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.

Lovink et al. are interested in the learning that occurs when SPs give students implicit feedback during SP encounters—not through debriefs after the encounter, but through their immediate, personal reactions as the encounters enfold. “Personal” is key: the authors are specifically looking at the SPs’ reactions—what they term SPs’ “authentic” reactions—not those that have been scripted into a case. According to the authors, this “implicit feedback-in-action” leads to “reflection-in-action,” which they argue is an important part of student learning, albeit one that requires a relaxation of standardization. As they wrote in the 2021 article: “It is possible that with ‘overtraining’ and standardization of our SPs, we unknowingly and with the best intentions withhold meaningful learning experiences from our students.” Although some activities require more standardization than others, they argue for “defining the minimal level of standardization” in an activity in order to allow “more freedom for the SP to react in an authentic way” (2024).

Although the authors draw a similar conclusion in both articles, the way they get there is different. Both are based on 15 semi-structured interviews at a single institution, but in the 2021 article they interviewed students to investigate “how does the SP contribute to meaningful learning of the student during a specific SP-student encounter, from a student perspective” while in the 2024 article, they interviewed SPs to investigate “what is the perspective of simulated patients on their contribution to meaningful student learning during SP-student interaction.” The articles explore the cohorts’ perspectives in depth, with both sets of interviews persuading the authors that, although standardization has its place, meaningful learning happens when SPs are allowed to be themselves as well as their roles.

Read the full articles in Perspectives on Medical Education here, and Advances in Simulation here.

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