Standardized/Simulated Patient Integration Introduction

Introduction

Revised: November 2023

Creator: Holly Sarvas

Reviewers: Meagan Vanderploeg & Laura Crick

Welcome to the standardized/simulated patient (SP) module! This module will be different from the others, as the focus is less on the creation of a task trainer, and more on the integration of actors into your training and education sessions. In this section we will explore:

  • The definition and currently supported integrations of SPs
  • Why you would integrate in an SP instead of using a manikin or task trainer
  • How to integrate in SPs alongside manikins and/or task trainers

Once done with the introduction, click on the additional tabs on the left-hand side bar prior to SP integration to learn about:

  • Key physical and psychological safety considerations for integrating in SPs
  • Recruiting, hiring, and training of SPs, including rural/remote unique considerations
  • Templates and resources for integration and implementation of SPs

Definitions and Uses

What is a standardized/simulated patient (SP)? 

  • A Standardized Patient is a healthy individual trained to portray a clinical problem or situation for the purpose of testing or teaching specific skills in the field of health care professionals. (University of British Columbia, n.d.) 

What are SPs typically used for? 

  • SPs are often placed in an acting role where significant emotionality, conversation, and/or range of motion is required to appropriately convey information for the assessment and/or case. 

  • Examples for assessment may include: health history, healthy physical assessment, musculoskeletal assessment, neurological assessment, skin assessment, point-of-care ultrasound, and reproductive assessment (breast examination, digital rectal exam, etc.). Please note that extra care, structure, and compensation is needed for the last category to ensure the physical and psychological safety of the SP. 

  • Examples for cases may include: behavioural/aggravated patient, preventative health discussions, chronic health discussions, birthing practices, overwhelmed family member, patient experiencing withdrawals, end of life/palliative discussions, and more. 

How can an SP be used instead of a manikin or task trainer?

  • SPs, compared to manikins and task trainers, can get up and move around. This may be integral for key body language findings, or practicing key assessment or interventional skills such as range of motion assessments, de-escalation, restraint application, and more. 

  • SPs can also show a broader range of facial expressions compared to manikins, and their voice and intonation can match the facial expression, compared to being the ‘voice of the manikin’. SPs can also elicit an emotional response in learners. By having realistic voice and body language (e.g. the ability to cry, scream, reach out, pace, etc.), learners are more immersed in the emotionality of the scenario. This can be integral for complex conversations, such as a person experiencing withdrawals, entering into end of life care, or an expectant mother entering into active labour. 

  • SPs also have actual human tissues and organs. Sometimes, nothing beats the real thing. When performing healthy physical assessments, or point of care ultrasound skills, seeing or hearing live feedback of actual organs at work can be incredibly meaningful for understanding placement of equipment and the position of the patient. 

How can an SP be used alongside a manikin or task trainer?

  • SPs can be used for hybrid cases or assessments. A hybrid simulation is where you combine one or more modalities of simulation together to get more learning out of the whole process. This could be combining an SP with a task trainer, or starting with an SP then moving to a manikin (or vice versa). 

  • Some examples of this could include combining our wound care module to an SP to have a discussion on chronic health or wound care management. You could also place our ultrasound IV module on an SP to have a discussion on consent and insertion. 

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.

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 (n.d.) Hybrid simulation. https://simulation.mcmaster.ca/hybrid_simulation.html.

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/.