title: Defining responsibilities of simulated patients in medical education.
abstract: BACKGROUND
  Simulated patients (SPs) play a critical role in medical education. The development of SP methodology has resulted in wide ranging responsibilities. For SPs to work effectively, we believed it was important to clearly articulate their responsibilities, and that this would be best achieved by consultation with all stakeholders-SPs, students, tutors, and administrators.
  
  
  METHODS
  As part of a quality assurance initiative, we designed a questionnaire and focus group study to explore stakeholders' perceptions of the responsibilities of SPs in teaching. Convenience and purposive sampling was used to recruit participants to questionnaires and focus groups, respectively. Data were analyzed thematically.
  
  
  RESULTS
  Eighty-six questionnaires were collected, and six focus groups were conducted. Five sets of guidelines on responsibilities were produced. In addition, guidelines were established for feedback that SPs and tutors could use to maximize impact.
  
  
  CONCLUSIONS
  The results highlight the complexity of SP-based teaching. Clarification of all stakeholders' responsibilities demonstrates the importance of a team approach to SP-based teaching. Focusing attention on just one set of stakeholder's responsibilities is unlikely to improve perception of quality. The process for developing the guidelines may be valuable for those who work with SPs. Stakeholder engagement is likely to ensure greater commitment than those developed by faculty.
authors.affiliation: Imperial College, London, UK. debra.nestel@med.monash.edu.au
authors.forename: Debra
authors.initials: D
authors.lastname: Nestel
authors.forename: Susan
authors.initials: S
authors.lastname: Clark
authors.forename: Diana
authors.initials: D
authors.lastname: Tabak
authors.forename: Victoria
authors.initials: V
authors.lastname: Ashwell
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Muir
authors.forename: Paraskeva
authors.initials: P
authors.lastname: Paraskevas
authors.forename: Jenny
authors.initials: J
authors.lastname: Higham
mesh_terms: D002983:Clinical Competence; D004501:Education, Medical / Q000379:methods*; D017144:Focus Groups; D006801:Humans; D016544:Patient Simulation; D016730:Program Development; D015397:Program Evaluation; D036301:Qualitative Research; D011785:Quality Assurance, Health Care / Q000379:methods*; D011787:Quality of Health Care; D011795:Surveys and Questionnaires; D013663:Teaching