Experiences of Standardized Patient in LGBTI Population and Victims of Sexual Violence: A Focus Group Study
https://orcid.org/0000-0002-5372-2459
Eduardo Diaz-Amado
https://orcid.org/0000-0002-9804-548X
María Eugenia Castellanos-Ochoa
https://orcid.org/0000-0001-7512-3142
Maria Juliana Guerra-Murillo
https://orcid.org/0000-0001-5905-2292
Valentina Pulido-Antolínez
https://orcid.org/0000-0002-2462-8156
Antonia Perilla-Orduz
https://orcid.org/0000-0002-6502-413X
Brunilda Del Socorro Zapata Monsalve
https://orcid.org/0000-0002-4633-7309
Isabel Del Socorro Moreno Luna
https://orcid.org/0000-0002-4633-7309
Jorge Mario Escobar Munevar
https://orcid.org/0000-0001-8911-3906
##plugins.themes.bootstrap3.article.details##
Introduction: Simulation-based education with standardized patients (SP) in high-fidelity scenarios is a tool for learning, skills development, and clinical competencies. Actors assume psychological risks when they portray these emotionally charged vulnerable patients. Objective: To describe the experience of the actors (as SPs) during simulation sessions where they portrayed victims of sexual violence and LGBTI population and were attended by health professionals from the district. Methodology: A qualitative phenomenological study was conducted on the experience of actors who portrayed SPs in the cases described, from the interpreted patient and actor's perspective. A focus group was held with the actors after the simulation sessions. Results: Negative attitudes towards patients were identified, rooted in prejudices, lack of empathy and avoidance behaviors. The confluence of emotional burden and repetitive simulations rendered it arduous for actors to disentangle themselves from their roles, thereby impacting their daily activities. Conclusions: The need for SP simulation to sensitize healthcare staff was evident. The high emotional burden and the proximity of the cases to the actors suggests the need for psychological support. The integration of such support mechanisms contributes not only to the efficacy of simulation-based education but also to the overall well-being of actors, ensuring a more proficient and empathetic healthcare workforce.
Patient Simulation. Health Education. Simulation Training. Sex Offenses. Sexual and Gender Minorities.Simulación de Paciente. Educación en Salud. Entrenamiento Simulado. Delitos Sexuales. Minorías Sexuales y de Género.Simulação de Paciente. Educação em Saúde. Treinamento Simulado. Delitos Sexuais. Minorias Sexuais e de Gênero.
1. Kneebone R. Evaluating clinical simulations for learning procedural skills: a theory-based approach. Acad Med. 2005 Jun;80(6):549-53. https://doi.org/10.1097/00001888-200506000-00006
2. Cantrell MJ, Deloney LA. Integration of standardized patients into simulation. Anesthesiol Clin. 2007;25(2):377-83. https://doi.org/10.1016/j.anclin.2007.03.003
3. Lewis KL, Bohnert CA, Gammon WL, Hölzer H, Lyman L, Smith C, et al. The Association of Standardized Patient Educators (ASPE) Standards of Best Practice (SOBP). Advances in Simulation. 2017 Dec;2(1). https://doi.org/10.1186/s41077-017-0043-4
4. Hopkins H, Weaks C, Webster T, Elcin M. The association of standardized patient educators (ASPE) gynecological teaching associate (GTA) and male urogenital teaching associate (MUTA) standards of best practice. Advances in Simulation. 2021;6(1):23. https://doi.org/10.1186/s41077-021-00162-4
5. Lioce L, Lopreiato JO, Anderson M, Chang T, Diaz D, Downing D, et al. Healthcare simulation dictionary. Washington: Agency for Healthcare Research and Quality; 2020.
