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The Evolution from Standardized to Virtual Patients in Medical Education

Lead Author: [Allan Hamilton
Submitted by: Amy Lorion, NBOME
 
Reading the title and abstract, I expected an article looking at the growing, post-COVID trend to virtual patients. This article provides that perspective, addressing limitations of SPs—especially budgetary—and the benefits (and limits) of recent advances in virtual options. However, the bulk of the article is dedicated to both exploring the extent of those virtual options and providing a brief history of virtual patients (VPs), starting from their beginnings in the late 90s. Hamilton et al. describe the capabilities of VPs as they evolved from the earliest “problem-solving” type to the later “narrative” or “systematic” type, comparing the relative strengths at each stage. The article is worth reading by those interested in the SP vs. VP debate, but I would also—and more strongly—recommend it for anyone interested in the evolution of computerized patients over the past 30 years.
Read the full article in Cureus here.
 
Communications and Connections Committee Mission: “To bring high-quality reporting of current research, trends, techniques and information regarding SP methodology and other relevant industry articles to the attention of the membership through the web-based ASPE eNews blog.” 
  
Please provide comments, questions or suggestions about the ASPE eNews Blog here.
 

Crystal Washington Inspires at IMSH 2025 with the Lou Oberndorf Lecture

IMSH 2025 Plenary Speaker: Crystal Washington
By: Samantha Syms, MS, CHSE, Gordon Center, University of Miami Miller School of Medicine

At IMSH 2025, the Plenary Session featured the dynamic Crystal Washington delivering the Lou Oberndorf Lecture on Innovation and Healthcare Simulation. A certified futurist, Hall of Fame speaker, and technology strategist, Crystal captivated the audience with her empowering vision for “future-proofing” in a rapidly evolving world.
 
Crystal’s engaging session combined humor, relatable analogies, and powerful insights to challenge attendees to own their future. She reminded us, “No one is coming to save you; we need to put on our own capes.” From exploring how humans are “stressed-out cyborgs” to guiding the audience through thought-provoking games like “Which is safer: a human baby or an axolotl?” she illustrated the challenges of change and the resilience required to overcome them.
 
She urged attendees to manage their responses to change with empathy—for others and themselves—acknowledging that “it’s a hard time to be human.” Her message emphasized the importance of curiosity, adaptability, and staying calm in the face of uncertainty. The simulation field, she noted, has demonstrated remarkable agility over the past 25 years and is poised for even greater innovation ahead.
 
As Crystal eloquently put it, “We must reach out, grab the future, and bring it closer to us—because resting on our laurels is not an option.” Her lecture left the audience inspired to embrace change, stay curious, and shape the future of healthcare simulation with intention and passion.
Learn more about Crystal Washington by visiting her website here: [https://crystalwashington.com]
  
Communications and Connections Committee Mission: “To bring high quality reporting of current research, trends, techniques and information regarding SP methodology and other relevant industry articles to the attention of the membership through the web-based ASPE eNews blog.” 
 
Please provide comments, questions or suggestions about the ASPE eNews Blog here.

[Dissertation]: Cultural Humility Training with a Simulated Therapy Client: A Qualitative Case Study By: Justine Piontek

By: Justine Piontek
Submitted by: Renee Wadsworth, Simclusive
 
A qualitative case study explored how simulation-based training with a marginalized simulated therapy client impacted counseling psychology doctoral trainees' cultural humility. Findings revealed that learners of color emphasized interpersonal skills like decentering oneself, while White learners focused on intrapersonal growth, such as recognizing power and privilege. Participants valued the safe, in vivo experience, which enhanced their cultural awareness and preparedness for diverse clinical contexts. Discover how these insights can refine SP methodologies and contribute to the development of culturally humble mental health professionals.
 
Read the full dissertation in ProQuest here.
 
Communications and Connections Committee Mission: “To bring high-quality reporting of current research, trends, techniques and information regarding SP methodology and other relevant industry articles to the attention of the membership through the web-based ASPE eNews blog.”
 
