By: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

By: Joseph Cross, et al
Submitted by: Marsha Harman, Rush Center for Clinical Skills and Simulation

By David H. Freedman
Submitted by: Kerensa Peterson, University of California, Riverside

Lead Author: Anthea Burnett
Submitted by: Amy Lorion, NBOME

The authors used unannounced standardized patients (USPs) to evaluate “the quality of refractive error care in Cambodia by estimating the proportion of prescribed and dispensed spectacles appropriate for people’s refractive error needs and factors associated with spectacle quality.” While much of the article focuses on the scientific aspects of the study, the authors also describe some of their methodology and general findings. As USPs, they recruited 18 adults with refractive error within specified ranges. These USPs underwent three days of in-person training and evaluation before beginning the study. Each USP visited 23-45 optical services, with each service visited by 1-5 USPs (60% of them by 5). At these visits, the USP would observe testing procedures, evaluate the clinician’s communication skills, and, depending on the clinician’s recommendation, purchase a pair of glasses. Research optometrists later examined the glasses for appropriateness for the USP. One intriguing finding: “44% of USPs who didn’t need glasses were prescribed them, with women being more likely to receive unnecessary prescriptions than men.”

Lead Author: Shelley Walker
Submitted by: Amy Lorion, NBOME

As Walker et al note: “Nursing trained faculty often work as embedded simulated participants (ESPs) in interprofessional simulations. Blending and switching their professional identities as educators, nurses, and role players in ESP roles can be challenging. How they balance tensions in their role portrayal is poorly understood. New and experienced faculty may benefit from clearer guidance about how to approach this task.” They used a descriptive phenomenological approach, performing semi-structured interviews with nine nurse ESPs. As the authors describe their findings: “The results of our study align with current ESP role descriptions in the literature, such as providing guidance, adding realism, and fostering psychological safety. However, we have revealed a much deeper and more layered experience of the nursing ESP role with significant tensions, complex and nuanced decision making when ‘in role’ and positive effects on other clinical roles.”

Lead Author: Hananditia Rachma Pramestutie
Submitted by: Amy Lorion, NBOME

This article details the results of a study of pharmacists in Malang, East Java Province, Indonesia using SPs. Although pharmacists in the community were informed that a study would be occurring, they were not provided with detailed information about it and, according to the researchers, were not aware that the mother asking them for advice for their 5-year-old child’s diarrhea was an SP portraying a scenario. Pharmacists who seemed to realize or suspect that the interaction was part of a study (the SPs were wearing voice recorders) were not included in the research. Pharmacists were told about the study after the fact, at which point they could agree or decline to have their encounter included in the research. The researchers concluded that “not all pharmacists gathered information, made appropriate therapy recommendations, and provided complete information about medicines.”

Lead Author: Sunyoung Son
Submitted by: Amy Lorion, NBOME

This article describes a study in South Korea in which 49 senior nursing students were trained on end-of-life hospice care using either a simulation-only program (control group) or a program that included lectures after the simulation (experimental group). The authors found that, while there were no significant differences between the groups in either their confidence levels or the positivity in their attitudes toward hospice care, only the students in the experimental group demonstrated increased hospice-related knowledge, this despite both groups having received self-directed learning materials before the simulation. According to the authors, this “suggests that self-directed learning of theoretical aspects and practical simulation training alone are insufficient to improve knowledge.” Accordingly, “the knowledge aspect of hospice care can be improved more efficiently by combining simulation training with lectures and debriefing than by simulation alone.”

Lead Author: Adesola C. Odole
Submitted by: Amy Lorion, NBOME

Odole et al. describe their objective as “to investigate the understanding and views of physiotherapy students and lecturers regarding simulated patient (SP) participation in clinical examinations” with the aim to “improve the integration of SPs into clinical training for young physiotherapists, ultimately enhancing both student preparedness and patient care.” They approached this through a mixed-method study, combining a survey with focus group discussions, with 207 clinical students and 37 lecturers participating. They found that, while “both students and lecturers have a positive perception of the involvement of SPs in clinical examinations… [p]hysiotherapy students in South-West Nigeria have a low level of knowledge about the involvement of simulated patients in clinical examinations compared to their lecturers,” a disparity they argue suggests “that current educational strategies may not effectively convey the importance and utility of SPs to all students.”

Lead Author: Darius Shaw Teng Pan
Submitted by: Amy Lorion, NBOME

Read the full article in the [Teaching and Learning in Medicine] [https://www.tandfonline.com/doi/full/10.1080/10401334.2023.2290611#abstract].

By: Nicole Last, et al
Submitted by: Marsha Harman, Rush Center for Clinical Skills and Simulation

Read the full article in the International Journal of Medical Education here.

