• Standardized patients (SPs) will identify themselves as such upon arrival to a booking.
  • SPs are encouraged to arrive a few minutes earlier than the start time to speak with the tutor about the simulation format (e.g., small group interviews, feedback expected, etc.).
• The SP will portray the case as trained. The tutor can direct the SP to scale the character’s affect down or up (depending on the level of the learner). However, scenario content is not to be altered at the simulation.
• The SP will be in the role of the patient/individual outlined in the case for the specific encounter immediately upon interaction with the learner and will introduce themselves as such.
  • Once the tutor has declared the simulation portion of the session has ended, the SP can step out of the role of the patient to provide feedback, if requested.
• A tutor may provide prompts to the SP and learners as to when the encounter begins and ends and may interject or ‘pause’ the simulation at any time.
  • If the simulation has been paused, the SP will act as a silent observer and will not participate in the conversation, unless asked to by the facilitator.
• If, for any reason, an SP is not comfortable during a simulation, they may stop the simulation
  • In the case of a physical exam, the SP may use a ‘safe word’ to indicate to the tutor (while not breaking character) that the physical exam must stop. This should be discussed prior to the beginning of the simulation.

Standardized Patients & Physical Exams

SPs scheduled for physical examinations will come prepared to the session in a gown, with shorts and undergarments underneath. It is expected that:

• Tutors and learners will take proper measures to protect the SP’s modesty and privacy through proper draping.
• SPs understand there may be some brief, but appropriate, exposure to access areas of the body that will be examined.
• Learners will wash/sanitize their hands before beginning to examine an SP.

Standardized patients are not expected to:

• Cooperate with inappropriate behaviour from the learner or tutor.
• Endure pain during the physical examination.
• Be examined and exposed without proper draping.
  • SPs should not be asked to remove undergarments. SPs for invasive examinations (urogenital and gynecological health etc.) will come prepared appropriately for those specific exams.

SPs should respond immediately to actions that do not comply with the expectations noted above or any other behaviours that risk the safety of the SP or the simulation environment or for protection of their privacy. Examples include:

• Asking the learner to wash their hands before beginning the physical exam(s)
• Stopping physical exams for which they were unprepared for: “I was not prepared for this exam.”
• Stopping inappropriate draping or exposure: “Please use the drape to cover me”; “Please use the privacy curtains around the door”; “I am more comfortable leaving my underwear on.”
• Intervening if experiencing pain: “Please be careful, that is hurting me”; “Can we stop examining my shoulder, it is causing me pain.”
• Requesting a brief break if experiencing soreness from repetitive movements/exams.
• Requesting to alternate side (i.e., left vs. right knee) should it be feasible with the exam.

To ensure safety and quality assurance, various caps on the number of physical exams and the length of sessions involving physical exams or a high physical/emotional/mental demand have been determined. This includes, but is not limited to:

• Physical exam SP bookings may be limited to a four-hour booking time, per SP. This practice also applies to other cases considered to be too demanding for long hours (i.e., extreme emotional portrayal), as determined by the Standardized Patient Program and based on feedback from SPs.