Simulated patient

In health care, a simulated patient (SP), also known as a standardized patient, sample patient , or patient instructor, is an individual trained to act as a real patient in order to simulate a set of symptoms or problems. Simulated patients have been successfully utilized for education, evaluation of health care professionals, basic, applied and translational medical research.

The SP can also contribute to the development and improvement of healthcare protocols; especially in cases where input from the SP are based on extensive, first-hand experience and observations as a clinical patient undergoing care.

Dr. Howard Barrows trained the first standardized patient in 1963 in University of Southern California. This SP simulated the history and examination findings of a paraplegic multiple sclerosis patient. Dr Barrows also developed a checklist that the SP could use to evaluate the performance of the trainee. Dr. Paula Stillman trained another set of standardized patients in 1970 at the University of Arizona. Her pilot program had local actors portray the "mothers" of imaginary children. The actors would describe the illness the unseen child was suffering from, requiring the medical students taking the history to develop differential diagnoses based on the mother's testimony. In 1984, a number of residency programs in the northeastern U.S. gave their residents the same examination using SPs. Medical Council of Canada was the first to use SPs in a licensure examination in 1993. The Educational Commission for Foreign Medical Graduates introduced the Clinical Skills Assessment exam in 1998 to test the clinical skills of foreign medical graduates. This exam is now the USMLE Step 2 Clinical Skills exam and is mandatory for obtaining medical licensure in the United States, for both foreign medical graduates and American medical students.

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