Simulated Patient Program

The benefits for the use of simulated patients from an organisational perspective includes the ease of timetabling, repetition of the scenario, equity for student learning, and the ability to provide training in specialised and sensitive areas before the students are in a real life situation.

Insightful learning

The ability to gain insight into one's own performance after an event by personal reflection is an important part of learning. Similarly, receiving timely and appropriate feedback enhances and improves the learning experience. SPs are trained to encourage the students to use reflection and also to provide feedback from the patient perspective - a unique benefit from the SP Program that cannot be replicated in the clinical environment.

Safe patient practice

Simulated patients provide an authentic safe learning environment without harming real patients - this includes the importance of clear explanations to gain informed consent; instructions to patients on preparing for clinical examinations and tests; respectful care with patient handling; the safe use of equipment, and the demonstration of infection control in clinical practice. Their use has been shown to be acceptable to learners with studies demonstrating that practicing clinicians are unable to distinguish between real and well-trained simulated patient.

Specific scenarios

In all sessions, whether for the purposes of learning or assessment, using Simulated Patients allows specific scenarios and conditions to be presented realistically.

Clinical scenarios can be written and portrayed to suit the educational purpose. A scenario can, for example be tailored to the level expected of students, with more complex cases later in the course. Similarly, scenarios can be scripted to focus on specific skills, or with specific conditions in mind.

Some issues are rarely dealt with by students with real patients because of their sensitive or challenging nature e.g. breaking bad news, intimate clinical examinations. For students to complete their training with no experience in these areas implies that they will meet these situations with no training nor supervision - an unacceptable situation in the 21st century. Simulated Patients are an excellent way of giving students experience in dealing with such issues, in an environment that is safe for both student and patient.

UQ's four-year medical degree incorporates the use of Simulated Patients (SPs) for clinical scenarios designed to develop or assess student medical interviewing skills and some clinical examination techniques.

Teaching tasks

In medical teaching sessions, Simulated Patients portray a specific patient case working with a small group of students or an individual student, with or without a tutor. This approach allows students to develop their reasoning and communication skills in a realistic, safe environment.

An important role for SPs is to ask the students to reflect on their performance and then provide feedback from the patient perspective (not on the medical content) - this is a unique situation and provides for the student an important learning opportunity that will not occur with real patients!

Assessment tasks

Simulated Patients are regularly required for medical students' Objective Structured Clinical Examinations (OSCEs), which are held during the year. These examinations are designed to assess students' communication and interpersonal skills as well as their diagnostic abilities through effective interviewing and/or examining of the Simulated Patient. To enable a fair and objective assessment of each student's skills, Simulated Patients need to play the patient role consistently and are therefore required to attend intensive training prior to OSCEs.

Health sciences education

Within the Faculty of Medicine, in Clinical Schools or community settings the SP Program can provide SPs for similar teaching and assessment tasks as described above. Sometimes these also involve portrayal of a physical problem e.g. for the physiotherapy program. Other activities may include working in a group activity or with equipment e.g. portrayal of a patient who is undergoing an intravenous cannulation or catheterisation (the invasive component on a synthetic model!).

Other organisations

Simulated Patients are also available to be utilised by other faculties within the university. This may include postgraduate teaching and assessment for postgraduate doctors, nurses, and other professional groups.

Simulated Patients are also often required for research projects that measure the effectiveness of educational interventions.

Most simulated patients perform role plays - telling a patient story - for the students to practice their clinical skills. However, there are other specialised groups of SPs trained and organised through the SP Program:

1. Physical examination: medical students need to learn and be examined on a range of physical examinations e.g. examining the chest
2. SPs and the therapies: Physiotherapy, speech therapy and occupational therapy use SPs to train students in these important areas

There are no particular qualifications to become an SP. We require people from all walks of life, across the adult age ranges and from all ethnic and cultural backgrounds. The work provides intermittent casual employment. Men and women who work in this area find the work rewarding, gain knowledge, and improve their own self-esteem and confidence. The SPs form a supportive group of colleagues whose commitment is to improve student inter-personal communication and other skills for better long-term outcomes for patients or clients.

