Why use Standardized Patients (SPs) or Simulators (S)?
SP/Ss have advantages over using real patients for some training and assessment experiences. SP/Ss compliment working with real patients or provide standard experiences for all learners which may not be available when working with real patients.
Availability - SP/S are available at any time and any place so they can be scheduled in advance. This makes it easy to plan learner experiences at the most appropriate time for effective and efficient learning. It is not necessary to rely on real patient cases to be available at any given time.
Repeatability - The same simulation is always available; psychological aspects, symptoms and signs remain stable from one encounter to the next. Learners can repeat a task over and over while the simulated picture remains the same. This level of consistency would be unusual in a real situation.
Controllability - The SP/S is controlled for the complexity of history, affect, emotions and physical findings so they can be adjusted to the level of the learners to maximize learning benefits. Junior learners will see a common, straightforward case, while a senior learner will see more complicated or atypical cases. Because the outcome is known, a performance standard can be established for evaluation purposes.
Adaptability - Simulation is adapted to educational needs and can be used in a variety of ways. Different aspects of a problem can be discussed in front of the SP/S with no risk to patient’s/person’s welfare (“time in” and “time out”). During these discussions, the SP/S maintains the role to improve the realism but suspends interaction until the discussion is complete. Because there is no risk to the SP/S, the learner can repeat an item or take extra time without feeling anxious about a patient's fatigue, pain or emotional strain.
Learner Anxiety - Learners need not be concerned that they will do or say something harmful to a real patient/person; therefore, anxiety is lessened. However, when it is an exam situation, learner anxiety reflects the stress they are facing in evaluation.
Roles and Feedback
A Standardized Patient (SP) portrays a patient in a simulated health care setting, while a Simulator (S) portrays a client, customer, interviewer, or other non-patient role in a office or other appropriate setting. "SP/S" refers to either an SP or an S. While the description below is more representative of the SP, the role of the S is analogous.
The SP/S is required to function in three roles.
The first role of a SP/S is to realistically simulate the behavior of a patient or situation. SP/S s are trained in the details of the history, personality and abnormal physical findings of an actual case.
The second role of a SP/S is to accurately document learner performance using predefined checklists.
A third role of the SP/S's is providing learners with feedback on techniques of interviewing, physical examination techniques, and communication skills.
Feedback is one of the most important skills of the SP/S's:
- A major advantage of using simulation rather than a real situation is the opportunity for learners to receive immediate feedback from a trained person on how their approaches and skills may affect a patient/person.
- Feedback is given at the end of a session and may be verbal, written or both.
- Feedback will help the learner(s) become aware of their behaviors and reinforce or modify these behaviors.