USING STANDARDIZED PATIENTS IN SPECIALTY NURSING SIMULATION SCENARIOS

Simulation as a teaching strategy has proven to be an effective tool for nursing programs to utilize in their curriculum. Scenarios are developed and usually include a manikin the students interact with and care for as a patient. For most courses this design works well, especially when the students need to put the whole picture of the patient presentation coupled with the treatment together. However some scenarios especially ones which require a high level of therapeutic conversation need an actual human who can interact accordingly. This type of “actor” is known as a standardized patient, someone who volunteers either to use their own history or act out a script written by a faculty member. By utilizing standardized patients a more realistic interactive setting can be established during community and psychiatric simulations in the nursing undergraduate curriculum as well as in the family nurse practitioner program at the graduate level. Each room creates a unique environment based on a hospital or home setting using cultural props. During the community “visit,” once the patient is discharged home the students are required to complete an initial intake assessment of the patient. During the home visit the students evaluate the home environment, complete medication reconciliation, provide follow-up teaching, and obtain any resources for the patient. Also incorporated in the scenario is a role that is played by one of the students as a neighbor and one of the students as an observer. During the psychiatric scenario the students establish a therapeutic relationship with the patient and administer care based on the patient’s diagnosis. This scenario allows the student to practice therapeutic communication with the psychiatric patient in a simulated setting. The goals for the nurse practitioners are to perform a health history and physical. Each of the scenarios is video-taped and at the completion of each of the scenarios the faculty member de-briefs the student(s) regarding their performance in the simulation.
The feedback given by the students is overwhelmingly positive when standardized patients are used. Due to the interactive nature and goals required in the setting using standardized patients allows for more realistic care.