6. Mavis B, Turner J, Lovell K, Wagner D. Faculty, students, and actors as standardized patients: expanding opportunities for performance assessment. Teach Learn Med. 2006 Mar;18(2):130-6. https://doi.org/10.1207/s15328015tlm1802_7
7. Willson MN, McKeirnan KC, Yabusaki A, Buchman CR. Comparing trained student peers versus paid actors as standardized patients for simulated patient prescription counseling. Exploratory Research in Clinical and Social Pharmacy. 2021 Dec;4:100081. https://doi.org/10.1016/j.rcsop.2021.100081
8. Panzarella K, Rivers L, Bright B, Whelan M, Butterfoss K, Russ L, et al. Using actors as simulated patients for interprofessional education. Med Sci Educ. 2013;23(supl 3):438-48. https://doi.org/10.1007/BF03341666
9. Moore P, Leighton MI, Alvarado C, Bralic C. Pacientes simulados en la formación de los profesionales de salud: el lado humano de la simulación. Rev Med Chil. 2016;144(5):617-25. https://doi.org/10.4067/S0034-98872016000500010
10. Roger Ruiz-Moral FCM. Programa para seleccionar y entrenar pacientes estandarizados en el contexto de un currículo universitario de simulación clínica. Reva Fund Edu Méd. 2014 Dec;17(4):199-204. https://doi.org/10.4321/S2014-98322014000400005
11. Englund H, Basler J, Meine K. Using simulation to improve students’ proficiency in taking the sexual history of patients identifying as LGBTQ: a pilot Study. Clin Simul Nurs. 2019;37:1-4.
12. Jiménez-Rodríguez D, García MTB, García AS, Del Pino FJP, Ponce-Valencia A, Arrogante O. Nurse training in gender-based violence using simulated nursing video consultations during the COVID-19 pandemic: A qualitative study. Int J Environ Res Public Health. 2020;17(22):1-15. https://doi.org/10.3390/ijerph17228654
13. Scannell M, Lewis-O’Connor A, Barash A. Sexual assault simulation course for healthcare providers: enhancing sexual assault education using simulation. J Forensic Nurs. 2015 Dec 1;11(4):190-9. https://doi.org/10.1097/JFN.0000000000000089
14. Nathan S, Ferrara M. An innovative trauma-informed curriculum for sexual assault care. J Nurs Educ. 2020 Jun 17;59(6):336-40. https://doi.org/10.3928/01484834-20200520-07
15. Noonan EJ, Weingartner LA, Combs RM, Bohnert C, Shaw MA, Sawning S. Perspectives of transgender and genderqueer standardized patients. Teach Learn Med. 2021;33(2):116-28. https://doi.org/10.1080/10401334.2020.1811096
16. Bartlett RS, Bruecker S, Eccleston B. High-fidelity simulation improves long-term knowledge of clinical swallow evaluation. Am J Speech Lang Pathol. 2021 Mar 11;30(2):673-86. https://doi.org/10.1044/2020_AJSLP-20-00240
17. Jarosinski JM, Webster DA. Acting with a purpose: the lived experience of actors in the role of standardized patients portraying mental illness. Clin Simul Nurs. 2016 Dec 1;12(12):539-45. https://doi.org/10.1016/j.ecns.2016.08.005
18. Janzen KJ, Jeske S, MacLean H, Harvey G, Nickle P, Norenna L, et al. Handling strong emotions before, during, and after simulated clinical experiences. Clin Simul Nurs. 2016;12:37-43.
19. Tyerman J, Ziegler E, Carroll B, Luctkar-Flude M. LGBTQI2S virtual simulation: lessons learned using actors with lived experience. Clin Simul Nurs. 2021 May 1;54:40-4. https://doi.org/10.1016/j.ecns.2021.01.016
20. Bokken L, Van Dalen J, Rethans JJ. The impact of simulation on people who act as simulated patients: a focus group study. Med Educ. 2006 Aug 1;40(8):781-6.
21. Spencer J, Dales J. Meeting the needs of simulated patients and caring for the person behind them? Med Educ. 2006 Jan 1;40(1):3-5. https://doi.org/10.1111/j.1365-2929.2005.02375.x
22. Woolf NH, Silver C. Qualitative analysis using NVivo: the five-level QDA method. New York: Routledge; 2017.
23. Saldaña J. The coding manual for qualitative researchers. 2.ª ed. London: Sage; 2013.
This work is licensed under a Creative Commons Attribution 4.0 International License.