This is a guest post by Amber A. Walton, a PhD candidate from Syracuse University, USA. Amber would like to invite participation in her research, The Instructional Design of SP Training.

The Instructional Design of SP Training

Amber A. Walton, PhD student, Syracuse University, USA

How do we train SPs?  Do we follow a particular process in which we analyze what SPs know and what they need to know, design and deliver instructional activities, then track how that instruction impacts SPs’ performance, giving and receiving evaluative feedback throughout the process?

There is not a lot published in the scholarly literature about how we conduct the SP training process, though the literature is exceptionally clear that SPs must be properly trained:


In the Association of Standardized Patient Educators (ASPE)’s standards of best practice document (Lewis, et al, 2017), SP training needs are described as such:

“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 (e.g., face-to-face, online, blended).” (p. 5)

Ideally, ongoing assessment of SP performance will be undertaken continuously (throughout both training and during actual simulations to monitor for quality assurance) (May 2009) by the SPE, especially as a component of a thorough training design.  What is not clear from the literature is whether SPEs are using any type of deliberate instructional design methods or models.

In chapter 14 of the book, Clinical Simulation (Chiniara 2019), authors Guillaume Der Sahakian, Clément Buléon, and Guillaume Alinier lay out the educational foundations of instructional design (ID) applied to simulation-based education.  They propose the use of the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) model of instructional systems design as the model upon which healthcare simulation educators may systematically and progressively build a simulation activity.  They admit that the process can be very time-consuming, but dictate that, “Any educational program in simulation must rely on a rigorous and systematic design process coordinated by a simulation educator…” (p. 203).  They do not specify how this model applies to SP simulations, nor do they discuss how the ADDIE model might also be systematically employed by SP educators in designing SP training.

To this goal, I have designed a survey research project to discover:

  1. Who are those who train SPs? What percentage of their job is spent training SPs? What training did they receive to prepare them for training SPs?
  2. What does a typical SP training process entail at their institution? What are the strengths of this process?
  3. To what extent are SP educators using any kind of deliberate instructional design process (i.e., analysis, design, development, implementation, evaluation) when they design SP training procedures? Are any SPEs using the ADDIE model for SP training?

By collecting, analyzing, and reporting on this information, I seek to identify the methods we use when conducting SP training so that our field can offer targeted professional development and support to those who train SPs.  I have also designed two follow-up studies: an ethnographic case study of one SP educator’s training process and environment, and an embedded mixed-methods, quasi-experimental research design that examines the difference between two groups of SPEs who either receive training on implementation of the ADDIE model or receive standard training on SP training techniques.  These two projects are scheduled to begin in the fall of 2020.

It is important to me that SP educators from around the world be represented in this survey research project.  I would like to encourage anybody who devotes at least 1% of their job responsibilities to training SPs to participate in the survey, even if you do not have experience with any instructional design models.  Capturing your current experience is important so that we all may grow as a field.

This is the link to the online survey:

Participants’ data will be kept anonymous (to the extent that web-based surveys can ever be safe from 3rd party hacking).  If participants are interested in being a part of future studies on this topic, a separate link will be provided so that contact information is not associated with the anonymous survey data.

I am grateful to the Simulated Patient Network for granting me the opportunity to share this research participation opportunity.  Please feel free to contact me at


Chiniara, G. (Ed.). (2019). Clinical Simulation: Education, Operations and Engineering. Academic Press.

Der Sahakian, G., Buléon, C., & Alinier, G. (2019). Educational Foundations of Instructional Design Applied to Simulation-Based Education. Clinical Simulation, 185–206.

Liao, C. S., Kao, S. P., Liang, S. Y., & Hsieh, M. C. (2015). Training actors as standardized patients. Tzu Chi Medical Journal, 27(2), 96–97.

Lewis, K. L., Bohnert, C. A., Gammon, W. L., Hölzer, H., Lyman, L., Smith, C., … Gliva-McConvey, G. (2017). The Association of Standardized Patient Educators (ASPE) Standards of Best Practice (SOBP). Advances in Simulation, 2(1), 1–8.

Keiser, M. M., & Turkelson, C. (2017). Using Students as Standardized Patients: Development, Implementation, and Evaluation of a Standardized Patient Training Program. Clinical Simulation in Nursing, 13(7), 321–330.

MacLean, S., Geddes, F., Kelly, M., & Della, P. (2018). Simulated patient training: Using inter-rater reliability to evaluate simulated patient consistency in nursing education. Nurse Education Today, 62(December 2017), 85–90.

May, W. (2008). Training standardized patients for a high-stakes clinical performance examination in the California Consortium for the Assessment of Clinical Competence. Kaohsiung Journal of Medical Sciences, 24(12), 640–645.

Szauter, K. (2019). Simulated and Standardized Patients. In Clinical Simulation.