Standardized Patients Providing Clinical Learning Opportunities for Learners across the Continuum

An integral component of the Clinical Simulation Center of Las Vegas is the standardized patient (SP) program. This program is housed in the 12 room standardized patient hall and provides both formative assessment and summative evaluation for medical students, residents and nursing students – undergraduate and graduate.

The SP program was developed by the University of Nevada School of Medicine (UNSOM) under the direction of an SP educator. This individual initially worked with the directors of the Clinical Reasoning in Medicine (CRIM) course to design and replicate a high-stakes examination for the third year medical students. This examination is given statewide twice a year at the end of the primary care semester.  After this initial success, the SP program began to participate in formative educational events. Standardized patients are used routinely as part of the learning process in CRIM. In addition, the SPs are incorporated into an informed consent exercise for the UNSOM residents and for a variety of remediation activities.

Based on the success of the SP program at the medical school, the University of Nevada – Las Vegas (UNLV) School of Nursing faculty believed that incorporating standardized patients in nursing education and evaluation would be beneficial. They worked closely with UNSOM faculty to extend their established SP program to Nurse Practitioner (NP) students. Initially, we offered an optional pilot program for 4 local NP students. This was reviewed well by faculty and participating students. Currently NP students have high-stakes examinations at the end of each clinical course. This allows faculty to evaluate students more fairly as they see the same types of patients. Once this program was established, faculty teaching UNLV BSN psychiatric course desired to use SP as part of their clinical orientation to psychiatric nursing in a formative educational experience. Cases focusing on bipolar disorder, paranoid schizophrenia, and anxiety were developed, piloted, and implemented during the first year of the program. Feedback from nursing students was overwhelmingly positive with students asking for more cases. Consequently, a post-traumatic stress disorder was developed and implemented. After these experiences in a safe environment, students feel more comfortable in psychiatric settings.

As the SP program expands, other demands for SP learning events increase. Standardized patients were used in an inter-professional activity demonstrating the challenges of dealing with geriatric patients and recently incorporated in a multiple mini interview program as part of the application process to medical school. The potential for this program is limitless however, funding constraints impose boundaries.

 Doolen, J. Giddings, M., Johnson, M., Guizado de Nathan, G., O’Badia, L. (2014). An evaluation of mental health simulation with standardized patients. International Journal of Nursing Education and Scholarship,11 (1), 1-8. 

 Mckenzie, F., Hubbard, T. W.,Ulian, J. A., Garcia, H. M., Castelino, R. J., Gliva,G.A. (2006). Medical student evaluation using augmented standardized patients: preliminary results. Studies in Health Technology and Informatics, 84(119), 379-384.