Use of Standardized Patient In Nursing Education

Standardized Patient In Nursing Education

What Is Meant by Standardized Patient,Use of Simulators In Nursing Educational Institutes,Utilization of Standardized Patient In Nursing Education,Associated Standardized Programs In Nursing Education.

What Is Meant by Standardized Patient

    Inception of the standardized patient was introduced by Dr. Howard Barrows in 1963. Originally called a programmed patient and then a simulated patient, the name was later changed to underline the major advantage and strongest feature of this type of simulation to provide a standardized patient problem that will not vary in presentation from student to student. 

    According to Barrows (1993), the term standardized patient is “the umbrella term for both a simulated patient (a well person trained to simulate a patient's illness in a standardized way) and an actual patient (who is trained to present his or her own illness in a way standardized)” (p. 443), The Association of Standardized Patient Educators (2013) calls a standardized patient an individual who portraying the role of a patient, is trained to consistently teach, assess, and evaluate students in physical presentation and health history.

Use of Simulators In Nursing Educational Institutes

    The use of simulation in nursing education has increased over the last decade. Decreased clinical sites, concerns for patient safety, rapid and constant technological innovations, and the push for inter-professional education are necessitating the need for more use of simulation in nursing education. Standardized patients play an important role in simulation. Standardized patients provide students in academia with additional training outside a textbook by putting them face to face with patients who can provide the physical, psychological, and emotional aspects of clinical practice.

    Standardized patients allow the instructor control of the teaching methodology and environment (Barrows, 1993; Cantrell & Deloney, 2007) Standardized patients can be present when real patients are not, and they can be brought into environments (classrooms, for example) when and where it is not feasible or practical to have a real patient. Faculty can control the learning objectives and integrate psycho-social issues into the case scenarios with standardized patients. Furthermore, cases or portrayals can be homogeneous and accurately reproduced for other students so that all students are exposed to the same case study. 

    The use of standardized patients can alleviate problems associated with evaluation. As opposed to preceptor input and instructor observation, which can incur unreliability and hiatus (Ebbert & Connors, 2004), standardized patients allow for careful evaluation of the student's clinical ability, inter student comparison, and teaching methodology (Barrows, 1968). Because standardized patients can provide a reliable means for teaching and evaluating, they are often used to provide an outcome measure of students' clinical competence, to access faculty effectiveness in teaching, and to assess clinical decision making. The reliability of standardized patient evaluations of student performance has been shown to be moderate to substantial when compared to a second rater team trained in the same manner (Bolstad, Xu, Shen, Covelli, & Torpey, 2012)

Utilization of Standardized Patient In Nursing Education

    The use of standardized patients to teach communication skills is frequently reported in the literature. Students and instructors can talk about the disease process without fear of upsetting a real patient, and learners can receive immediate and constructive feedback. Conversations that students may rarely encounter in academic clinical practice, such as end-of-life discussions and communicating bad news, can be practiced in a safe, non threatening environment. Communication skills are enhanced by the use of standardized patients. Recent studies have shown that, when compared to alternate teaching methods for teaching communication skills, students preferred training that included standardized patients (Lagan et al., 2012). 

    In addition, communication skills were significantly superior (p <.0001) when standardized patients were used (Schlegel, Woermann, Shaha, Rethans, & Vander Vleuten, 2011), and knowledge and self-efficacy increased with students trained with standardized patients.The use of standardized patients to teach health examination skills has been found to be an effective educational technique (Grice, Wenger, Brooks, & Berry, 2013). Students can practice physical assessment skills in a safe environment without the concern of touching, hurting, or inconveniencing a patient. 

    Furthermore, the student does not aggravate the patient's disease Physical examination skills can be practiced over and over until the student and/or instructor are satisfied that the technique is correct (Barrows, 1968, 1993; Cantrell & Deloney, 2007). The use of standardized patients in health assessment can alleviate problems related to unreliable feedback and inconsistent physical presentations, which are often encountered when students use peers to hone examination skills in the laboratory setting Feedback can come not. only from the instructor but from the standardized patient as well, who many times has been trained to give valid and reliable feedback to students (Van Zanten, Boulet, & McKinley, 2007).

    Providing nursing students with practical experiences related to psycho-social and mental health illnesses can be challenging to nursing educators due to shortened clinical time and a lack of experienced psychiatric faculty (Hermanns, Lilly, & Crawley, 2011). Simulations that incorporate standardized patients are able to not only provide students with educational experiences involving these patient encounters and diagnoses but also the opportunity to practice therapeutic communication skills that are essential in psychiatric and mental health nursing (Lang & Hahn, 2013). 

    In recent studies, standardized patients have allowed students the opportunity to screen for adolescent depression and suicide (Fallucco, Conlon, Gale, Constantino, & Glowinski, 2012) as well as alcohol and substance abuse (Satterfield et al. 2012). Authors in both studies reported that knowledge and confidence increased for students who participated in the simulations.

Associated Standardized Programs In Nursing Education

    Many standardized patient programs are associated with schools of medicine, limiting the access some schools of nursing have to this type of simulation. Additionally, the cost of recruiting, training, and managing a pool of standardized patients excludes some nursing education programs from enjoying the benefits of standardized patients. While the feedback standardized by patients provided to students has been shown to be beneficial to learning, there is no standardized approach for how to train standardized patients to give effective feedback to students nor are there established guidelines for providing feedback to standardized patients (Bokken, Linssen , Scherpbier, van der Vleuten, & Rethans, 2009). To strengthen the benefits that standardized patients bring to simulation, future development in these areas is recommended in nursing education.