically ranges from 8 to 12. Another constraint is that SPs may not be able to simulate every physical sign
Integration of standardized patients into simulation
Simulation is a training and feedback method in which learners practice tasks and processes in lifelike circumstances using models or virtual reality. Feedback from observers, peers, or video cameras has been used to assist skills improvement. High-fidelity medical simulation provides a new set of tools for clinical skills development that is similar to professional training where there is no zero tolerance for error (aviation, defense, maritime, and nuclear energy).
Adding an SP to the
Feedback and debriefing
After an encounter, SPs can provide immediate and constructive feedback to learners based on their objective reports (checklists) or subjective ratings of interpersonal skills. The debriefing process helps people learn from their experience by reflecting, analyzing, and talking about the experience. It is recommended to debrief the participants immediately after a high-fidelity simulation, while the experience is fresh and it is easy to demonstrate a key point or repeat part of the simulation.
Recommended resources
For the medical educator interested in learning more about working with SPs, the following resources are recommended:
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Arizona Clinical Interview Rating Scale. Available at: http://www.spputoronto.ca/docs/ACIR_1_Page_Communication_Skills_scores_blank_sheet.doc. Behaviorally anchored checklist to assess medical interviewing skills.
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Association of Standardized Patient Educators. Available at: http://www.aspeducators.org/. Link to the international organization for professionals in SP methodology.
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Summary
SPs can greatly enhance high-fidelity simulation. The educational experience becomes more realistic than by simply using a simulator. If an institution has an SP program, the SP trainer can hire and train SPs for simulation. Once the SPs are trained, the simulation can be replicated many times. The SP's ability to record what happens during the simulation and give feedback to the learner enriches the experience. Faculty are free to participate in the simulation in an observer role, taking notes
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Cited by (26)
“Two heads are better than one”- pharmacy and nursing students' perspectives on interprofessional collaboration utilizing the RIPE model of learning
2020, Research in Social and Administrative PharmacyCitation Excerpt :Simulation is considered to be a “technique not a technology”9 and as such there are a vast range of simulation learning modalities and approaches used for healthcare professional education. These include but are not limited to the following: the use of ‘medium-fidelity’ or the more technologically advanced ‘high-fidelity’ human simulators or manikins (manikins which are interfaced with a computer program to produce simulated responses such as heart rate and rhythm or respiratory patterns);1,2,10 the use of standardized patients for case studies which may include (i) use of actors that “play” the role of the patient or the use of other healthcare professional students or practitioners who are coached to simulate a specific patient's symptoms and illness in a standardized way; and/or (ii) an actual patient who is coached to present their symptoms and illness in a standardized way.2,11–14 Some simulation educational programs may include “virtual online” processes such as gamified learning scenarios, augmented and virtual reality and others may include part task trainers and/or hybrid simulation i.e. combinations of two modalities in one simulation, for example, a standardized patient and part task trainer.2,15
Perceptions of simulation-assisted teaching among baccalaureate nursing students in Chinese context: Benefits, process and barriers
2017, Journal of Professional NursingCitation Excerpt :Their performance can be computerized, allowing students to check, correct errors and make progress easily. In addition to skill training, simulation is also helpful in improving student critical thinking, clinical reasoning, and team working (Cantrell & Delony, 2007; Durham & Alden, 2008; Elfrink, Kirkpatrick, Nininger, & Schubert, 2010). Due to its learning efficacy and efficiency, simulation has replaced part of the clinical practice sessions in some U.S. nursing schools (Nehring, 2008).
Value of simulation in pediatrics
2013, Archives de PediatrieStandardized Patients in Educating Student Nurses: One School's Experience
2010, Clinical Simulation in NursingCitation Excerpt :As discussed, adding SPs to manikin-based simulation may increase the realism of the scenario, as well as the communication skills students must use in the simulation. Cantrell and Deloney (2007) reported that using SPs with manikin-based simulation increases not only the realism but also the reproducibility of the scenario for all participants. In our pediatric nursing course, students are providing care to the infant or child manikin as well as working with a parent, grandparent, or caregiver.
Management of Common Postoperative Emergencies: Are July Interns Ready for Prime Time?
2008, Journal of Surgical EducationCitation Excerpt :Task trainers allow the trainee to practice a variety of invasive procedures and technical skills prior to performing them on patients.16-21 In addition, the use of an HPS to train residents and critical care teams in crisis management of medical or surgical emergencies has become increasingly popular.4,6,22-24 The use of an HPS is especially helpful to create a multidisciplinary patient-care environment as observed in the intensive care unit, trauma bay, or operating room.3,5,7,25,26