Using standardized patients in advanced practice nursing education

Standardized patient encounters, a pedagogic approach to helping students develop appropriate clinical skills, are widely used in medical education and are being adopted by advanced practice nursing programs. Two types, simulated clinical encounters, in which students complete an episodic or comprehensive visit, and objective structured clinical experiences, multiple stations each presenting a different clinical problem, are used for formative and summative evaluation. Graduating adult and pediatric nurse practitioner students (N = 26) completed a simulated clinical encounter for an episodic visit. Students' performance on the simulated clinical encounter did not reflect their performance on other clinical evaluation measures or their performance on national certifying examinations. This one-time simulated clinical encounter was shown to lack the necessary reliability and validity to appropriately evaluate the clinical skills of nurse practitioner students. Videotaped, simulated patient encounters are useful, however as formative learning experiences. This reinforced our position that multiple site visits by faculty to students and their preceptors at all their clinical sites are necessary to accurately evaluate students' clinical performance.