In this paper, we define the Association of Standardized Patient Educators (ASPE) Standards of Best Practice (SOBP) for those working with human role players who interact with learners in a wide range of experiential learning and assessment contexts. These human role players are variously described by such terms as standardized/simulated patients or simulated participants (SP or SPs). ASPE is a global organization whose mission is to share advances in SP-based pedagogy, assessment, research, and scholarship as well as support the professional development of its members. The SOBP are intended to be used in conjunction with the International Nursing Association for Clinical Simulation and Learning (INACSL) Standards of Best Practice: SimulationSM, which address broader simulation practices. We begin by providing a rationale for the creation of the ASPE SOBP, noting that with the increasing use of simulation in healthcare training, it is incumbent on ASPE to establish SOBP that ensure the growth, integrity, and safe application of SP-based educational endeavors. We then describe the three and a half year process through which these standards were developed by a consensus of international experts in the field. Key terms used throughout the document are defined. Five underlying values inform the SOBP: safety, quality, professionalism, accountability, and collaboration. Finally, we describe five domains of best practice: safe work environment; case development; SP training for role portrayal, feedback, and completion of assessment instruments; program management; and professional development. Each domain is divided into principles with accompanying key practices that provide clear and practical guidelines for achieving desired outcomes and creating simulations that are safe for all stakeholders. Failure to follow the ASPE SOBP could compromise the safety of participants and the effectiveness of a simulation session. Care has been taken to make these guidelines precise yet flexible enough to address the diversity of varying contexts of SP practice. As a living document, these SOBP will be reviewed and modified periodically under the direction of the ASPE Standards of Practice Committee as SP methodology grows and adapts to evolving simulation practices.Electronic supplementary materialThe online version of this article (doi:10.1186/s41077-017-0043-4) contains supplementary material, which is available to authorized users.

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BackgroundThe literature on simulated or standardized patient (SP) methodology is expanding. However, at the level of the program, there are several gaps in the literature. We seek to fill this gap through documenting experiences from four programs in Australia, Canada, Switzerland and the United Kingdom. We focused on challenges in SP methodology, faculty, organisational structure and quality assurance.MethodsWe used a multiple case study method with cross-case synthesis. Over eighteen months during a series of informal and formal interactions (focused meetings and conference presentations) we documented key characteristics of programs and drew on secondary document sources.ResultsAlthough programs shared challenges in SP methodology they also experienced differences. Key challenges common to programs included systematic quality assurance and the opportunity for research. There were differences in the terminology used to describe SPs, in their recruitment and training. Other differences reflected local conditions and demands in organisational structure, funding relationships with the host institution and national trends, especially in assessments.ConclusionThis international case study reveals similarities and differences in SP methodology. Programs were highly contextualised and have emerged in response to local, institutional, profession/discipline and national conditions. Broader trends in healthcare education have also influenced development. Each of the programs experienced challenges in the same themes but the nature of the challenges often varied widely.

The cultural, legal and ethical aspects of medical practice in Canada can be problematic for International Medical Graduates (IMGs) to access and learn. The professional behaviours that depend on effective communication often challenge IMGs as they attempt to enter the Canadian medical system. The Communication and Cultural Competence Program provides a complex interactive web-based environment in which IMGs can learn and practice skills required to navigate these specific elements of medical practice. The educational design of this web site is based on the theory of knowledge building (Scardamalia & Bereiter, 2003). This paper examines how video simulation is used on the web site to support this design. Experiential simulation pedagogy, typically used in high-fidelity face-to-face encounters, is analyzed. Strategies to translate this pedagogy to an e-learning format to operationalize authentic knowledge building are described. Commentaries replace live facilitation and a communication tool, the Observation Guide, allows learners to participate in the simulation. This examination provides insight into the complexity involved in creating on-line resources that extend beyond clinical content repositories, illustrating the potential for web-based programs to provide reflective and recursive learning. A wide skill set with a broad base of support was necessary to create a virtual environment with depth and authenticity. Translating the process from live simulation to a mid-fidelity digital video format allowed for deeper understanding of how the unique skills of experienced simulators impact the educational process. This multi-dimensional e-learning platform has potential for teaching complex skills in medical programs.Les médecins diplômés à l’étranger (MDE) peuvent avoir des difficultés à accéder aux aspects culturels, légaux et éthiques de la pratique médicale au Canada et à les apprendre. Les comportements professionnels qui dépendent de l’efficacité de la communication posent des difficultés aux MDE lorsqu’ils tentent d’entrer dans le réseau de la santé canadien. Le « Programme de communication et de compétence culturelle » offre un environnement virtuel interactif complexe permettant aux MDE d’apprendre et de pratiquer les compétences requises afin d’intégrer ces éléments particuliers de la pratique médicale. Le concept pédagogique de ce site Web est basé sur la théorie de la construction du savoir (Scardamalia & Bereiter, 2003). Le présent article traite de la façon dont la simulation vidéo sur le site Web est utilisée pour appuyer ce concept. Il analyse la pédagogie expérientielle faisant appel à la simulation généralement utilisée dans les rencontres en face à face en haute fidélité. Il décrit les stratégies visant à traduire cette pédagogie en un format de cyberapprentissage afin d’opérationnaliser le concept de construction du savoir authentique. Les commentaires remplacent l’animation en direct et un outil de communication, le Guide d’observation, permet aux apprenants de participer à la simulation. Cette...

Scaffolded design supports complex knowledge building. These findings are concurrent with educational research on the importance of recursion and revision of knowledge for improvable and relational understanding.