The Role of Standardized Patient Programs in Promoting Equity, Diversity, and Inclusion: A Narrative Review

Integrating equity, diversity, and inclusion (EDI) in curricula for training health professionals is a frequent institutional goal. The use of standardized (or simulated) patient programs (SPPs) to support EDI in health sciences training is not well described. Here the authors present a theoretical model based on a synthesis of the literature for using SPPs in EDI training, along with a narrative review of the available literature.

The authors searched PubMed, Scopus, Science Direct, and Google Scholar databases for studies published between January 2000 and October 2019 describing the use of SPPs to support EDI in health sciences education. Studies were included if they described standardized patient (SP) education involving EDI and reported empiric data about its design, delivery, or effectiveness. The authors conducted a narrative review and provided a synthesis of the available literature, identifying key themes.

Out of 117 studies identified, 17 met the inclusion criteria. Most studies (53%; n = 9) focused on cultural competence; many focused on communication with diverse patients (29%; n = 5) or health inequity (18%; n = 3). Studies employed portrayal of diversity (71%; n = 12) or learning objectives supported by diversity (29%; n = 5) as approaches to EDI relevant to SP training. Three primary themes emerged: improving cultural competence, effective communication with diverse patients, and highlighting health inequalities.

This review outlines approaches to EDI-based SPPs, with the perspectives and priorities of institutional approaches in mind. SP education around specific EDI issues is reported; however, programmatic approaches to EDI by SPPs are lacking. More research is needed to provide further evidence for the challenges, effectiveness, and outcomes of developing and implementing EDI-based SPPs in health sciences education.