SP Recruiting, Training, and Hiring Considerations

Recruiting, Hiring, and Training Considerations

The following section will cover:

  • Recruiting strategies including advertisement and local resources

  • Hiring strategies including interviews, contracts, compensation, etc.

  • Considerations for recruitment and hiring for rural/remote locations

  • Best practices for training SPs including day-of considerations

  • Equity, diversity, and inclusion considerations

  • Recruiting 

    • Look to your local universities and colleges to see if they already have an SP program established. If they do, there may already be a running list of individuals interested and trained in providing SP-related work that you can email or call. 

    • If your location does not have a local university or college (or associated branch), work towards advertisement. Advertise in areas that people would typically look for volunteer or job opportunities, or for community events. Ensure the poster/ad is brightly coloured and clearly indicates the profile/SP demographics, training and event time, date, location, objective, and compensation (if relevant) provided. Highlight where and who to contact for more information. An example of a poster can be found here:

      Volunteers Needed Poster
      Open in Google Docs

    • Provide several weeks in advance to advertise, setting yourself up for time to interview, sign agreements/contracts, and schedule training. 

    • Know your community: if advertising online, in-person, via word of mouth, or other means will be more impactful, use these tools to your advantage. 

  • Hiring 

    • If recruitment is successful, you want to ensure you are hiring or bringing on someone who can successfully perform the task. Even if this is a volunteer position, key questions should be asked to ensure the success of the event.

    • Interview:  

      • Ensure availability – indicate expected training time and dates, if the training times are flexible or specific, and the expected start and end times of the exact date. Ensure the individual is available for all components 

      • Explain role – provide a detailed profile of expected learning objectives and SP tasks expected from the role/event. Ensure the potential recruit is comfortable and consents to these objectives & tasks, and provide clarity where required. 

      • Re-clarify compensation – indicate compensation (if training is paid, if all hours are paid, are volunteer hours signed for, etc.) and ensure no confusion. 

      • Establish a relationship – ensure the individual knows that this is for education and no advantage is present within the healthcare/medical community based on participation. Create distinction between therapeutic relationships, especially for remote communities. Check-in that the person is capable and willing to maintain confidentiality of performance. 

    • Contract 

      • Regardless if the position is voluntary or paid, a contract should be established between the institution/healthcare worker and the potential SP. An example of an SP template can be found in the Templates and Resources tab. 

      • Contracts should address the following information:

        • Understanding of expectations of the role as an SP 

        • Potential risks associated with role (physical and psychological) and relinquishing/waiver of responsibility from institution (if relevant). 

        • Potential risk for unintended discovery (physically or psychologically) and next steps expected from healthcare worker/institution.

          • Unintended discovery may include assessment or diagnostic findings during a case relevant to the SP as a person rather than the role they are portraying. (For example performing an ultrasound workshop and an unknown lump is found). The recommendation from the simulation community is if an unintended discovery is made the SP be asked to go to their primary healthcare provider/come back later as a patient, for assessment rather than receive a full assessment or diagnosis during the simulation, as this can blend the therapeutic relationship, and confuse learners. An exception would be an emergent finding that requires immediate intervention (even in this case the person should be transported to an area where the intervention can be safely performed).  

        • Expectation for training from SP and institution/healthcare worker 

        • Expectation for arrival, scheduling, cancellation, and no-shows from both the SP and the healthcare worker/institution. 

        • Expectation for compensation/finances; and routine scheduling or guaranteed work

          • This section may not be relevant to all groups but an indication that none of these are guaranteed/granted should be present 

        • Confidentiality of the case/assessment and learner performance by SP (attach confidentiality agreement) 

        • Waiver for loss of personal property 

        • How to terminate agreement/contract 

Example Contract and Non-Disclosure Form for SPs
Open in Google Drive

Key considerations for rural/remote locations?

  • The hiring pool is smaller. It is important to set a wide timeline to hire the right individual for the role, and also to create flexible timelines & schedules to meet the SP where they are at. Where you can, ensure your case is adaptable to age, gender, ethnicity, and so forth to not limit your hiring pool or the feasibility of bringing the case to life. 

  • There is a higher likelihood you will know the individual who you are hiring. It is important to establish the goals and relationship for this interaction compared to the usual therapeutic relationship. This is especially true in remote locations, where the education may be taking place in the only healthcare setting in the community. 

  • Confidentiality is especially important to emphasize. Ensure the SP hired knows the importance of and is capable of keeping the performance of the learners confidential. Simulation is a space where learners can make mistakes and grow. However, if the small community learns that one of the few healthcare professionals working there has significant learning gaps, there may be panic or unrest in the community. 

