title: The Benefits and Risks of Being a Standardized Patient: A Narrative Review of the Literature.
abstract: Standardized patients (SPs) are a widely used, valid, and reliable means of teaching and evaluating healthcare providers (HCPs) across all levels of training and across multiple domains of both clinical and communication skills. Most research on SP programs focuses on outcomes pertinent to the learners (i.e., HCPs) rather than how this experience affects the SPs themselves. This review seeks to summarize the current literature on the risks and benefits of being an SP. We reviewed the literature on the effects that simulation has on adults, children/adolescents, and medical professionals who serve as SPs, in addition to real patients (RPs) who are involved in teaching by sharing their medical histories and experiences. To collect the literature, we conducted two separate systematic searches: one for SPs and one for RPs. Following the searches, we applied standardized eligibility criteria to narrow the literature down to articles within the scope of this review. A total of 67 studies were included that focused on the outcomes of SPs or RPs. The benefits for those portraying SP roles include improved health knowledge and attitudes, relationships with their HCPs, and changed health behaviors. Negative effects of being an SP include anxiety, exhaustion/fatigue, and physical discomfort immediately following a simulation, but the literature to date appears to indicate that there are no long-lasting effects. These findings are consistent across age groups and the type of role being simulated. They are also supported by studies of RPs who are involved in medical education. Overall, the benefits of being an SP appear to outweigh the known risks. However, there are significant limitations in the current literature, and additional studies are needed to better characterize the SP experience.
authors.affiliation: Program on Medical Education Innovation and Research, Department of Medicine, New York University School of Medicine, 550 First Avenue, BCD D401, New York, NY, 10016, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Plaksin
authors.affiliation: Department of Medical Library, New York University Langone Medical Center, New York, NY, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Nicholson
authors.affiliation: Program on Medical Education Innovation and Research, Department of Medicine, New York University School of Medicine, 550 First Avenue, BCD D401, New York, NY, 10016, USA.
authors.forename: Sarita
authors.initials: S
authors.lastname: Kundrod
authors.affiliation: Program on Medical Education Innovation and Research, Department of Medicine, New York University School of Medicine, 550 First Avenue, BCD D401, New York, NY, 10016, USA.
authors.forename: Sondra
authors.initials: S
authors.lastname: Zabar
authors.affiliation: Program on Medical Education Innovation and Research, Department of Medicine, New York University School of Medicine, 550 First Avenue, BCD D401, New York, NY, 10016, USA.
authors.forename: Adina
authors.initials: A
authors.lastname: Kalet
authors.affiliation: Program on Medical Education Innovation and Research, Department of Medicine, New York University School of Medicine, 550 First Avenue, BCD D401, New York, NY, 10016, USA. lisa.altshuler@nyumc.org.
authors.forename: Lisa
authors.initials: L
authors.lastname: Altshuler
mesh_terms: D002983:Clinical Competence; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000193:education*; D006801:Humans; D016544:Patient Simulation; D011369:Professional-Patient Relations