"It's Not an Acting Job Don't Underestimate What a Simulated Patient Does": A Qualitative Study Exploring the Perspectives of Simulated Patients in Health Professions Education.

INTRODUCTION: Simulated patients (SPs) are individuals who have learned to realistically portray patient roles in health professional education. Program recommendations are increasing for simulation programs, and as key stakeholders, SPs' perspectives seem underrepresented. The aim of the study was to explore the experiences, perspectives, and practices of SPs to gain insights on topics of importance to SPs and inform program recommendations. METHODS: An interpretivist research paradigm and qualitative design were adopted. Eighteen SPs participated in 2 focus groups that were audio recorded, transcribed, and deidentified. Three researchers completed inductive thematic analysis. Institutional ethical approval was obtained. RESULTS: Three themes represented the different elements of SP practice: becoming and being a SP, preparing for a SP role, and performing a SP role. Simulated patients identify as educated specialists with unique responsibilities and attributes. Simulated patients are committed to representing the perspectives of real patients, while simultaneously supporting learners and educators. Simulated patients can feel unprepared to perform a role but have innovated responsive strategies. CONCLUSIONS: Simulated patients considered 3 primary aspects to their practice and shared ways that they might be well supported. Simulated patients represent a community of practice, characterized by mutual engagement, joint enterprise, and a shared repertoire. Ongoing SP input in SP programs may benefit SPs and lead to higher-quality educational experiences for learners.

Simulation can offer a sustainable contribution to clinical education in osteopathy.

Background: Clinical education forms a substantial component of health professional education. Increased cohorts in Australian osteopathic education have led to consideration of alternatives to traditional placements to ensure adequate clinical exposure and learning opportunities. Simulated learning offers a new avenue for sustainable clinical education. The aim of the study was to explore whether directed observation of simulated scenarios, as part replacement of clinical hours, could provide an equivalent learning experience as measured by performance in an objective structured clinical examination (OSCE). Methods: The year 3 osteopathy cohort were invited to participate in replacement of 50% of their clinical placement hours with online facilitated, video-based simulation exercises (intervention). Competency was assessed by an OSCE at the end of the teaching period. Inferential statistics were used to explore any differences between the control and intervention groups as a post-test control design. Results: The funding model allowed ten learners to participate in the intervention, with sixty-six in the control group. Only one OSCE item was significantly different between groups, that being technique selection (p = 0.038, d = 0.72) in favour of the intervention group, although this may be a type 1 error. Grade point average was moderately positively correlated with the manual therapy technique station total score (r = 0.35, p < 0.01) and a trivial relationship with the treatment reasoning station total score (r = 0.17, p = 0.132). Conclusions: The current study provides support for further investigation into part replacement of clinical placements with directed observation of simulated scenarios in osteopathy.