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Simulated patients in medical education 

Simulated patients in medical education
Chapter:
Simulated patients in medical education
Author(s):

Keiko Abe Jennifer Cleland

and Jan-Joost Rethans

DOI:
10.1093/med/9780199652679.003.0017
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date: 08 December 2021

Medical and healthcare training has traditionally depended on patient contact. However, changes in healthcare delivery and in the availability of real patients, coupled with concerns about lack of standardisation of clinical examinations, led to the introduction of the ‘simulated patient’ (SP). SPs are lay people who are trained to portray a patient with a specific condition in a realistic way, sometimes in a standardized way (where they give a consistent presentation that does not vary from student to student). Simulated or standardized patients are now almost ubiquitous in modern medical education programmes. Their use is firmly based in theories of medical education including experiential learning, deliberate practice, and situated learning. SPs are central to teaching and assessment in undergraduate, postgraduate, and continuing education across many different educational contexts and cultures. SPs can be used for teaching and assessment of consultation, clinical and procedural skills—in simulated teaching environments or in situ. They are involved in a range of teaching and learning: from simple communication skills to highly skilled advanced communication; from systems-based examination to complex hybrid simulations. All SPs play roles but SPs have also been used successfully to assess learner performance and give feedback. Clearly, given this potential level of involvement in medical training, it is critical to recruit, train and use SPs appropriately. We provide a detailed overview on the basic criteria for any SP—ability, suitability, and credibility for teaching and assessment. Some of the practical considerations relevant to implementing a simulated patient programme, such as costs and training, are also covered. We briefly discuss some of the areas of SP use which require further research to maximize our understanding of best practice and ensure best evidence medical education.

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