Tips from BESD: Keeping it real: Standardized patients bring training to a whole new level

Staff Development Weekly: Insight on Evidence-Based Practice in Education, September 3, 2010

by Mary E. Holtschneider, RN-BC, BSN, MPA, NREMT-P

Are you a staff development educator who uses simulation techniques? Do you sometimes wonder how you might add more depth and breadth to such simulations? Or are you still new to the world of simulation and just want to see what's out there? In both cases, consider the use of standardized patients (SP), who are trained medical actors.

In a staff development setting, SPs can be effective as confederates, or disrupters, in scenarios. SPs can portray a disruptive family member of an ICU patient or a rude clinician who barks incorrect orders at team members. Learners must attempt to deal with the disrupter, which could be an integral part of the scenario. Since an SP is a human being and can react with complex human emotions, this method of simulation can greatly enhance realism and make it easier for learners to suspend disbelief.

An easy way to start using SPs is to integrate them into advanced cardiac life support (ACLS) or pediatric advanced life support (PALS) scenarios as disruptive family members or overbearing physicians during a mega-code situation. For example, with a mega-code in ACLS training, consider using an SP to role-play a physician who orders the team members to do inappropriate things, such as give the wrong drug or wrong dose, defibrillate at the incorrect amount of joules, etc. This reinforces to the learners that they not only need to know the ACLS algorithms, but also must use assertive communication skills.

Editor's note: Subscribers to Briefings on Evidence-Based Staff Development can read the rest of this article in the September 2010 issue. Discover all the benefits of subscribing to Briefings on Evidence-Based Staff Development.

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