Contact Us: 866.479.6828

When Life Gets in the Way: Getting SPs out of Their Heads and into the Role

Mirigliani L, Lorion, A. When Life Gets in the Way: Getting SPs out of Their Heads and into the Role. Presentation delivered at the 2019 Association for Standardized Patient Educators Annual Conference, Orlando, FL, June 2019.



We ask Standardized Patients (SPs) to put the outside world aside during encounters and focus only on what is happening in the room, but this is not always easy, even for the best SPs. SPs being distracted by real-life concerns may lead to struggle with portrayal, recall, late arrivals or callouts, or unpredictable responses to co-workers or feedback. Without attention, an SP may continue to struggle—in work and out. Yet, the integrity of the simulation must be protected, and sometimes the SP’s employment will be in jeopardy. This session will help participants be prepared to recognize potential signs of SPs who are struggling emotionally; be receptive to having conversations with those SPs; identify tools and resources that can assist the SPs; be able to set limits; and be able to hold to those limits, even if it means the SPs going through corrective action, up to and including termination.



An SP’s emotional state can have serious repercussions, impacting other SPs and staff as well as the SP, making portrayal of some cases more difficult and potentially risking an examination’s standardization. Being aware that shifts in emotional state are a possibility, being able to address the situation with the SP, and having tools and resources readily available for the SP will help trainers and administrators intervene, address the root cause of unusual behavior, and potentially assist a valued SP. Setting and holding to limits will help the trainer or administrator protect him or herself and the simulation.



Participants will be able to:
1. Help SPs recognize what may be “triggers” for them, including having to simulate something they are experiencing in real life.
2. Encourage SPs to do emotional “self-checks” prior to simulations.
3. Start a potentially uncomfortable conversation with the SP.
4. Have tools and resources at hand.
5. Set limits to preserve the integrity of the simulation.


Intended Discussion Questions

1. Have you been in this situation before, on either side of the conversation? If so, what did/did not go well and what did you learn?
2. What tools have you used/could you use to help SPs dealing with emotional issues to focus on the simulation and their responsibilities to the center, their co-workers, and the students?
3. What resources are available at your institution that could assist SPs struggling with emotional difficulties?
4. Given your role, how will you prepare your colleagues and share information?



Spencer, John and Jill Dales, “Meeting the Needs of Simulated Patients and Caring for the Person Behind Them?” Medical Education 40.1 (2006): 3-5.

Bokken, Lonneke, Van Dalen, Jan, and Jan-Joost Rethans, “Performance-related stress symptoms in simulated patients,” Medical Education 38.10 (2004): 1089-1094.
Varlander, Sara, “The Role of Students’ Emotions in Formal Feedback Situations,” Teaching in Higher Education 13.2 (2008): 145-156.

Lewis, Karen L.,Carrie A. Bohnert,Wendy L. Gammon, Henrike Hölzer, Lorraine Lyman, Cathy Smith, Tonya M. Thompson, Amelia Wallace, and Gayle Gliva-McConvey “The Association of Standardized Patient Educators (ASPE) Standards of Best Practice (SOBP)” Advances in Simulation 2:10 (2017).

“Building Workplace Resilience.” Guidance Resources Online. 2018. ComPsych Corporation. Retrieved from https://www.guidanceresources.com/groWeb/s/article.xhtml?nodeId=809859&conversationContext=1

More information for...