  • Training - Administrative Considerations 

    • A time and location should be arranged for SP training regarding the assessment/case. Ideally this time should be flexible, and well in advance of the assessment/case, to adjust to the SPs schedule. A content expert should be present.

    • The first part of the training should be a verbal review of the expectations of the assessment/case from all parties (SP, learners, and facilitator). Then, a brief explanation of the SP-specific roles and actions should be discussed. Videos and cognitive aids can help this section. A pause should occur at the end of this portion for the SP to ask any questions or pose any concerns.

    • Afterwards, a walkthrough or dry-run of the assessment/case should commence. It may be helpful for the facilitator to demonstrate first and then have the SP mirror the actions. Having multiple facilitators present to play the role of learners can really establish the expectations of the event. However, this may not always be possible for rural/remote locations. During the walkthrough or dry-run, there should be pauses after every stage or key objective to allow the SP to ask questions or pose concerns.

    • More time may be required to test out moulage/special effects or to fit task trainers to the SP.

    • The training should end with a debrief where the SP and facilitator can discuss any questions that arose from the training. Key safety concerns and boundaries should be established here, including the safe word. If the SP feels they cannot fill this role, this is their final opportunity to opt out before coming to a case/assessment.

    • At the very end, the SP should be provided with instructions and expectation regarding their arrival. This can be either emailed or provided on a paper copy, and should include the time, location, clothes to wear, general appearance, etc., and contact information.

    Cancellations / No-shows

    • It is entirely possible that even with well-established recruitment, hiring, and training practices that some individuals will have to cancel their SP role, or that there may be no-shows.

    • In the event of a cancellation in advance:

      • See if you can recruit from a list of SPs who also expressed interest. See if there is time for training, even if it is on the same day as the simulation.

      • If no SPs are available for recruitment, see if a fellow facilitator or staff can take on the SP role. This should be the last option as it will take the learners out of the experience if it is someone they work with or who holds authority over them.

    • In the event of a last-minute cancellation or no-show:

      • See if a fellow facilitator or staff can take on the SP role, this should be the last option as it will take the learners out of the experience if it is someone they work with or who holds authority over them.
      • If there are no facilitator/staff deployable to take on the role, the event may have to be rescheduled. Notify learners as soon as possible.

    Re-contacting

    • Some SPs may be well suited to fit into many different assessments or case scenarios. You can also cut back on training time if you bring back the same SP for the same assessment or case scenario that has a new group of learners.

    • A structure should be in place whereby you create an agreement that an individual can be re-contacted for additional SP opportunities with your institution/healthcare worker group.

    • When re-contacting, ensure the SP is informed whether the assessment/case is the same or different, and re-establish the relationship as educational. If the assessment/case is different, ensure that the objectives are explained so the SP can determine whether they can take on this new role.

Training - Instructor Considerations

How do I properly train up an SP for an assessment style scenario?

  • Show a video or demonstrate on a co-worker what is expected during the assessment.

  • As required, perform a dry-run of the assessment with the SP prior to the event to increase recognition and reduce anxiety.

  • If the assessment involves a health history or interview, provide the SP with an SP profile and planning guide (see more in Templates and Resources tab) that provides them the necessary background information regarding the person their portraying. Provide the SP profile at least 48 hours in advance so that they can ask any follow-up questions and have enough time to memorize necessary information.

  • Inform the SP what sort of clothing they will be expected to wear during the assessment. For example, a hospital gown, loose light-fitting clothing, or normal street clothes. Indicate whether a second set of clothes is recommended (e.g., in case gel or fluids accidentally ends up on their clothing).

    • Gowns and clothes should be provided by the facilitator/institution if damage/staining is expected or highly likely to occur.

  • If the assessment involves a skill, demonstrate it, or show a video of the skill to the SP. Explain what safety precautions, if any, are in place for the SP. Establish a safe word as required.

  • Ensure the SP has contact information for the facilitator running the event if there are any issues with accessing the facility, if they get lost, or if they can no longer attend (e.g., sickness, etc.).

How do I properly train up an SP for a case-based scenario? 

  • Provide an SP profile and planning guide (see Templates and Resources tab) that provides the SP the necessary background information about the person they are portraying including, but not limited to, key demographic information, social history, health history, current presentation, motivations, etc.

    • Provide the SP profile at least 48 hours in advance so that they can ask any follow-up questions and have enough time to memorize necessary information.

  • Provide an SP script – this script will provide the following:

    • Starting set-up and SP location & demeanour
    • Opening line for the SP
    • Expected learner actions at each stage
    • Expected SP responses to actions
    • Triggers to change language/verbiage/body language/actions
      • “If this, then this” statements that cause the case to change direction
    • Operator/facilitator instructions (can be separate if it will overwhelm SP)
    • How the case is expected to close
    • Safety considerations

  • Templates for SP cases are available in the Templates and Resources tab. Provide the SP case template at least 48 hours in advance so that they can ask any follow-up questions and have enough time to memorize necessary information.

