Power and adolescent simulated patients: A qualitative exploration

Adolescent simulated patients (SPs) work in an environment where complex and dynamic power relationships are at play. These relationships differ to those encountered in clinical practice. Instead of health professionals exerting their power from a foundation resting on knowledge, to a patient consumed with worry, SPs in simulation scenarios often have less worry and more knowledge than the learner. Combined with this, their role in judging and assessing learner performance adds to their power base. Adolescent SPs also experience power from the opposite perspective; where they have power exerted upon them, with limited ability to resist. This research aims to explore power relationships from adolescent SP's perspectives. Ten adolescent SPs, (10-19 years), participated in semi-structured interviews that were analysed using an interpretive phenomenological approach. Four themes resulted from an in-depth analysis of interview transcripts: 1) Becoming and being a powerful simulated patient; 2) redirection, resistance & responsibility; 3) the power of the role; and 4) a complex maze of interactions. These themes reflect the experiences adolescent SPs are exposed to and the powerful interactions that can result. Whilst there are positive outcomes for adolescent SPs, there is also a risk of harm. Recognizing this is an ethical imperative to ensure adolescent safety during the simulation process.