Dawn Mangine

    This is Part Two of a two-part series; read Part One here.

    Once standardized patients (SPs) have been recruited into your program, the next steps include casting, scripting, and, finally, of course, the actual simulation scenario.

    Casting depends on the scenarios you have decided to run with your students. Be ready and willing to communicate with your SPs, because they will have lots of questions, especially if this is their first time acting as an SP.

    The cast will need to know the following:

    • The script – Make sure you have the script ready to go.
    • Call time – This is the time you want the SP to arrive to prepare for simulation. This is when they will be reviewing the script, asking questions, and getting ready with moulage or wearable trainers.
    • End time – Give the SPs an idea of how long the scenario will run, how many times, and if they will be asked to give feedback.
    • Role requirements – What’s going to happen in the simulation? Make sure you tell them what they need to wear and advise on whether they are getting a physical assessment. Shorts and sports bras worn under clothing are treated like skin for the purposes of simulations; make sure SPs and students know that.
    • Safety – An SP has the right to stop the simulation at any time if he or she feels uncomfortable or unsafe. Tell them to call a “time out” if they need; they aren’t there to sacrifice themselves.

    You will need to make sure to have an adequate number of SPs on hand as you run through scenarios. Being an SP can be fairly intense, and your cast will need breaks. Cast enough people so that they can rotate into the simulation, or in the case of no-shows.

    A Good Script

    Send the SPs the entire script prior to the simulation. The script should include who learners are, objectives of the scenario, and a character description with medical details. The script should also set expectations for the intensity level required from the SP and be clear about details versus improvisation.

    It should be made clear to SPs what their emotional intensity needs to be during the scenario. Mood scales can be helpful here, informing an SP on the level of his or her intensity, how easy or hard they need to emote, whether medical information is hard to extract from them, and what level of emotional portrayal they need to bring.

    Along with mood, communicate with the SP about improvisation. Although it can be appropriate in many scenarios, you don’t want an SP to improvise to the point that the scenario is complete derailed. The script should include details that are important to the scenario, such as the answers to questions like, “Do you smoke?” or “Are you on birth control?” But if an answer isn’t in the script, it is a detail that doesn’t matter, and the SP should give a neutral answer, for example, “Do you have a pet?” “Yes, I have a dog” not “Yes, I raise ferrets in my home.”

    Finally, SPs are usually expected to give feedback to the students after the simulation. Feedback needs to be concise so the learner can take it in. Two models to think about for feedback are:

    • SP-led – “When you did this, I felt that.” This model has the SP explain how he or she felt. It is hard for a student to refute feelings, which helps them learn what behavior needs to be changed.
    • Guided feedback – In this model, the learner asks specific questions to garner feedback, instead of saying, “Well, how did I do?” They go through the steps of the scenario to see how their actions made the SP feel.

    A great source for all this information and how to use standardized patients in healthcare education is ASPEducators.

    This article is based on a presentation by Jan Barber, MSN, RN, the Operations Manager / Education Planner for the RISE Center at Robert Morris University. “Building a Standardized Patient Program,” was presented at the SimPOW meeting of November 16, 2018, at Pocket Nurse Corporate Headquarters.