Guide for Integrating Standardized Patients with Disabilities in Nursing Curriculum
People with disability (PWD) can assume roles as standardized patients (SPs) following training and practice. The cases available on the NLN ACE.D website describe certain disabilities (e.g., a woman following a stroke and a man with a history of an amputation), however, these cases and related physical disabilities could be modified easily if someone with a similar disability is available and willing to serve as a standardized patient. For example, the Mary Lou Brady case was modified and is also used for a woman who was born with a congenital hemipelvectomy (born with only one leg and hip). She had similar issues during pregnancy and similar safety concerns prior to discharge. The Mary Lou case can be adapted to suit the person who is available to you. The same is true for the Patrick Lake case. The scenario can be modified to accommodate a different type of amputation or other physical disability that seems relevant to the objectives for the scenario.
The rationale for using people with actual disabilities is because in doing so, students are exposed to real people with actual disabilities who can speak to and describe the actual issues related to their disability and its impact on their life and healthcare. Someone who does not have a disability can assume a role, but has not had these same “lived experience”, and therefore may not be able to provide the same insight. PWD serving as SPs provide a level of expertise related to disability, and can help students to better gain insight into what it is like to live with a disability, thereby helping to dispel students’ fears and possible misconceptions about living with disability (Long Bellil et al., 2011; Smeltzer, Mariani, & Meakim, 2017, In Press).
When training people with disability who have not had experiences in acting out roles, it is important to provide training similar to that for other untrained SPs. Reviewing the objectives for the case, the level of the students who will be involved as well as the scenario and its nuances are critical in preparing SPs for their role. Providing opportunities for standardized patients with a disability (SPWD) to practice the case and receive feedback about their performance is also very helpful. If a previous recording of a scenario is available, viewing of this recording is helpful for SPWDs to gain perspective on what is desired of them. (Smeltzer, Mariani, & Meakim, 2017, In Press).
SPWD should be provided an opportunity to give feedback to students following the interaction. Because communication with PWD is a key component to having them as participants in simulation-based learning experiences (SBLEs), this is essential following the experience. This can be accomplished with a brief checklist including:
Did the nurse or care provider:
- speak to me directly as opposed to the family member or support person,
- sit at eye level or in a position that was comfortable for me to interact,
- use active listening techniques,
- make eye contact with me,
- treat me respectfully and as an adult;
- ask about my disability and how it affects my current life situation,
- and ask if assistance is needed, rather than just taking action.
Long-Bellil, L.M., Robey, K.L., Graham, C.L., Minihan, P.M., Smeltzer, S.C. & Kahn, P. (2011). Teaching medical students about disability: The use of standardized patients. Academic Medicine. 86(11). 1163-1170. doi: 10.1097/ACM.0b013e318226b5dc.
Smeltzer, S. C., Mariani, B., & Meakim, C.H. (2017, In Press). Integration of disability in nursing education with standardized patients with disabilities (PWD) into nursing curricula. In Campbell, S.H. & Daley, K.M. (Eds), Simulation scenarios for nursing educators (3th ed.). New York, NY: Springer Publishing Company.
Copyright Colleen Meakim, Suzanne C. Smeltzer, & Bette Mariani, Villanova University College of Nursing, January 28, 2017.