Authors: Elizabeth Chawla, MD, and Sarah T. Deutsch, MD
In a previous Medical Educator Minutes, we discussed the benefits of using simulation in medical education to allow trainees to practice essential clinical and procedural skills in a low-stakes environment. The use of actors as standardized patients (SPs) has been a core element of simulation in medical education over the past several decades, and their application has become widespread throughout various stages of medical training. While standardized patients can be valuable for both formative and summative assessments, they also hold significant potential for teaching and learning activities. Given the increasing variability in how SPs can be utilized, there is a great opportunity for educational innovation with SPs.
The Medstar SiTEL education team offers resident and fellowship programs the opportunity to work with SPs for education and training. Please contact the SiTEL team to learn more. If you are thinking about using SPs for your GME program educational needs, consider these best practices:
Twelve Tips for running an effective session with standardized patients:
Understand the curriculum and the learner – The session should be designed to meet specific learning objectives appropriate for your learner. Deciding whether the session will be summative or formative informs all other details.
Use teams for script writing – A team approach, including content experts, core faculty, and the SP director, ensures appropriate medical content, realistic psychosocial details, and appropriate cues to prompt the SP to respond as needed.
Know your actors – Understanding the unique contributions of your actors can help make scripts more realistic and help you maximize the SP’s strengths for your specific session.
Know your technology needs – Newer technologies like virtual reality, advanced trainers for procedural skills, or visual tracking devices can enhance simulation sessions with SPs. However, they might also distract trainees from learning essential skills. Be sure to use technology intentionally.
Work out the logistics – Details should be granular and shared with all participants (i.e., trainees, faculty facilitators, SPs, etc.) to ensure standardization for all learners.
Train the actors – Script writers and SPs should have the opportunity to practice the educational session beforehand to ensure the intended objectives are clear, feasible, and delivered consistently from one trainee to the next.
Train the facilitators – Faculty facilitators should receive training on session structure, content, and expectations for facilitating to ensure reliability between faculty.
Engage all participants – If using a group structure, make sure each member understands how to engage with the learning, even if they are not performing the main action.
Use time-out liberally – Allowing the trainee to pause during the session, whether to reset or receive coaching, promotes awareness, cognitive reflection, reengagement, and can boost psychological safety.
Don’t forget to debrief – The post-encounter discussion is critical to consolidate learning, and adequate time should be saved for this piece during session planning.
Assess the quality of cases, scripts, actors, and facilitators – In line with established standards in medical education, program evaluation is a key step to close the feedback loop in curriculum development, verify that the objectives were achieved, and enhance the session for future iterations.
Create an SP community – For many actors, having the opportunity to influence future clinicians as an SP can be very rewarding, especially when helping to develop empathy, communication skills, and patient-centered care. It’s essential for medical educators to support and promote this community as a vital part of shaping the future of healthcare.
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