The Association of Standardized Patient Educators (ASPE) Standards of Best Practice (SOBP) were developed for those working with clinical human role players who interact with healthcare learners in a wide range of experiential learning and assessment contexts. ASPE, now called the Association for SP Educators to cover both “Standardized Patients” and “Simulated Patients”, produced the ASPE SOBPwhich are intended to be used in conjunction with the International Nursing Association for Clinical Simulation and Learning (INACSL) Healthcare Simulation Standards to address broader healthcare simulation best practices. This article by Dr. Teresa Gore, PhD, DNP, APRN, FNP-BC, CHSE-A, FSSH, FAAN Content Manager for HealthySimulation.com, covers how the ASPE Standards are a foundation to guide the practice and management of Standardized Patient Programs for educators who use this methodology in clinical simulation.
The terms standardized patient and simulated patient (SP) are often used interchangeably and refer to a person trained to portray a patient in realistic and repeatable ways. SPs interact with learners in experiential education and assessment contexts. Depending on the context, learners are described as students, trainees, participants, examinees, or candidates. According to the Healthcare Simulation Dictionary, there are different definitions for Actor, Simulated Patient, Simulated Person, Standardized Patient, Standardized Patient Educator, Standardized Patient Simulation, Standardized / Simulated Participant. Make sure to utilize this dictionary in healthcare simulation practice and dissemination.
SPs can also provide feedback on learner performance from the perspective of the person they portray, which is unique to working with SPs. SP-based education has grown in size and scope of practice to include many different roles. For this reason, the term simulated participant is used as a more inclusive term to refer to all human role players in any simulation context.
ASPE Standards of Best Practice Development
The ASPE SOBPs were developed by a consensus opinion of experts in the field of SP methodology. The ASPE Board of Directors collaborated with the ASPE Standards of Practice Committee to determine the best practices. A modified Delphi process was implemented to identify the main domains, the principles of the domains, and the practices to achieve the principles. Drafts with revisions of global SP educators occurred in three rounds. The ASPE SOBP results from a team of reviewers and final revisions.
View the HealthySimulation.com Webinar Simulated Patients: The Who, What, & Why of Physical Exam Teaching Associates to learn more!
ASPE Standards of Best Practice
The SOBP are organized into five domains: safe work environment, case development, SP training for role portrayal, feedback, and completion of assessment instruments, program management, and professional development. Each domain is divided into principles with accompanying key practices, which are numbered for ease of reference. Not all practices apply to every situation, and the order in which the practices emerge may vary.
Domain 1: Safe Work Environment: It is incumbent on simulation educators to ensure that all stakeholders—SPs, learners, faculty, patients, or program staff—have a safe psychological and physical learning environment. Domain 1 has three principles that consist of Safe work practices (13 practices), Confidentiality (3 practices), and Respect (3 practices)
Domain 2: Case Development: Curricular or programmatic goals drive teaching and evaluation activities, and the design and development of materials required for SP-based contributions to these activities are critical aspects of the SP educator role. For case development, the materials include all descriptive case documents, any supporting documents, evaluation instruments, training resources, and training protocols an SP needs to prepare for a teaching or evaluation activity. Domain 2 has two principles that consist of Preparation (5 practices) and Case Components (11 practices).
Domain 3: SP Training: SP training prepares SPs to portray roles, give feedback, and complete assessment instruments. These three areas are discrete skills, but are not mutually exclusive. It is the responsibility of the SP educator to integrate the development of these skills into SP training according to the learning objectives of the activity and the experience of the SP. Training can be done in many formats. Five principles that consist of Preparation for Training (5 practices), Training for Role Portrayal (5 practices), Training for Feedback (5 practices), and Training for Completion of Assessment Instruments (8 practices), and Reflection on the Training Process (1 practice).
Domain 4: Program Management: SP programs are responsible for quality management practices, including quality planning, quality assurance, quality control, and quality improvement. Clearly stated policies and procedures allow an SP program to demonstrate that it meets legislated, institutional, and practice standards. Domain 4 has six principles that consist of Purpose (3 practices), Expertise (5 practices), Policies and Procedures (5 practices), Records Management (3 practices), Team Management (5 practices), and Quality Management (5 practices).
Domain 5: Professional Development: SP educators engage in professional development to promote excellence in their own practices, within the community of practice, and among stakeholders. Domain 5 has three principles that consist of Career Development (6 practices), Scholarship (3 practices), and Leadership (3 practices).
Citation of the SOBP: Lewis, K.L., Bohnert, C.A., Gammon, W.L. et al. The Association of Standardized Patient Educators (ASPE) Standards of Best Practice (SOBP). Adv Simul 2, 10 (2017).
ASPE GTA / MUTA Standards of Best Practice
Gynecological Teaching Associates (GTAs) and Male Urogenital Teaching Associates (MUTAs), individuals who instruct learners to conduct breast, pelvic, rectal, urogenital, and prostate examinations, are two examples of the application of SP methodology. Gynecological Teaching Associates (GTAs) and Male Urogenital Teaching Associates (MUTAs) teach learners to perform accurate and respectful breast, speculum, bimanual vaginal, rectal, urogenital, and prostate examinations. As part of the instruction, the GTAs/MUTAs use their bodies to teach while providing real-time feedback. While GTAs/MUTAs fall under the broader umbrella of Standardized Patient methodology, the specificity of their role indicated the need for Standards of Best Practice tailored for their work. Using the original ASPE SOBP as the foundation for the new standards development, ASPE published The Association of Standardized Patient Educators (ASPE) Gynecological Teaching Associate (GTA) and Male Urogenital Teaching Associate (MUTA) Standards of Best Practice in Advances in Simulation.
Read about the GTA / MUTA Standards in HealthySimulation.com. Citation of the ASPE GTA / MUTA SOBP: Hopkins, Holly, et al. “The association of standardized patient educators (ASPE) gynecological teaching associate (GTA) and male urogenital teaching associate (MUTA) standards of best practice.” Advances in Simulation 6.1 (2021): 23.
More About ASPE and Standardized Patient Methodology
As the international organization of simulation educators, the Association of Standardized Patient Educators (ASPE) is dedicated to promoting best practices in the application of SP methodology for education, assessment, and research. ASPE’s purpose includes fostering the dissemination of research and scholarship in the field of SP methodology, and working to advance the professional knowledge and skills of its members.
In transforming professional performance through the power of human interaction, ASPE members serve as a great resource and are always ready to help others with SP training, curriculum and program development, and center creation. Encouraged to share their expertise and experience regarding SP methodology, members worldwide provide strength and insight to the association.
