From Simulation to Conversation: Simulated Patients' Contribution to Meaningful Feedback Dialogues

Simulated patients (SPs) play a key role in medical communication training, yet their contribution to feedback dialogues during post-simulation feedback sessions remains underexplored. This study explored how SPs contribute to meaningful feedback dialogues among students during feedback sessions after simulation-based consultations.

Using an interpretivist qualitative approach, video-recorded feedback sessions with first-year technical medical students and SPs were analyzed. Episodes identified as meaningful feedback dialogues were thematically analyzed, focusing on SP contributions.

Of the 120 one-minute episodes during feedback sessions, 36 episodes were classified as meaningful feedback dialogue. These were characterized by one or more of the following aspects: SPs' guidance on task performance, shifting positions of SPs, and SPs supporting the contribution of students by facilitating and creating space.

SPs' guidance on task performance appears to respond to students' need for direction. While such guidance can support learning, it also risks reducing student reflection. Therefore, SPs need awareness of when and how to provide guidance. Although instructed to remain in the patient positions, SPs adopt multiple positions: the patient's position, the expert's position, and the meta-position during the feedback dialogue, which can enrich learning if managed consciously. Increasing SPs' awareness of these different ways of contributing to students' learning may enhance their educational impact in communication training.