A qualitative exploration of quality assurance for standardized patient in China

The educational value of standardized patient (SP) programs depends on the quality of SP performance, which in turn requires appropriate quality assurance (QA) mechanisms. However, empirical descriptions of how QA systems are organized and maintained in the Chinese context remain limited.

To qualitatively examine structures, processes, challenges, and improvement strategies related to QA for SP programs in China from multiple stakeholder perspectives.

An exploratory qualitative study was conducted using three focus groups and 16 individual interviews (N = 23) with SP program coordinators/educators, clinical educators, and experienced SP from 12 institutions across four economic regions. Data were analyzed using thematic analysis.

Five themes described key QA-related practices and experiences. (1) Upstream quality control in recruitment and admission, including targeted recruitment, multi-dimensional entry criteria, diverse recruitment channels, and scale adjustment. (2) Standardized yet differentiated training, comprising modular curricula, flexible training formats, educator team development, standardized materials, and tailored strategies by SP type. (3) Closed-loop assessment and monitoring through post-training evaluation, ongoing supervision, periodic re-training, and graded management. (4) Key challenges, including performance inconsistency, workforce instability, resource constraints, and cross-cultural, ethical, and technological issues. (5) Optimization strategies, including enhanced standardization, incentive and management systems, resource integration, scenario-specific measures, and iterative evaluation.

The findings describe a context-responsive QA practices and operational experiences characterized by structured processes and continuous refinement within prevailing resource conditions. These insights may support the development and maintenance of SP programs in similar settings.