Comparison of real and standardized patients in Degree in Medicine: a randomized controlled intervention study

Introduction

Simulated clinical scenarios allow students to learn in a safe environment. Although it is recommended that standardized patients (SP) participate in these scenarios, few studies compare the impact of SP and real patients (RP) on medical education.

Methods

Forty medical students per course (4th, 5th, and 6th) were selected and randomly assigned (1:1) to two groups: a scenario with RP or SP. The students and the external observer were unaware of the type of patient participating in the scenario. The students completed questionnaires on perceptions and knowledge, and the responsible professors and external observer completed questionnaires on perceptions. Qualitative information was collected through focus groups with the students.

Results

No significant differences were found between both groups in perceptions and acquired knowledge, but there was a significant difference in the probability of correctly identifying the type of patient (p < 0.001): most students in the scenario with SP identified it as RP. No differences were found between groups in the professor and external observer questionnaires. Students were more prepared and involved if they believed they were facing a RP and considered the patient's feedback enriching, regardless of the type of patient.

Conclusions

Medical students do not differentiate SP from RP in scenarios and evaluate them similarly. Given the difficulty of having PR with diverse pathologies and severity levels, SP is a good alternative for training medical students.