Standardized participants (SPs) are beneficial to healthcare simulation programs for a variety of reasons. One reason is the increased realism that is added to a simulated clinical experience (SCE) upon the use of SPs. Other reasons include the ability of SPs to communicate with learner participants in a way manikins and task trainers cannot. Additionally, the cost of using SPs is generally quite lower compared to purchasing and maintaining manikins. Yet, quality SPs may be difficult to find due to several factors including both time and pay. This HealthySimulation.com article will explore options for finding and securing quality volunteer standardized participants for any clinical simulation program, as well as standards of best practice to help guide the development of an SP program.
Volunteer SP Programs
While larger healthcare simulation programs can often pay SPs for their time and talents, this unfortunately is often not the case for smaller clinical simulation programs. When implementing SPs and creating an SP program, there are several factors to consider. A few factors are the objectives of the medical simulation, the benefits of utilizing SPs for the clinical simulation, and the ability of the SP to accurately portray the client.
Finding volunteer SPs is challenging. Contacting local theater programs, senior citizen centers, and high school health occupation programs is a great way to locate SPs. In addition, previous program graduates or current learners are options. When building an SP program, another key factor to keep in mind is the diversity of SP volunteers. Diversity is key to any successful SP program.
When SP volunteers are enrolling in a program, the SP educator is responsible for gathering essential information about each volunteer. Volunteer SP documentation must include SP contact information, days and hours the SP is available, scenarios in which they may be willing to participate, and emergency contact information. Setting clear expectations allows for a well-run SCE and a positive learner experience.
Standards of Best Practice
The Association of Standardized Patient Educators (ASPE) recognizes five best practices to guide SP programs. These five practices include a safe work environment, training for role portrayal, feedback and completion of assessment instruments; case development, program management, and professional development. The most important of the aforementioned best practices is likely a safe work environment.
Healthcare simulation program leaders must recognize that a safe work environment is not only refers to physical safety but psychological safety as well. Prior to participating in a healthcare simulation, a volunteer SP must consent that they have reviewed the simulation objectives and are both physically and psychologically prepared to participate in the SCE.
Not all SP volunteers will be well suited to every encounter due to various life experiences. For example, if an SP has a previous experience with a spouse who passed from cancer, they may not be well suited to portray a client or family member who is going through a similar life event. Additionally, creating a safe work environment involves training to orient all SPs to program expectations, audiovisual equipment, and simulation lab space.
Also essential to the success of the SP encounter, SPs must be trained for role portrayal, feedback, and completion of assessment instruments. Training can be completed in a variety of formats including online, hybrid, or face-to-face.
The emphasis that role portrayal must be consistent and accurate is key. SPs will need client history (medical, surgical, and social), history of present illness, information on client demeanor, instructions on moulage to be utilized, etc. As previously mentioned, the SP will also need information regarding a social and emotional vulnerability that may be encountered during the SCE.
Ideally, an SP will participate in both the SCE and debrief sessions. Debriefing is often the part of the SCE where learners report the most learning occurs. If an SP is expected to participate in debriefing of the SCE, instruction on providing constructive criticism must be provided as part of the SPs training.
This allows learners to have the opportunity to receive constructive feedback from the SP. This constructive feedback must reflect on the learner’s ability to meet healthcare simulation objectives, communicate with the client, and performance of a procedure if appropriate. A debrief session that includes SP feedback is invaluable, as this allows learners a rare opportunity to receive constructive feedback from a “clients” perspective.
Completion of assessment instruments is valuable training for SPs because this allows evaluation by a person other than a content expert. While this evaluation can be valuable, SP educators must ensure SPs are trained on how to appropriately use the assessment tool, have time to practice using the assessment tool, and are capable of completing the assessment tool in the time allotted. If more than one SP will be evaluating learner performances, they must be trained well in order to provide consistent and fair feedback.
Selecting an SP
When determining if an SP will be appropriate for an SCE, the content expert and SP educator must collaborate. As part of this collaboration, healthcare simulation objectives and minimum expectations of students must be reviewed. When reviewing this information, discussion regarding SP selection (age, physical attributes, experiences [including as an SP and life experiences]) are necessary.
Also, as part of this discussion case development details must be shared. In addition to portraying client roles, SPs are great selections for mental health simulations and portraying friends or family members of a client as well.
Conclusion
While challenges will certainly arise when developing a volunteer SP program the benefits will remain far greater. Quality clinical simulation education is the cornerstone of healthcare programs across the world. Implementing SPs into all types of simulation education programs is beneficial for a variety of reasons. Overall, SPs add realism, verbal and non-verbal communication, as well as diversity to clinical simulation programs of all types.