Application to become a simulated patient involves completion of an online form questionnaire, and interview. This gives both the program and you an opportunity to see if you are suited or like this type of work. During your work you will be given feedback on your performance. At any time you may choose to leave the SP program; similarly, we may ask you to leave the program if it is perceived that you are not suited to the work.

Simulated Patients receive training for each role they portray. For experienced SPs or small role plays, the training may be held half an hour prior to the assignment.

For assessment activities, however, the training is more intensive. Playing the patient role consistently is extremely important for any examination, which are designed to be a fair and objective assessment of each student's skills. To ensure a standard patient performance across Simulated Patients, case scripts and role training are provided one week prior to each examination and attendance at examination training sessions is compulsory. This training is usually between one and two hours long.

Working conditions

In order to be paid for your work as a Simulated Patient, you will need to become a casual employee of The University of Queensland. The Human Resources (HR) information that you need to complete to become an employee is contained in the information pack sent to you when you join the program. The HR process commences once you accept an assignment.

Simulated Patients are paid to attend training sessions, as well as for their work in simulated patient sessions/examinations. It is a minimum of two hours training and a minimum of three hours work.

It is important to remember that, every time you work for the simulated patient program, you need to complete a casual timesheet at the venue where the assignment is carried out. Completed timesheets should be submitted to the SP coordinator. It is your responsibility to submit a pay claim after the completion of work.

Confidentiality, punctuality and reliability

We require Simulated Patients to attend all activities they have committed to and to be punctual. This is particularly so for student examinations, as one late arrival or non-attendance can hold up the entire examination and have serious consequences for students.

It is also essential that you maintain confidentiality, and that you do not:

• Discuss scripts, scenarios or patient cases in a public place
• Discuss scripts, scenarios or patient cases with others apart from those in the Program
• Leave written materials in an area where they may be seen or taken
• Discuss any particular student, examiner or other SP outside the program

Doing so may jeopardise examinations and lead to an unfair advantage for some students. All Simulated Patients are asked to sign a confidentiality agreement to say that they understand and will abide by these conditions.

Similarly, we ask both you and the students to respect each other's privacy; this includes -

• Keeping a student performance confidential
• Not sharing personal information with a student
• Not asking a student for personal information about themselves
• Acknowledging each other simply as student and teacher outside the teaching/assessment environment without particular details

Feedback / Debrief

After an examination session a feedback form is provided to allow you comment to on aspects such as the Patient Case, the preparation for the role, and examiner behaviour. Likewise, the examiners fill in a feedback form on the performance of the Simulated Patient with whom they work in the examination.

This feedback guides us in the support we can offer Simulated Patients, how to improve Patient Cases and any other concerns.

At the end of an assessment session the SPs meet the coordinator to de-brief. This involves discussing the session, any concerns, and most importantly taking time to "come out of role" - essential when the role play was particularly emotional.

Occasionally you will have had an upsetting or emotional event that may be remembered with a particular role that you are asked to play. Make this known to the coordinator who will be able to assist, change the role if required, or offer you a de-briefing session. Your welfare is important to the program.

The Simulated Patient Program (SPP) accepts applications at any time.

For more information, contact:

Simulated Patient Program Coordinator
Phone: 07 3163 3660
Email: spp@uq.edu.au

The Simulated Patient Program is a vital part of medical education at UQ. Specially trained community members are paid to attend training sessions and simulated patient activities to offer our students a unique "patient" perspective to learning.

We invite educators and organisations within UQ to make use of our experienced Simulated Patients. To request simulated patients and for a quote on costs contact:

Simulated Patient Program Coordinator
Phone: 07 3163 3660
Email: spp@uq.edu.au