Charlotte's Commentary:
A nursing student enters a patient's room, expecting to prepare him for his upcoming bronchoscope.   A lung mass was recently detected on X-ray However, the patient has already been transported to the Special Procedures lab, and his wife is in the room, anxious and upset.  "What's going to happen?  Is my husband going to die?  How am I going to raise our children all alone?"  The unnerved student, eyes wide, turns and flees the room - not a good response!   But it's okay.   She's in the nursing skills lab, the "wife" is a standardized patient, and the student has the opportunity to collect herself, re-enter the room, and practice her therapeutic communication skills by talking with the patient's "wife."
Hi!  I'm Charlotte Kuss, a nursing professor at Northwest Florida State College.  Welcome to the Standardized Patient Simulation Laboratory.  The SPSL, as it is known, was developed by the faculty of the NWFSC Nursing Program.
Standardized patients are real people who play the role of patients with whom students interact.  They are widely used in medical schools around the world, but few nursing programs utilize this approach to clinical instruction.  The volunteer actors receive coaching prior to any contact with students.  A script provides a basic explanation of a disease process, symptoms, questions, and behaviors that the "patients" should present as students assess them, communicate with them, and care for them.  Of course, no invasive assessments or interventions are performed.
The nursing faculty developed this innovative lab with several goals in mind.  These goals were formulated after analyzing our program and identifying weaknesses.  We asked our graduates and the nurse managers who hire them about their perceptions of how well prepared these new nurses are to work in the clinical setting.  We also evaluated the program reports on the national licensure examination to help pinpoint knowledge gaps our graduates reveal when taking that exam.  We perform ongoing analysis of our program to evaluate outcomes of SPSL and to identify other areas for improvement.
Primarily, we want to ensure that all students are exposed to key clinical situations.  We know that we cannot manipulate the real clinical setting in such a way that guarantees every student will have the opportunity to care for a patient with a specific disease process, one we deem important to our students' educational experience.  Once identified, we create a scenario focusing on that disease process, making it real through the use of standardized patients.  Scenarios that we have developed for our SPSL include patients who are experiencing chest pain, GI bleed, and depression with suicidal ideations.
A vitally important aspect of the SPSL is therapeutic communication.  We make that skill a key ingredient of every scenario that is developed.  Some scenarios focus solely on developing those communication skills.  Other examples of these focused scenarios are dealing with a dissatisfied patient and interacting with a colleague who has a substance abuse problem.  We also include professional communication skills in the SPSL experience, requiring that students present a verbal report on the patient to a "physician" or another "nurse."   They also must call a "physician" to receive telephone medical orders and transcribe them properly, a skill that cannot legally be developed in the real clinical setting.
The SPSL provides a safe environment for students to practice the art and science of nursing.  They must tap into their developing knowledge of pathophysiology and nursing process to think critically, prioritize care, and interact with real human beings who talk, listen, respond, and feel.  In debriefing sessions and written evaluations, students overwhelmingly convey excitement and satisfaction with their SPSL experiences.  And the volunteer actors think it's pretty neat, too!