Why bother with a simulated patient?
There are many limitations to what a manikin can do, in which case it may be prudent to simply have a clinically trained actor in their place.
Humans are much higher fidelity than a manikin, providing realism through variations in personalities & emotions, body language and clinical signs.
While many will jump in an play the part, there will be variable success in how this is delivered, and richer experiences can be gained when the actor is suitably prepared as the 'expert' patient.
So who is best to take on the role? There are several companies out there with paid individuals who can be used to support your simulations. While their experience and expertise should not be undermined, not everyone has access to the funding, or resources, to utilise agency SPs in their scenarios. In simulation departments, let alone the extended hospital or sim community of practice, there is a general shortage of willing actors, let alone simulated patients, to meet demand.
What are the qualities expected of simulated patients?
They should be self-aware, and mindful of their performance, while maintaining respect & empathy for the sim participant(s).
Coordinate with other SPs and sim departments, considering the expanded role they can provide for support, with or without knowledge of feedback and debriefing practice.
Aim to provide realistic, and emotionally engaging characters without stereotyping roles.
Demonstrate excellent communication skills and deal with a range of challenging situations, both within, and outwith scenarios.
In order to support SPs appropriate some considerations to their role must be taken into account:
Who is the character they are playing; consideration of emotions, background, medical history etc...
What is expected of the participant, how supportive are they to be, will they be expected to contribute feedback, either via debriefing or directly...
What is the context of the learning - the patient's "lived" experience and how can learning be optimised
Practice makes perfect - how many opportunities are there for a dry run, both of the scenario and key points to highlight - will they be given opportunity to share their ideas / concerns (friends & family test)
Consider needs of training for incorporation in any assessments or formal feedback processed required for the trainee and sim programmes development.
Consider the SPs demographics and the realism for the scenario, as well as their overall experience, personality, and overall confidence and sustainability if running a prolonged or challenging course.
University of Toronto - Standardized Patient User Guide: https://spp.utoronto.ca/sites/default/files/SP%20User%20Guide_Jan2020_1.pdf
Defining Responsibilities of Simulated Patients in Medical Education - https://spntraining.simulatedpatientnetwork.org/pluginfile.php/1265/mod_book/chapter/19/Nestel%20et%20al%202010%20SP%20responsibilities.pdf
The use of simulated patients in medical education: AMEE Guide No 42 - https://spntraining.simulatedpatientnetwork.org/pluginfile.php/1278/mod_book/chapter/36/Cleland%20et%20al%2C%20MT%202009.pdf
Recruiting simulated patients - https://spntraining.simulatedpatientnetwork.org/pluginfile.php/1278/mod_book/chapter/35/Dudley%2C%202012.pdf
Medical student experience as simulated patients in the OSCE - https://onlinelibrary.wiley.com/doi/epdf/10.1111/tct.12016
Medical students as standardized patients to assess interviewing skills for pain evaluation - https://onlinelibrary.wiley.com/doi/epdf/10.1046/j.1365-2923.2002.01070.x