Strengths and Weaknesses of Simulated and Real Patients in the Teaching of Skills to Medical Students: A Review

Abstract

The aim of this review was to identify the strengths and weaknesses of the roles of real and simulated patients in undergraduate medical education. The literature was reviewed in relation to four patient roles: real patients as educational "resource" (passive role), real patients as teachers (active role), and simulated patients as educational resource and teachers. Each of the four patient roles was found to have specific advantages and disadvantages from the perspectives of teachers, students, and patients. For example, advantages of real patients as educational resource were patient-centered learning and high patient satisfaction. Disadvantages were their limited availability and the variability in learning experiences among students. Despite the considerable amount of literature we found, many gaps in knowledge about patient roles in medical education remain and should be addressed by future studies.

Comparative effectiveness of instructional design features in simulation-based education: Systematic review and meta-analysis

“…Technology-enhanced simulation encompasses diverse products including computerbased virtual reality simulators, high fidelity and static mannequins, plastic models, live animals, inert animal products, and human cadavers. Because they have been the subject of recent reviews, we excluded studies in which the only simulation activities involved computer-based virtual patients (Cook & Triola 2009;Cook et al 2010a) and human patient actors (standardized patients) (Bokken et al 2008;May et al 2009). …”

Simulation in healthcare: A taxonomy and a conceptual framework for instructional design and media selection

“…It can be used, for example, to simulate encounters with patients that are programmed to respond to user input. Simulated Patients (SPs) are also a simulation modality that can be used to replicate encounters with real patients (Bokken et al 2008;Cleland et al 2009). They have been used for more than three decades in medical education (Barrows 1993).…”

The use of standardized patients to teach medical students clinical skills in ambulatory care settings

“…Other studies demonstrated that students regarded the standardization of the learning experience, a safe learning environment and the feedback offered by SP as important advantages (Bokken et al 2008(Bokken et al , 2009. Given that increasing proportion of care is delivered in ambulatory settings and access to real patients with educational value are limited, we describe the design, implementation, and evaluation of a simulated outpatient clinic using SPs.…”