By Cedar Wang and Beth Hallmark
In the famous words of Marvin Gaye, “Ain’t nothing like the real thing, baby.” When it comes to increasing the realism of simulation scenarios, there is nothing like replacing a manikin with a live person. But how do you find the right person to play the “real thing” in a manner that suspends disbelief and facilitates meaningful learning? Recruiting and hiring simulated or standardized patients (SPs) requires careful consideration of qualifications, hiring options, and onboarding processes.
First, whom should you hire? Some simulation programs utilize theater students, willing faculty, alumni, or community volunteers. Other programs seek out professional standardized patients, such as members of the Association of Standardized Patient Educators (ASPE), other professional organizations, or companies, such as InterActors, that specialize in supplying SPs for clinical trials and educational settings. Acting experience and the ability to stay in character while keeping the role consistent are important elements in maintaining the quality and safety of any simulation experience.
In stand-alone academic settings, hiring SPs can be a challenge, but there are creative ways around the challenges. Budgetary restraints may limit the resources available but there are economical avenues you can pursue. Local acting groups often have Facebook pages where you can recruit actors. And some schools involve community resources to seek out senior citizens, recruiting from retired nurses or senior programs at local religious organizations. While most SPs are paid between $15 and $20 an hour, these actors are often paid $8 an hour for what they see as extra work.
While we all want a bargain we must also consider quality. The process of hiring can be tedious, but it is very important. We ask for “head shots” and a history of work performed in the initial application. Interviewing applicants first in a group setting and then one-on-one can be effective. During the group interview you can typically assess demeanor and mood fairly quickly and eliminate anyone about whom you have concerns. The one-on-one interview enables you to get more personal information. Often community actors know one another, and if you get a good group of actors you can then hire from a referral base. Think outside the box!
Hiring options will depend on the setting and frequency of needs in your particular program. Working with the human resources department of your organization is critical. In our hospital-based simulation center, SPs are hired as per diem employees at an hourly rate. As members of the hospital staff, health/drug screening, infection prevention, and other annual regulatory training are required and must be discussed as an expectation in the hiring process. At some centers a background check and an honorarium agreement/SP form may be required.
Whether in an academic or medical center setting, we must be creative while considering the goals of the simulation event and seek out and train the most qualified SPs. Finding the right person to play the “real thing” is the first step to a successful SP program. Scheduling and coaching SPs will be discussed in future posts.
I am excited to see so many people interested in foundation and theories behind the practice of SP methodology and the hiring and training of quality SPs. This is exactly what the Association of Standardized Patient Educators (ASPE) is about !
ASPE is the leading organization in the field of SP methodology and focuses on best practice in all environments. It has a yearly conference in June that is the premier conference for those interested in developing methodologically driven SP activities . We are a non- profit association dedicated to helping each other to learn how to work with and train SPs in any environment. :
this topic has broad-based implications . The field of SP methodology has been around for many years and has strong literature to support it’s efficacy in evaluation and teaching across fields. It has grown far beyond the acting realm and is now a known field in education circles.
Besides the typical literature searches , the following website is a great resource for SP educators and is developed and maintained by a leader in the field, Dr. Karen Szauter. It is a searchable bibliography that can provide foundational literature.
Office of Clinical Simulation – Bibliography | UTMB School of Medicine | UTMB Health
The incoming President of SSH is Dr. Joe Lopreiato, who is an expert in SP Methodology . The SSH journal and IMSH programming is increasingly robust with workshops focused on SP methodology.
Deb Nestel , another leading expert, has written an editorial in Advances in Simulation on the recently published ASPE Standards of Best Practice.
You may read it :
She has also written a book on the topic.
INACSL embeds the work of SPs in their published Standards.
I hope to see some of you at IMSH this January so that we can continue this conversation.
President Elect, Association of Standardized Patient Educators
Director, Standardized Patient Program
University of Pittsburgh, PA
Valerie, thank you for your comments. I hope more people will take advantage of the resources ASPE has to offer!
Do you know anyone in the Philadelphia area who is willing to act as a patient for a Nurse Practitioner student? Will pay