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Cited by 81Simulation-Based Education in HealthcareInnovations in Medical EducationAnatomy and Medical Technology

Standardized Patients in Medical Education: A Review of the Literature

Open access
Flanagan, Octavia L, Cummings, Kristina M·2023·Cureus
DOI 10.7759/cureus.42027PMC PMC10431693
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Abstract

The concept of standardized patients (SPs) was first introduced in the 1960s by Dr. Howard Barrows of the University of Southern California and has been applied in medical school education since that time. This practice has allowed medical students to practice skills on live persons who are teachers rather than on real patients, who may be endangered by their emerging skills. Previous studies supported the use of SPs but did not measure whether they improved clinical competence or students' confidence in their skills. This literature review evaluated whether current medical education literature supports or refutes the use of SPs compared to other modalities such as simulated patients (SiPs) and virtual reality (VR) in the improvement of student confidence, clinical performance, and interpersonal communication skills. The research questions posed for this review were as follows: do medical students in their first two years of education who have practiced skills using SPs have more self-confidence in their ability to perform skills on real patients than those students who did not use SPs, do medical students in their third and fourth years of medical school have higher clinical competency with sensitive patient examinations after using SPs in their first two years of medical education than those students who did not use SPs, and do medical students who have used SPs for discussing sensitive issues have better interpersonal skills when they encounter real patients in the clinical setting than those who have not used SPs? The methodology for this descriptive, systematic review of the literature was organized using a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart to describe how articles were collected and synthesized to evaluate the variables under study. The results of this study revealed that students learned the most when SPs were used because they were able to teach students the skills that they needed in a safe learning environment. Medical students performing sensitive patient examinations with SPs learned not only how to perform the examinations but also how to improve their communication with patients. Students and residents reported increased confidence and clinical competence when performing new skills with SPs rather than with peer practice, virtual reality, or real patients in a clinical setting. Although the utilization of SPs has been studied in multiple ways and found to be a powerful tool in the education of undergraduate medical students and interns, there is still much study to be done to address the human needs of real patients. Gaps in this literature included small sample sizes, a lack of standardized assessment tools, and the need to include a multidisciplinary approach that addresses cultural awareness and appreciation. The authors found limited studies analyzing the effect the coronavirus disease 2019 (COVID-19) pandemic had on the use of SPs in medical school education. Continued scientific inquiry in post-pandemic medical education is an essential component for dissemination as most schools have reintroduced the use of SPs, which strengthens the concept that their use is superior to the other simulation methods used when SPs were not available.

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  • Feedback from both standardized patients and instructors provides a dual perspective, helping learners refine their communication approach while enhancing emotional intelligence and professionalism.

    “Feedback from both the SP and instructors provides a dual perspective, helping learners refine their communication approach while enhancing emotional intelligence and professionalism [105,106].”

    From Formative assessment and feedback in medical education: A practical guide: AMEE Guide No. 189 (2026) · cites this paper as [105]

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Authors
Flanagan, O. L., & Cummings, K. M.
Affiliations
Lake Erie College of Osteopathic Medicine (US)
Corresponding author
Flanagan, Octavia L
ORCID
Venue
Cureus
Publisher
Springer Science and Business Media LLC
Published
2023-07-17
Volume
15
Issue
7
Pages
e42027-e42027
ISSN
2168-8184 (ISSN-L)
DOI
10.7759/cureus.42027
PMC
PMC10431693
OpenAlex
W4384500039
Cited by
81
References
40
Citations by year
2026: 28 · 2025: 37 · 2024: 15 · 2023: 1
FWCI
2.88
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Cureus (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Simulation-Based Education in Healthcare
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
  • Physical Sciences › Engineering › Biomedical Engineering › Anatomy and Medical Technology
Keywords
standardized patients, medical education, clinical competence, student self-confidence, interpersonal communication skills, virtual reality, clinical skills training, medical students, residents, COVID-19 pandemic impact on medical education, cultural awareness, peer practice, assessment instruments, competency-based education, simulation-based education, faculty development

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