By: Lou Clark, PhD, MFA, Andrea Doyle, PGDip, Med Phys, MedEd, BSc, PhD, Melih Elcin, MD, MS, CHSE-A, Nancy McNaughton, PhD, Cate Nicholas, EdD, MS, PA, FSSH, Tamara Owens, PhD, MEd, CHSE, Cathy Smith, PhD, MA, BA Hons, CHSE, Karen Szauter, MD, MACP, FAMEE, Kuan Xing, PhD, Debra Nestel, AM, PhD, FAcadMEd, FSSH
Submitted by: Miranda Powell, AS, CHSE, University of South Alabama

In modern healthcare education, simulated participants (SPs) play an essential role in bridging the gap between theoretical knowledge and clinical practice. These trained individuals portray patients, family members, or other key roles in structured simulations, allowing healthcare learners to refine their communication, clinical reasoning, and procedural skills in a controlled environment. Their contributions are critical to improving patient safety and the overall quality of medical training. However, despite their significance, SPs often face challenges related to recognition, training consistency, and emotional well-being. The article, Call to Action: Honoring Simulated Participants and Collaborating With Simulated Participant Educators, underscores the need for institutions to formally acknowledge and support these vital members of the healthcare education ecosystem. Simulated participants facilitate experiential learning by providing students with realistic patient interactions, enabling them to develop essential competencies before engaging with real patients. Their ability to offer structured, high-quality feedback enhances the learning experience, ensuring that learners gain both technical proficiency and strong interpersonal skills. However, despite their integral role, SPs frequently remain undervalued within the academic and clinical training landscape. Many institutions fail to provide formal recognition or adequately define their roles, treating SPs as ancillary components rather than core contributors to healthcare education. Beyond the issue of recognition, a lack of standardized training presents another significant challenge. Variability in preparation methods can lead to inconsistencies in SP performance and the quality of feedback delivered to learners. Establishing comprehensive training protocols would help ensure uniformity and reliability in simulations, ultimately enhancing educational outcomes. Additionally, the emotional and psychological demands of portraying patients—particularly those with complex or distressing conditions—should not be overlooked. Without appropriate support mechanisms, SPs may experience undue stress or emotional fatigue, which can impact their performance and overall well-being. To address these challenges, institutions must adopt a structured and intentional approach to integrating SPs into healthcare education. First, formal recognition through clearly defined roles and professional titles will help solidify their status as key members of the educational team. Second, the development of standardized training programs will promote consistency and improve the overall quality of simulated encounters. Third, providing emotional and psychological support—such as debriefing sessions, peer support networks, and access to counseling—will help safeguard the well-being of SPs, enabling them to perform their roles effectively. Finally, fostering collaboration by involving SPs in curriculum development and feedback processes will further enhance the educational experience for both learners and educators. Simulated participants are invaluable to the advancement of healthcare training. Their contributions extend beyond simple role-playing; they serve as educators, evaluators, and facilitators of critical learning experiences. Recognizing and supporting SPs is not merely an ethical imperative but a necessary step toward ensuring high-quality, patient-centered medical education. As healthcare training continues to evolve, institutions must prioritize the inclusion and professionalization of SPs, ensuring they receive the respect and resources necessary to excel in their roles.

Lead Author: Adam Kronish, MD
Submitted by: Amy Lorion, NBOME

Kronish, et al. note that, because of an increase in hospitalizations for mental illness, children and adolescents in need of psychiatric care are increasingly being admitted into general pediatric wards until beds in psychiatric wards are available, creating a need for staff outside of psychiatric wards to be trained in how to respond to “escalations due to dysregulated behavior.” Accordingly, they designed a study to train residents in how to deal with an adolescent patient who becomes “acutely agitated with aggressive behaviors.” They opted for “a standardized patient (SP) case as the teaching method to immerse the learner and evoke authentic emotional and physical reactions to this difficult scenario.” Based on results from 22 residents, the authors found that they had “effectively evaluated learner self-efficacy, with residents expressing an aggregate increase in confidence in their own knowledge and abilities.”

Lead Author: Violeth E. Singano
Submitted by: Amy Lorion, NBOME

This article describes a study in Tanzania comparing two approaches to teaching nursing students to perform a mental status evaluation (MSE): one where lecture is paired with practice performing the MSE with patients in a general medical ward who do not have symptoms of mental illness (control group) and one where the lecture is instead paired with performing the MSE with SPs trained to portray mental health symptoms (intervention group). The study involved 311 students from nursing schools across two regions of the country, with 202 students in the control group and 109 in the intervention group. The intervention group demonstrated “a significantly higher level of cognition regarding Mental Status Evaluation (MSE) when compared to the control group” plus “a 25% increase in confidence and cognition about mental health compared to traditional instructional hours.”

Lead Author: Banafsheh Ghorbani
Submitted by: Amy Lorion, NBOME

This article is a striking reminder of cultural differences surrounding SP work as well as the need to engage with SPs about their experiences and their perceptions of their role. Ghorbani et al. interviewed 15 SPs in Tehran, Iran, on their experiences “as SPs in the student education process.” The interviews were semi-structured and each lasted 60-90 minutes. The authors found two themes, with three subthemes each, including the subthemes of “guilty conscience” and “fear of judgment by others” in the “duality of feeling” theme. Among the SPs, they found there was “a prevailing feeling of guilt because participants received payment for their involvement in the educational process. They believed that as educators, they should contribute without monetary compensation. …participants shared concerns about the perception others might have if they found out about receiving payment. They feared being seen as financially needy or from a lower social class, leading to a diminished sense of worth. Consequently, they preferred to keep their involvement and compensation a secret. The worry about how students perceived them consistently occupied their thoughts.”

By: Kimberly A. Conway and Robert L. Scoloveno
Submitted by: Renee Wadsworth, Simclusive