Please provide comments, questions or suggestions about the ASPE eNews Blog here.
 

[Dissertation]: Training GPT as a Standardized Patient

By: Mercedes Lorena Pedrajas López, Ana Sanz Cortés, Eva García Carpintero-Blas, Esther Martínez Miguel, Sara Uceda Gutiérrez
Submitted by: Renee Wadsworth, Simclusive
 
A recent exploration into using GPT-4 as a standardized patient (SP) highlights the transformative potential of AI in simulation-based education. This approach allows for scalable, realistic interactions that adapt to diverse clinical scenarios, enriching student training without the logistical constraints of human actors. By establishing detailed patient identities and incorporating AI into curricular design, educators can provide tailored learning experiences that enhance diagnostic, communication, and decision-making skills. Discover how AI can complement traditional SP methodologies, offering innovative tools to prepare students for complex healthcare environments​.
 
Read the full article in Artificial Intelligence and Education here.
 
Communications and Connections Committee Mission: “To bring high-quality reporting of current research, trends, techniques and information regarding SP methodology and other relevant industry articles to the attention of the membership through the web-based ASPE eNews blog.”
  
Please provide comments, questions or suggestions about the ASPE eNews Blog here

The Use of Standardized Patients as an Educational Strategy in Baccalaureate Psychiatric Nursing Simulation: A Mixed Method Pilot Study

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

A pilot study in a psychiatric nursing course replaced student role-play with standardized patients, and more than 80% of participants reported increased learning, confidence, and satisfaction. This shift in methodology also enabled effective simulation of complex behaviors, including auditory hallucinations and non-verbal depression. The innovative approach helped senior nursing students meet course objectives and enhanced preparation for clinical settings. Discover how these measurable outcomes can inform best practices for SP educators seeking to advance simulation experiences in psychiatric nursing.
 
Read the full article in the Journal of the American Psychiatric Nurses Association here.
 
Communications and Connections Committee Mission: “To bring high-quality reporting of current research, trends, techniques and information regarding SP methodology and other relevant industry articles to the attention of the membership through the web-based ASPE eNews blog.”
 
Please provide comments, questions or suggestions about the ASPE eNews Blog here.
 

Incorporating Real-time Simulated Patient and Instructor Feedback to Enhance Simulation Learning Experience for Occupational Therapy Students: A Mixed Methods Study

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

This study aimed to examine how occupational therapy (OT) students incorporate real-time Simulated Patient (SP) feedback, numerical feedback (i.e. scores), and instructor-written feedback to enhance their learning from the simulation experience. This mixed methods study collected learner assessment numerical data and qualitative data (SP feedback and instructor written feedback) in first-year OT students’ simulation learning sessions. The students answered six debrief questions reflecting on the simulation process, explaining how they plan to incorporate the feedback in future OT practice. Quantitative results of student performance data were reported. Seven themes emerged from the thematic analysis of the debrief reflections. These themes provided information on students’ perceptions of the experience and illustrated how they plan to use the feedback. The findings of this study provide instructors strategies that can be used to enhance student learning when designing simulations. This study found that numerical and written feedback from the instructor was more meaningful when combined with real-time SP feedback.

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Psychiatrists' Perceptions of and Reactions to a Simulated Psychiatric Genetic Counseling Session


Lead Author: Katharine Cardiff
Submitted by: Amy Lorion, NBOME

According to Cardiff et al., “Psychiatric genetic counseling (pGC) has been demonstrated to have meaningful positive outcomes for people with psychiatric conditions and their families. However, it is not widely accessed, and clinical genetics services tend to receive few referrals for these indications.” To gain insight into how to breach this gap, the authors undertook a study “to understand the perceptions of and reactions to a simulated pGC session among psychiatrists.” The study involved recording a 65-minute simulated pGC session with an SP.

