Learning in the moment: simulated patients' engagement in students' meaningful learning during communication training-a stimulated recall study.

Background: Previous studies have focused on the role of simulated patient (SP) feedback on students' learning outcomes after an SP-student encounter, whereas more recent studies have aimed to unravel meaningful learning during the encounter. We gain a more detailed understanding of students' meaningful learning by examining the perspectives of students and SPs during the SP-student encounter. The research question was as follows: What are characteristics of meaningful learning moments for students during SP-student encounters and what are the perceptions of SPs during these moments?

Methods: Twelve second-year Technical Medicine students conducted a medical consultation with SP presenting the same patient case. Each consultation was followed by qualitative, video-stimulated recall (SR) sessions, first with the student and then with the SP. During these sessions, students were prompted to articulate the thoughts they had during the consultation to identify meaningful learning moments. Video-fragments of the meaningful learning moments identified by the student were subsequently shown to the SP to explore their perceptions. All verbatim-transcribed recall data were thematically analyzed.

Results: Student-identified meaningful learning moments were characterized by experiences that offered new insights, evoked emotions, and/or involved feedback-in-action from the SP. The SP's perspectives of the same moments were compared to those of the students, revealing that these perspectives aligned approximately as often as they differed. SP experienced the moments as if they were the actual patient, fully embodying the patient's role, while simultaneously maintaining an overview and being aware of the student's learning position.

Conclusions: This stimulated recall study enhanced our understanding of students' learning during SP-student encounters. For students, meaningful learning moments involved new insights, emotional responses, and feedback-in-action from the SP. When SP fully engage in their patient role while maintaining awareness of the student's learning context, they can respond authentically and supportively. Preparing SP to balance authentic role portrayal with educational awareness can enhance their contribution to students' learning.