Perspectives of Simulated Patients Who Portray People Living With Serious Illness, a Qualitative Study

BackgroundMany clinicians lack the skills and training necessary to have goals of care conversations. Training to develop these skills often uses simulated patients (SPs) who are asked to portray patients living with serious illness. The psychological impact of portraying a patient with serious illness has not been well studied.ObjectiveThe aim of this study was to explore the perspectives, motivations, and experiences of SPs portraying patients living with serious illness.MethodsIn this single center qualitative study, we developed a semi-structured interview guide, performed cognitive testing and then interviewed 13 SPs who had participated in our goals of care communication trainings. All interviews were recorded and transcribed. We utilized thematic analysis to identify domains, themes, and representative quotes.ResultsThirteen SPs participated. We identified four domains: 1. Motivated by belief in the mission of the work; 2. Intersection between portrayal and personal experience; 3. Portrayal is emotionally taxing and self-care mechanisms are essential for the longevity of the work; 4. Format and structure of the curriculum can be challenging.ConclusionAltruistic motivators contributed to emotional resilience that offset the potential toll of this work for SPs. Both meaning and benefit were perceived from intersections between portrayals and personal experience. Understanding SP experience can generate improvements to help promote wellness and longevity for SPs to participate in these valuable trainings.