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Reflecting on My Scholarship to Attend the ASPE Conference in Vancouver

By: Erin Walsh, Standardized Patient Educator, Rosalind Franklin University of Medicine and Science, North Chicago, IL

Receiving a scholarship to attend the 2024 ASPE conference in Vancouver, BC, Canada, was a profound honor. The theme of this year's conference, “Inspiring growth, motivating change, and creating opportunities,” resonates with me during this time of intense change in politics, education, and training. This last year was challenging professionally when my mentor, Barbara Eulenberg, retired. ASPE helped me shift my focus from looking at these major changes in the negative to reframing them as opportunities for growth and change.

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ASPE 2024 Scavenger Hunt

By Amy Rush and Samantha Syms

The ASPE Communications and Connections Committee took its name seriously when planning for the 2024 ASPE conference in Vancouver, B.C. To facilitate connections, create some fun activities and make memories, it was decided that a conference-wide scavenger hunt was in order. Committee members Renee Wadsworth, Amanda Fernandez-Acosta, Amy Rush and Samantha Syms designed the hunt and the ASPE board backed the endeavor. The scavenger hunt, open to all conference attendees, but completely voluntary, was facilitated using the Whova conference app, with which the committee communicated with attendees via the community message board.

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ASPE 2024 Awards Ceremony


By: Mary Launder

The depth of extraordinary work and contributions given to the ASPE Community is highlighted through the annual awards presented to those outstanding members who serve the ASPE community. Eligible ASPE members are nominated by colleagues and coworkers and the nomination committees hold a standard fair and inclusive process. This 2024 awards ceremony was held in person in Vancouver, British Columbia, Canada on June 26th, 2024.

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ASPE 2024 Conference Opening Plenary


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

The Opening Plenary of the 2024 ASPE Conference in Vancouver started with a splash. Or should I say song? There was no PowerPoint. There was no one standing on the big stage with screens behind them. Instead, we were treated to Petula Clark’s “Downtown” and a dancing Janece Shaffer, along with two ASPE members who have some skilled dance moves. Of course we sang along.

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2024 Conference President and Past President Address Highlights Our Unique Backgrounds, Announces Groundbreaking Accreditation Program


By: Amy Rush, Center for Healthcare Improvement and Patient Simulation at University of Tennessee Health Science Center

Our thirteenth ASPE president Dr. Lou Clark gave the ASPE president address during the opening session of the 2024 ASPE Conference in Vancouver, B.C. on Sunday, June 23. She began by acknowledging the work Jen Owens did as conference chair, not only for this ASPE conference, but for the past four years. She read a message on behalf of the current conference committee, thanking Owens for her, “exceptional service as the ASPE conference chair.” Clark then gave a talk called, “Our Story.” She highlighted ASPE’s mission and its members. We currently have 918 members from 44 countries and 65 are Canadian members! She recognized the 16 ASPE Board of Directors.

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Challenges facing standardised patients representing equity-deserving groups: Insights from health care educators

Journal Article: Challenges facing standardised patients representing equity-deserving groups: Insights from health care educators

By: Matt Sibbald et al

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The Contribution of Simulated Patients to Meaningful Student Learning

Article 1: The Contribution of Simulated Patients to Meaningful Student Learning
Article 2: How Simulated Patients Contribute to Student Learning in an Authentic Way, an Interview Study
Lead Author: Annelies Lovink
Submitted by: Amy Lorion, NBOME

Annelies Lovink et al. published two articles looking at the same phenomenon from two perspectives: that of the student and that of the SP. The articles stand on their own but can also be read in conversation with one another.


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LGBTQ+ Microaggressions in Health Care

LGBTQ+ Microaggressions in Health Care: Piloting an Observation Framework in a Standardized Patient Assessment
Lead Author: Hallie Decker
Submitted by: Kerensa Peterson, UCR School of Medicine

“Microaggressions are subtle derogatory behaviors that unintentionally communicate hostility toward marginalized social groups. This article describes the preliminary validation of a framework for observing LGBTQ+ microaggressions in healthcare, which can lead to distrust and disengagement from the healthcare system. Coders used the framework to observe microaggressions in video-recorded clinical-skills assessments with medical students who elicited health histories from standardized patients.

