The simulated patient's view on teaching: results from a think aloud study

This study explored third-year clinical teaching encounters from the perspective of the simulated patient (SP) participants.

In August through December 2008, to obtain data from SPs, the authors used retrospective Think Aloud (rTA) methodology on video recordings of teaching sessions in which the respective SPs had participated. While watching the video, SPs were instructed to speak aloud their thoughts in response to the question "What made you feel comfortable or uncomfortable during the session?" Recordings of rTA exercises were analyzed by qualitative content analysis.

From 27 teaching sessions with 23 different teachers, 269 relevant comments were extracted and categorized. SPs felt comfortable if the atmosphere was calm (10 comments), appropriate physical contact was established (8), the student attended to the patient (8), the student acted in a well-structured manner (7), and the role-play was well structured by the clinical teacher (7). SPs felt uncomfortable if they were excluded from communication (16), actions were not properly explained (14), students did not attend to the patient (10), students did not stay in their role (10), and everyone talked at the same time (8).

SPs highly valued a clear structure of the teaching setting and appropriate preparation and good communication skills on the students' part. Many of the aspects of teaching quality were found to be under the influence of the clinical teacher and may, therefore, be important for teacher training.