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The Benefits and Risks of Being a Standardized Patient: A Narrative Review of the Literature

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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.

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Acknowledgments

At the time when this work was conducted, Sarita Kundrod and Lisa Altshuler were funded by grants through the Clinical Translational Science Institute H-3 (CTSI H-3) and the Association of American Medical Colleges (AAMC). The authors declare no conflicts of interest.

Author contributions

Joseph Plaksin and Joseph Nicholson structured and conducted the initial literature searches—Joseph Plaksin for standardized patients and Joseph Nicholson for real patients. The “Background” section was initially drafted by Sarita Kundrod, the “Methods” section by Joseph Nicholson, and the “Results”, “Discussion”, and “Conclusion” sections by Joseph Plaksin. The complete first draft was compiled and edited by Joseph Plaksin. All authors then commented on that first complete draft and subsequent versions, and all agreed on the final version of the paper. Lisa Altshuler acts as guarantor for the paper.

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Authors and Affiliations

  1. 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

    Joseph Plaksin, Sarita Kundrod, Sondra Zabar, Adina Kalet & Lisa Altshuler

  2. Department of Medical Library, New York University Langone Medical Center, New York, NY, USA

    Joseph Nicholson

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  1. Joseph Plaksin
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Correspondence to Lisa Altshuler.

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Plaksin, J., Nicholson, J., Kundrod, S. et al. The Benefits and Risks of Being a Standardized Patient: A Narrative Review of the Literature. Patient 9, 15–25 (2016). https://doi.org/10.1007/s40271-015-0127-y

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