The current Accreditation Council for Occupational Therapy Education (ACOTE) Standards include a provision for the use of experiential learning methods as level I fieldwork experiences by entry-level occupational therapy (OT) education programs (ACOTE, 2018). Included in these experiences are two specific types of simulation: simulated environments and standardized patients. Earlier versions of the ACOTE Standards did not allow for the use of simulation as level I fieldwork experiences. This provision may help mitigate a shortage of level I and level II fieldwork placements and allow academic programs to provide consistent quality level I fieldwork across students (American Occupational Therapy Association [AOTA], 2017). This use of simulation as a fieldwork training method is an emerging area of OT education that has limited research on its use and best practice. This doctoral project sought to contribute to the existing knowledge by conducting a research study which investigated the use of both simulated environments and standardized patients by academic programs, as well as identifying the primary supports and barriers to its implementation. The project included the creation, distribution, and analysis of a national survey of entry-level OT programs. The survey found that the main barrier and support to implementation of simulation was funding and that private institutions are more likely to utilize standardized patients than public institutions. The results of this study will help inform future ACOTE Standards, provide both the American Occupational Therapy Association and ACOTE with additional information to help determine how to best provide resources for academic programs that facilitate successful implementation of the simulation methods, and help identify programs that can participate in the dissemination of best practice in the use of simulation as fieldwork experiences. The author recommends that ACOTE should also consider mandating the use of simulation, along with other experiential learning activities, as partial fulfillment of level I fieldwork requirements, to allow for better access to funding, decrease the fieldwork burden on traditional fieldwork sites, and allow for more consistent level I fieldwork experiences.

Objective. To determine whether using standardized patients dressed in moulage improves pharmacy students' ability to assess skin disorders compared to using picture-based paper cases. To determine pharmacy student preferences when learning assessment of skin disorders through these two educational methods. Methods. Faculty members investigated student assessments of drug-induced skin disorders and contact dermatitis by using picture-based paper cases compared with using standardized patients dressed in moulage in a patient assessment course. Faculty members measured student knowledge via multiple-choice questions before laboratory, immediately after laboratory, and during a final examination 3 weeks later. Student preferences were measured immediately after laboratory via survey instrument in this randomized, non-blinded, crossover design educational study. Results. No significant differences in knowledge scores related to skin disorders were found after laboratory or 3 weeks later when comparing the two educational methods. However, survey results suggested student preferences for using standardized patients dressed in moulage for drug-induced skin disorders. No significant differences were found for contact dermatitis cases. Conclusion. Using standardized patients dressed in moulage did not improve pharmacy students' ability to assess skin disorders compared to using picture-based paper cases. Pharmacy students preferred standardized patients dressed in moulage only when learning assessment of drug-induced skin disorders.

Purpose: The Standardized Patient [SP] Program is a potential avenue through which students from races and ethnicities underrepresented in medicine [URiM] experience bias, due in part to the inherent subjectivity of an SP’s evaluation of the doctor-patient interaction. In most training programs, medical students are assessed on their clinical and interpersonal skills via simulated encounters where students assume the doctor role and SPs act as patients. Researchers conducted this qualitative study to (1) understand the SPs’ perception of their role within the Objective Structured Clinical Exam and medical school education, (2) investigate biases that medical students may experience during SP evaluations of simulated clinical encounters.Methods: Participants were recruited from Lewis Katz School of Medicine at Temple University. Interviews and focus groups were conducted between August through October of 2022. A total of 14 medical students, 11 of which self-identified as URiM, were distributed into 6 focus groups. A total of 9 SPs were interviewed, 3 of which self-identified as non-white ethnic minorities. All interviews were then transcribed and analyzed using a combination of first-cycle coding methods. In the final stages of analysis, we examined the data to determine frequent themes across the study populations. Results: The results demonstrated conflicting sentiments between SPs and students. Although SPs described an intensive training process that promoted standardization of DPI scoring across SPs, URiM students reported high interrater variability, referring to the variation in the interpretation of a student’s communication skills by SPs. The consensus amongst minority students was that SPs evaluate students more leniently in interactions where the SP and student share ethnic identities. The themes present in the resulting data aligned closely with a social determinants of health conceptual framework, illustrating how disregarding the topic of implicit bias in the SP Program leads to a downward trajectory of differential attainment. Conclusion: Although medical education administrators have begun shifting their attention towards diversity, equity, and inclusion initiatives, there has been minimal focus on the key perspectives necessary to navigate this space. Our research analyzes those perspectives as an important first step towards acknowledging and effectively mitigating bias in medical education programs. / Urban Bioethics

The methods used to train actors can be modified to train standardized patients to simulate patient encounters with medical students. With some background in standardized patients and simulation, a member of Theatre Department can start a standardized patient program at their own institution. This is based on the pilot year of the VCU Standardized Patient Program which began in June, 2011.

Training delivered to medical students and residents in behavioral health is widely acknowledged to be inadequate. While the use of standardized patients is common in medical training and education for physical health conditions via the adherence to clinical protocols for evaluation and treatment, this approach is infrequently used for behavioral health conditions. Used under specific circumstances, standardized patient encounters have long been considered a reliable method of training and assessing trainee performance on addressing physical health conditions, and are even comparable to ratings of directly observed encounters with real patients. This paper discusses common issues and challenges that arise in using standardized patients in behavioral health. Although current evidence of its value is modest and challenges in implementation exist, the use of standardized patients holds promise for medical training and education and as an evaluation tool in behavioral health.

Intensive care units in South Africa have been faced with various challenges which in turn affect the working condition of critical care nurses, thus leading to poor productivity. Nurses in the work environment blame this poor work quality of nursing to the way critical care nurses are trained and assessed in nursing schools. There is general concern that graduate nursing students lack the knowledge and skills necessary to equip them to work in intensive units. Objectives: To measure the perceptions of critical care nursing students as well qualified critical care nurses on the use of OSCE as a valid and reliable tool to assess clinical competence in critical care nursing students. Methods: A quantitative approach and descriptive survey was administered to critical care nursing students and qualified critical care nurses who had participated in OSCE examination. The intensive care departments of two provincial (states) hospitals and (provincial) nursing college that trained critical care nurses were used. Results: The findings revealed that OSCE was still overwhelmingly accepted as a relevant tool for assessing clinical competencies in Critical Care courses by both students and staff. It was also clear that the students did not believe that all the competencies required in the ICU environment can be assessed using the OSCE method. Discussion: Critical care nursing educators are facing a challenge to develop more comprehensive method for assessing clinical skills in critical care students nurses since OSCE x examination cannot assess all the skills that are necessary in intensive care environment. In order for effective learning to take place during assessment, it is extremely important for nurse educators to give formative feedback in OSCE. / M.N. University of KwaZulu-Natal, Durban 2012.

Simulation, in its many forms, has been a part of nursing education and practice for many years. The use of games, computer-assisted instruction, standardized patients, virtual reality, and low-fidelity to high-fidelity mannequins have appeared in the past 40 years, whereas anatomical models, partial task trainers, and role playing were used earlier. A historical examination of these many forms of simulation in nursing is presented, followed by a discussion of the roles of simulation in both nursing education and practice. A viewpoint concerning the future of simulation in nursing concludes this article.