School of Nursing turns to alums as patient actors in novel training approach

Nursing School
Alumna and retired nurse Laura Nosek (NUR ’61, ’81; GRS ’86) assumed the role of a depressed alcoholic as part of the school’s Alumni Standardized Patient Program.

Alumni from the Case Western Reserve University Frances Payne Bolton School of Nursing switched roles from being nurses to patients with depression and substance abuse issues, in order to give student nurses some special training in communications.

The novel use of alumni as standardized patients, the name for actors playing the role of patients, was reported in the Clinical Simulation in Nursing article “Nursing Alumni as Standardized Patients: An Untapped Resource.”

Five alumni volunteered to act in simulated medical scenarios to provide student nurses with experience working with real people rather than just manikins. The new approach allows students one-on-one training before they start working with actual patients.

“These experiences allow students to build on the basic communication and assessment skills taught in undergraduate clinical courses,” said Celeste Alfes, assistant professor and director of the simulation program.

In seeking creative ways to train students, Alfes, who runs the skills and simulation center, decided to tap alumni as stand-in patients.

Nursing school faculty, she explained, agreed that alumni—because of their professional knowledge and clinical skills—were ideal candidates to serve as standardized patients. Alumni received two hours of training and detailed descriptions of their roles.

Alfes was pleased with the results.

“Given their clinical backgrounds, the alumni assumed the roles effortlessly. They acted out depression, withdrawal, and even cried spontaneously,” she said.

The alumni felt they had made a valuable contribution to undergraduate education and enjoyed building a relationship with students from their alma mater, Alfes said.

Students were videotaped to gauge how well the new approach worked. Third-year bachelor’s of nursing students enrolled in the psychiatric/mental health nursing course exceeded performance expectations, she said. Students received feedback while watching videos of themselves working with standardized patients.

Using alumni as patients was also cost-effective, Alfes said, helping save on fees paid to actors for playing the patient role.

Based on the success of the alumni pilot program, the National League for Nursing awarded the school a $20,000 grant last summer to study whether training with students playing the role of patients can be as effective as using professional actors, who get paid $20 per hour.

“We are trying to justify the cost and time to hire the professional actors,” Alfes said. “We want to see if the interactions between student-to-student role play is as effective as student-to-standardized patient actors.”

While the nursing school is trying different methods to provide pre-clinical training, the volunteer alumni will return next spring to help train first-year students on taking health histories from “real” people.