title: Simulated patients versus manikins in acute-care scenarios.
abstract: BACKGROUND
  Manikins and simulated patients (SPs) are commonly used in health care education and assessment. SPs appear to offer a more realistic experience for learners than 'plastic' manikins, and might be expected to engender interactions that approximate real clinical practice more closely. The analyses of linguistic patterns and touch are methodologies that could be used to explore this hypothesis. Our research aims were: (1) to compare verbal interactions and the use of procedural touch by health care workers (HCWs) in scenarios with SPs and with manikins; and (2) to evaluate the methodologies used to inform a large-scale study.
  
  
  METHODS
  We conducted a pilot preliminary comparative study on conversations and touch in two scenarios in emergency care training, each performed using an SP and a high-fidelity manikin. The setting was a simulation centre. Two scripted acute-care scenarios (chest pain and acute breathlessness) were performed using both an SP and a high-fidelity manikin. Audiovisual recordings were subsequently analysed. Two teams comprising a clinician (medical student), a senior nurse and a clinical support worker took part in the study. The linguistics research methodology integrated a multimodal corpus-based approach and discourse analysis. Simulated patients appear to offer a more realistic experience for learners than 'plastic' manikins
  
  
  RESULTS
  Overall, HCWs had far more interactions with the SPs than with the manikins, and the utterances and behaviours were more akin to what one would expect in real clinical practice. HCWs used procedural touch without the patient's permission much more frequently with the manikin.
  
  
  CONCLUSIONS
  These methodologies offer opportunities for further research projects studying interactions with SPs, manikins and real clinical practice.
authors.affiliation: Department of Research and Education in Emergency Medicine, Acute Medicine and Major Trauma, Nottingham University Hospitals NHS Trust, Nottingham, UK.
authors.forename: Frank
authors.initials: F
authors.lastname: Coffey
authors.affiliation: Foreign Language Centre, Tokai University, Hiratsuka, Kanagawa, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Tsuchiya
authors.affiliation: Centre for Health Innovation, Leadership and Learning, University of Nottingham, Nottingham University Business School, Nottingham, UK.
authors.forename: Stephen
authors.initials: S
authors.lastname: Timmons
authors.affiliation: The Trent Simulation and Clinical Skills Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK.
authors.forename: Bryn
authors.initials: B
authors.lastname: Baxendale
authors.affiliation: School of English, University of Nottingham, Nottingham, UK.
authors.forename: Svenja
authors.initials: S
authors.lastname: Adolphs
authors.affiliation: School of English, University of Nottingham, Nottingham, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Atkins
mesh_terms: D003142:Communication; D003422:Critical Care / Q000379:methods; D004635:Emergency Medicine / Q000193:education*; D005260:Female; D006801:Humans; D008297:Male; D008348:Manikins; D008875:Middle Aged; D016544:Patient Simulation; D010817:Physician-Patient Relations; D013663:Teaching