Simulated patient
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The SP can also contribute to the development and improvement of healthcare protocols; especially in cases where input from the SP are based on extensive, first-hand experience and observations as a clinical patient undergoing care.[citation needed]
History
Dr.
Uses
![](http://upload.wikimedia.org/wikipedia/commons/thumb/4/4f/Anesthesia_Resident_Simulation.jpg/220px-Anesthesia_Resident_Simulation.jpg)
Simulated patients (SP) are extensively used in medical and nursing education to allow students to practice and improve their clinical and conversational skills for an actual patient encounter. SPs commonly provide feedback after such encounters. They are also useful to train students to learn professional conduct in potentially embarrassing situations such as pelvic or breast exams. SPs who perform such training are given titles such as Gynecological Teaching Associate (GTA) or Urological Teaching Associate (UTA), as covered in more detail below. SPs are also used extensively in testing of clinical skills of students, usually as a part of an objective structured clinical examination. Typically, the SP will use a checklist to record the details of the encounter.[citation needed]
SPs have also been sent unannounced into a physician practices to evaluate the standards of care. They are also employed as field researchers on health informatics projects. They can also assist in the development of seminars and lectures in an academic setting, under the supervision of full or associate professors.[citation needed]
SPs can also serve as a "confederate" in a simulation to perform the roles of other clinicians within the care team.[4] SPs used for in situ simulation activities may require special training.[5]
For teaching future healthcare professionals how to perform intimate examinations, a specially trained simulated patient may be used. Intimate examinations include breast and pelvic examination on females and urogenital, prostate and rectal examination on males. Such roles are known by various names. One form of instruction is where a medical professional, a preceptor, teaches the medical student how to perform the examination using a simulated patient as the model.[6]
For nursing, SPs are successfully supporting large cohorts of students in the undergraduate curricula.[7]
Advantages
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The use of simulated patients has several advantages:[3][8]
- Effectiveness: a SP with extensive clinical out-patient experience, would have first-hand knowledge and experience with the clinical out-patient environment, which should have an advantage over a professional actor who has to learn how to "play the part" of a clinical patient.
- Convenience: SPs are able to provide cases that are needed at the time they are needed. They are likely to be more reliable, and may tolerate more students than real patients.
- Standardization: The use of standardized clinical scenarios allows direct comparison of the students' clinical skills, locally as well as nationally and internationally.
- Compression/expansion of time: SPs can provide a longitudinal experience and enable students to follow through patients over time, even in a compressed time frame of examination. One technique employed in SP encounters is the use of information cards. When the trainee or examinee articulates the need for an examination or a laboratory test, the SP hands him/her a small card with the results of that exam/test, and the encounter can continue.
- Safety: SP encounters allow students to learn about situations they may not be able to manage alone in a real clinical setting, or where the use of a real patient may be inappropriate. For example, counseling a cancer patient.
- Efficiency: The monitoring of students by SPs reduces the need for supervision of medical students by physician faculty during clinical encounters.
- Repetition: Simulation allows students to repeat skills, and each time, the skill can increase in complexity.[9]
Limitations
The largest limitation of simulated patients use can be their cost.[10]
At the same time, SPs are case specific and are able to assess clinical competency in a limited area only. Multiple encounters may be needed for broad ranged training or testing. Also, while SPs are quite proficient in simulating the
Recruitment
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SPs need to draw on their own personal experiences with physicians, conversations with healthcare professionals, talking to specific patient populations etc. They also need to be trained to accurately and reliably simulate particular clinical scenarios.[11] Frequent quality assessment may be needed to ensure consistency in the portrayal of the patient role; especially since SPs may absorb a significant amount of clinical knowledge from their interactions with healthcare professionals.[11]
See also
References
- ^ Peggy Wallace. "Following the Threads of an Innovation: The History of Standardized Patients in Medical Education". Archived from the original on December 28, 2008. Retrieved 2008-09-28.
- ^ Biography of Dr. Paula L. Stillman
- ^ a b "Standardized/Simulated Patients in Medical Education". Archived from the original (Word document) on June 23, 2003.
- S2CID 77647625.
- ^ Messina J, Smith K, Hobbs GW (2015-06-14). "From the Skills Center to the Clinic: Preparing SPs for in situ Simulations". Proceedings of the 14th Annual Association of Standardized Patient Educators Annual Scientific Meeting.
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: CS1 maint: multiple names: authors list (link) - ^ News article posted by Association of Standardized Patient Educators, December 2013.
- ^ Irwin, P., Butler, S., & Brown, R. A. (2023). Implementing the undergraduate simulation framework for large nursing cohorts: A program evaluation. Clinical Simulation in Nursing, 80, 1-8. https://doi.org/10.1016/j.ecns.2023.02.013
- ^ a b J P Collins; R M Harden (2004). "The Use of Real Patients, Simulated Patients and Simulators in Clinical Examinations. AMEE Medical Education Guide No 13" (PDF). Association for Medical Education in Europe. Archived from the original (PDF) on 2007-10-23. Retrieved 2008-09-28.
- ^ Irwin, P.M., Brown, R.A. and Butler, S. (2021), "The undergraduate simulation framework: standardising design and delivery", Higher Education, Skills and Work-Based Learning, Vol. 11 No. 2, pp. 576-586. https://doi.org/10.1108/HESWBL-04-2020-0070
- ISBN 978-0-7637-1427-7.
- ^ ISBN 978-1-84619-022-3.
Further reading
- Suzanne M. Kurtz; Jonathan Silverman; Juliet Draper (2005). "Simulated patients". Teaching and Learning Communication Skills in Medicine. Radcliffe Publishing. ISBN 978-1-85775-658-6.
- Barrows, H (1993). "An overview of the uses of standardized patients for teaching and evaluating clinical skills". Academic Medicine. 68 (6): 443–453. PMID 8507309.
- Spencer, J; Dales J (2006). "Meeting the needs of simulating patients and caring for the person behind them". Med Educ. 40 (1): 3–5. S2CID 42233757.
- Kulze, Elizabeth (2015-02-19), These Medical Models Teach With Their Own Bodies, retrieved 7 March 2017