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2024 ASPE Annual Conference Scholarship Inaugural Recipients

2024 ASPE Annual Conference Scholarship Inaugural Recipients
By: Amber Snyder, Vice President for Finance

Each year, we get requests for scholarships to attend ASPE and we didn’t have a funding source for these opportunities. At the ASPE conference in Portland in 2023, we stretched our imaginations on how we could bring more member benefits and launched the ASPE Fund. The goal of the ASPE fund was to provide an income stream for grassroot donations to build a fund to allow us to continue to bring existing membership benefits to you all, but also expand our international reach, our SP community, and Equity, Diversity, and Inclusion efforts.

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Simulating Inclusive Dialogues

Simulating Inclusive Dialogues: Encouraging Faculty-led Conversations Surrounding Bias and Microaggression
Lead Author: Vikasni Mohan, et al.
Submitted by: Amanda Fernandez-Acosta, University of Miami

Within the University of Miami, medical students and residents noted a lack of dialogue surrounding bias and microaggressions, and uncertainty on how to handle these types of situations. To assist, the authors designed a course for faculty to better understand the harmful impact of bias/microaggressions and provide them with the proper tools to engage in meaningful dialogue surrounding the subject. The authors adapted the PAAIL framework and added the Bridge-the-Gap component to better support conversations surrounding bias/microaggressions in healthcare education. The course followed self-selected participants who indicated first-hand personal experiences with bias and microaggressions and offered clinical faculty a framework to intervene in such cases. Next steps include evaluating whether practicing these difficult conversations promotes psychological safety among faculty and normalizing these conversations to foster inclusivity and engagement among faculty, staff and learners.

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Student empathy in standardized patient experiences

Student empathy in standardized patient experiences: Applying concepts from a critical thinking emulation model
Lead Author: Lance Brendan Young PhD, MBA
Submitted by: Amy Lorion, NBOME

According to Young et al., research has shown that dental students’ empathy for patients declines over the course of their education and this “empathy-reducing influence of training” can have a real and negative impact on the students’ future patients. In order to address this concern, the authors aspired to “(1) Develop a learning guide for observable behaviors communicating emotional and cognitive empathy and (2) determine whether the learning guide can be used as a rubric for assessing empathy in a standardized patient experience.” The authors created a learning guide/evaluation rubric using an emulation model that focused on, “the communication of empathy,” a guide that SPs then used to score student performance in simulated encounters. According to the authors, the study’s results show that their model, “is viable as both a learning guide and evaluation rubric in a standardized patient format.”

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Standardized Patients in Medical Education: A Review of the Literature

Standardized Patients in Medical Education: A Review of the Literature
Authors: Flanagan O L, Cummings K M
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

The research questions posed for this review were as follows: do medical students in their first two years of education who have practiced skills using SPs have more self-confidence in their ability to perform skills on real patients than those students who did not use SPs? Do medical students in their third and fourth years of medical school have higher clinical competency with sensitive patient examinations after using SPs in their first two years of medical education than those students who did not use SPs? And finally, do medical students who have used SPs for discussing sensitive issues have better interpersonal skills when they encounter real patients in the clinical setting than those who have not used SPs? I’m going to take a leap and say yes.

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Using Simulation-Based Learning with Standardized Patients (SP) in an Implicit Bias Mitigation Clinician Training Program

Using Simulation-Based Learning with Standardized Patients (SP) in an Implicit Bias Mitigation Clinician Training Program
By: Jennifer Tjia et al
Submitted by: Marsha Harman, Rush Center for Clinical Skills and Simulation

This article describes the design, implementation, and response to a simulation-based training program on implicit bias awareness and mitigation skills. Two aspects of this undertaking really stood out to me. First, the SPs were recruited from the local community and were involved in case development to ensure that the scenarios were realistic and relevant to the community's needs.  Second, the program creators revised the structure of the program based on participant responses to create a more safe environment and a more robust learning experience.

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