Key challenges in simulated patient programs: An international comparative case study

Abstract

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.

Experience towards Simulated Patient-based Simulation Session: An Integrative Literature Review

“…Professional behaviour (e.g. answer call in the middle of OSCE) as part of SP performance (12). Maastricht Assessment of Simulated Patients (MaSP) is commonly used as an instrument to evaluate SP performance (13)(14)(15).…”

“…Less established SP programmes were less vigorous in their approaches towards SP quality assurance. Each SP programme had informal measure in place to identify under-performing SP, such as informal feedback from faculty (12,16). A study done on an adolescent SP programme in 2009 examined the adolescent SP performance.…”

Investigating a self-scoring interview simulation for learning and assessment in the medical consultation

“…Experiential learning afforded by adaptive simulations can provide the learner with a rich opportunity to construct a new schema and build upon prior knowledge. In addition, empirical evidence suggests that the use of simulations significantly enhances knowledge transfer in students compared with traditional classroom delivery methods in medical and other health professional curricula 8,21–23. Technology-enhanced learning (TEL) may contribute added value due to the administration of a flexible (any time, any place) educational experience by increasing the number of medical students undertaking continuous assessment (undergraduates) and continuous professional development (postgraduates).…”

Pacientes simulados en la formación de los profesionales de salud: el lado humano de la simulación

“…En el marco de estos antecedentes es posible observar la existencia de una tensión para el docente clínico: es difícil centrarse en el paciente y en el estudiante en la misma instancia. Buscando una alternativa para abordar esta tensión, la simulación clínica tiene como fin representar experiencias reales de pacientes a través de escenarios adecuadamente guiados y controlados: esto permite al docente centrarse en el estudiante pero enfocado en el paciente 10 . Dos vertientes en simulación han emergido en estos años: la simulación tecnológica con maniquíes y máquinas y la simulación humana en lo cual los simuladores son personas que han sido formados para representar un caso clínico en contextos de docencia.…”