The safety of the learner, faculty and SP are not mutually exclusive, but inextricably connected to the simulation process. Safety considerations are embedded in the physical setting, learning atmosphere and educational methods, all of which foster best practice learner success.
The Association of Standardized Patient Educators (ASPE) Standards of Best Practice (SOBP) (Lewis et al., 2017) identifies and embeds safety first in their five underlying values, first in their five domains of best practice where safety is the cornerstone of simulation practice, and key practice principles.
Creating a supportive environment for taking risks, cultivating unconditional positive regard that embodies empathy and respect for learner anxiety, and creating relevant scenarios designed for successful student outcomes are all hallmarks of safe practice. When we consider learner safety we endeavor to ensure that the simulation portrayal is realistic, physically and psychologically safe, and meets all the learning objectives set for each session. This requires a close collaboration between the faculty who conceives and develops the case and the SP trainer who determines training protocols to ensure both learner and SP safety during the simulation process.
Training and applicable preparation of the SP provides further safety for both student and the SP during the simulation process. By reducing emotional and physical safety risks through on-site training, faculty pressure to intervene may be mitigated or alleviated during challenging interactions.
Attention should be paid at all times to the physical and emotional well-being of all participants in the simulation. The session must be stopped immediately if an injury or sudden illness occurs.
The Michener SP Program is committed to ASPE Standards of Best Practice (SOBP), which cite the following three distinct principles related to creating a safe work environment: safe work practices, confidentiality, and respect. Specific principles include (Lewis et al., 2017):
- Attention paid to occupational hazards such as allergic substances, exposure to sharps, etc.
- Screen SPs to ensure that they are appropriate for the role – e.g. no conflict of interest, no compromising of their psychological or physical safety
- Allow SPs to opt out of any given activity if they feel it is not appropriate for them to participate
- Brief SPs so they are clear about the guidelines and parameters of a simulation activity
- Provide SPs with strategies to mitigate potential adverse effects of role portrayal and prevent physical injury or fatigue
- Attention paid to the number of rotations, breaks, and physical and psychological challenges inherent to the role
- Provide SPs with adequate information so that they can make informed decisions about participation in work assignments
- Ensure that SPs understand and maintain the principles of confidentiality related to specific simulation events
Simulation is continuously learner-focused. Identification, alignment and disclosure of the learning objectives between learner, faculty and the SP are key facets and contributors to safe practice. This becomes a transparent alliance where physical procedures and psychological considerations are attended to in SP training in order to promote and optimize teaching in role that benefit both the learner in practice and the faculty in briefing and debriefing.
Lewis, K. L., Bohnert, C. A., Gammon, W. L., Holzer, 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). https://doi.org/10.1186/s41077-017-0043-4