  • Inform the SP what sort of clothing they will be expected to wear during the case. For example, a hospital gown, loose light-fitting clothing, or normal street clothes. Indicate whether a second set of clothes is recommended (e.g., in case gel or fluids accidentally ends of on the clothing).

    • Gowns and clothes should be provided by the facilitator/institution if damage/staining is expected or highly likely to occur

  • At a minimum, provide a verbal walkthrough with the SP; ideally provide a full dry-run. During this time:

    • Clarify triggers
    • Check interpretations of phrases/body language from SP
    • Provide direction on what phrases or actions cannot be modified (i.e., what phrases are “standardized” vs. what can be improvised)
    • Review set-up and safety considerations (e.g., fitting of task trainers, slip/trip hazards, location of facilitator, etc.)
    • Create safety protocols for both physical and psychological safety. Establish a safe word. Review pre-briefing (see Templates and Resources tab) and ensure everything is mentioned to keep the SP safe including considerations for sharps, electricity, and simulated medication.
    • If the case involves a skill(s), demonstrate it, or show a video of the skill. Explain what safety precautions, if any, are in place for the SP. Establish a safe word as required.
    • If hybrid, ensure the SP is knowledgeable and comfortable with the task trainer or the manikin they are interacting with.

  • Ensure the SP has contact information for the facilitator running the event if there are any issues with accessing the facility, if they get lost, or if they can no longer attend (e.g., sickness, etc.).

  What are some key considerations for day-of SP integration? 

  • Ensure the SP is oriented to the space. 

  • Provide an opportunity for a dry-run in advance

  • Provide time for application of make-up/special effects. 

  • For hybrid cases, provide time to walk-through timing, or for application of the task trainer. 

  • If the SP is to be involved in the debrief, go over the debriefing guide and expected goals/take-aways to ensure they are on the same page. 

  • Consider including SP in lunch order or catering 

  • Have a dedicated area for the SP to prepare for the case and for breaks/pauses in-between cases. 

Equity, Diversity, and Inclusion (EDI) Considerations

  • Have persons with lived experience inform SP selection, the case set-up, and design.

  • Have persons with lived experience inform SP coaching and training, if at all possible.

  • When for non-EDI outcomes – keep selection as broad as possible (indicate age range – then determine if additional categories are necessary to achieve learning outcomes).

  • When EDI outcomes present – be purposeful with selection and be specific with recruitment. Take extra time in structuring the pre-brief and debrief to ensure it is psychologically safe for all participants, including the SP.

  • Do not paint skin or add moulage for features.

  • Avoid stereotypes linked to race or gender and presentation (i.e. dishevelled POC with addictions presentation; uncontrolled diabetes with an overweight POC, women POC with chest pain – is it panic attack?) unless prepared for discussion.

  • An example of how you can acknowledge equity, diversity, and inclusion parameters into the pre-brief is included in the Templates and Resources tab.

References

Block, L., Brenner, J., Conigliaro, J., Pekmezaris, R., DeVoe, B., & Kozikowski, A. (2018). Perceptions of a longitudinal standardized patient experience by standardized patients, medical students, and faculty. Medical Education Online, 23(1), 1548244.

Chester, K. (n.d.). Standards of best practice. https://www.aspeducators.org/standards-of-best-practice

Foundation for Healthcare Simulation Safety. (2022, March 10). Home. Foundation for Healthcare Simulation Safety. https://healthcaresimulationsafety.org/

HealthySimulation.com. (2022, November 2). About | Healthcare Simulation | HealthySimulation.com. https://www.healthysimulation.com/healthcare-simulation/

Lewis, K.L., Bohnert, C.A., Gammon, W.L. et al. The Association of Standardized Patient Educators (ASPE) Standards of Best Practice (SOBP). Adv Simul 2, 10 (2017). https://doi.org/10.1186/s41077-017-0043-4

McMaster University (2017). Policies and procedures manual for standardized patients. McMaster University Centre for Simulation-Based Learning. https://simulation.mcmaster.ca/documents/PPForStandardizedPatients2017.pdf

Mills, A. (n.d.). Healthcare Simulation Standards of Best PracticeTM. https://www.inacsl.org/healthcare-simulation-standards

UBC Faculty of Medicine. (2021, May 19). Standardized Patients - UBC Faculty of Medicine. https://www.med.ubc.ca/about/careers/standardized-patient-program/