Perspectives of the Asian Standardised Patient

Abstract

Introduction: Standardised patients (SPs) have been involved in medical education for the past 50 years. Their role has evolved from assisting in history-taking and communication skills to portraying abnormal physical signs and hybrid simulations. This increases exposure of their physical and psychological domains to the learner. Asian SPs who come from more conservative cultures may be inhibited in some respect. This study aims to explore the attitudes and perspectives of Asian SPs with respect to their role and case portrayal. Methods: This was a cohort questionnaire study of SPs involved in a high-stakes assessment activity at a university medical school in Singapore. Results: 66 out of 71 SPs responded. Racial distribution was similar to population norms in Singapore (67% Chinese, 21% Malay, 8% Indian). SPs were very keen to provide feedback to students. A significant number were uncomfortable with portraying mental disorders (26%) or terminal illness (16%) and discussing Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS, 14%) or Sexually Transmitted Diseases (STDs, 14%). SPs were uncomfortable with intimate examinations involving the front of the chest (46%, excluding breast), and even abdominal examination (35%). SPs perceive that they improve quality of teaching and are cost effective. Conclusion: The Asian SPs in our institution see themselves as a valuable tool in medical education. Sensitivity to the cultural background of SPs in case writing and the training process is necessary to ensure that SPs are comfortable with their role. Additional training and graded exposure may be necessary for challenging scenarios and physical examination.