Nursing Students' Experiences of Standardized Patient Practice: A Qualitative Study

Year 2026, Volume: 33 Issue: 1, 59 - 70, 21.03.2026

Afra Çalık , Sıddıka Ersoy

https://doi.org/10.17343/sdutfd.1757910

https://izlik.org/JA96TY52PK

Abstract

Objective
Standardized patient (SP) applications are the general
term for educational activities in the field of health that
are conducted with simulated patients playing the
role of trained patients. This study aimed to explore
nursing students’ experiences with standardized
patient simulation in relation to the components of the
NLN Jeffries Simulation Theory.

Material and Method
This study used a qualitative research design.
Involving focus group interviews with 24 second-year
nursing students who participated in the SP simulation.
Data were collected through open-ended questions
structured according to the NLN Jeffries Simulation
Theory and were analyzed thematically based on the
framework’s five components: context, background,
design, simulation experience, and outcomes.

Results
Students perceived the SP simulation as realistic,
educationally valuable, and confidence-enhancing.
While they reported gains in communication and
patient education skills, some noted unclear role
definitions and limited peer collaboration.

Conclusion
SP simulations were found to be effective in
supporting experiential learning and developing
professional competencies in nursing students. The
study confirms the applicability of the NLN Jeffries
Simulation Theory in evaluating SP experiences
and suggests that structured role assignments and
more detailed preparatory materials can enhance
simulation outcomes.

Keywords

Communication , Nursing education , Simulation theory , Standardized patient

Ethical Statement

This study was carried out under the ethical standards of the research committee of the institution by the 1964 Helsinki Declaration and its later amendments or comparable ethical standards, after the decision of the Suleyman Demirel University Human Research Ethics Committee (Approval number: 11/08/2023, 621085). The participants were informed about the aim of the study, the use of simulated patient (SP) training, and the audio recording of the interviews. Written informed consent was obtained from all students before participation, and verbal consent was also recorded at the start of each session.

Supporting Institution

This research did not receive any specific grant from funding agencies in the public, commercial, or not-forprofit sectors.

Thanks

The authors thank the students and SPs for their participation.

References

• 1. Norman J. Systematic review of the literature on simulation in nursing education. ABNF J. 2012;23(2):45-52
• 2. García-Velasco L, Alcoceba-Herrero I, García S, López M, Albertos-Muñoz I, Castro M-J, et al. Assessing anxiety and stress levels in undergraduate nursing students during their clinical placements: a quasi-experimental study. BMC Nurs. 2025;24(1):620.
• 3. Kaddoura MA. New graduate nurses’ perceptions of the effects of clinical simulation on their critical thinking, learning, and confidence. J Contin Educ Nurs. 2010;41(11):506-16.
• 4. Luctkar-Flude M, Wilson-Keates B, Larocque M. Evaluating high- fidelity human simulators and standardized patients in an undergraduate nursing health assessment course. Nurse Educ Today. 2012;32(4):448-52.
• 5. Robinson-Smith G, Bradley PK, Meakim C. Evaluating the use of standardized patients in undergraduate psychiatric nursing experiences. Clin Simul Nurs. 2009;5(6):e203-e11.
• 6. Rutherford-Hemming T, Alfes CM, Breymier TL. A systematic review of the use of standardized patients as a simulation modality in nursing education. Nurs Educ Perspect. 2019;40(2):84-90.
• 7. Ross JG, Furman G, Scheve A. The impact of standardized atients on first-year nursing students’ communication skills. Clin Simul Nurs. 2024;89:101513.
• 8. Park YM, Hwang WJ. Development and effect of a simulation- based disaster nursing education program for nursing students using standardized patients. J Nurs Res. 2024;32(1):e314.
• 9. Byrne D, Overbaugh K, Czekanski K, Wilby M, Blumenfeld S, Laske RA. Assessing undergraduate nursing students' attitudes toward the dying in an end-of-life simulation using an ACE.S unfolding case study. J Hosp Palliat Nurs. 2020;22(2):123-9.
• 10. Jeffries P. The NLN Jeffries Simulation Theory. Williams & Wilkins; 2021.
• 11. Cowperthwait A. NLN/Jeffries simulation framework for simulated participant methodology. Clin Simul Nurs. 2020;42:12-21.
• 12. Bozkurt SA, Samia R, Gazarian PK. Using standardized patient simulation in undergraduate nursing education: a scoping review. Clin Simul Nurs. 2023;74:3-18.
• 13. Tabriz ER, Sadeghi M, Tavana E, Miri HH, Nabavi FH. Approaches for boosting self-confidence of clinical nursing students: A systematic review and meta-analysis. Heliyon 2024;10(6).
• 14. Rutherford-Hemming T, Herrington A, Ngo TP. The use of standardized patients to teach communication skills—A systematic review. Simul Healthc. 2024;19(1S):S122-S8.
• 15. Lewis KL, Bohnert CA, Gammon WL, Hölzer H, Lyman L, Smith C, et al. The association of standardized patient educators (ASPE) standards of best practice (SOBP). Adv Simul. 2017;2(1):10.
• 16. Cope DG. Methods and meanings: credibility and trustworthiness of qualitative research. In the Oncology nursing forum. 2014;41(1).
• 17. Guest G, Bunce A, Johnson L. How many interviews are enough? An experiment with data saturation and variability. Field methods. 2006;18(1):59-82.
• 18. Hussein MTE, Harvey G, Favell D. Using exploratory sequential mixed methods design to develop simulation safety practice tool (SSPT). Clin Simul Nurs. 2025;101:101704.
• 19. Conway KA, Scoloveno RL. The use of standardized patients as an educational strategy in baccalaureate psychiatric nursing simulation: A mixed method pilot study. J Am Psychiatr Nurses Assoc. 2024;30(2):414-7.
• 20. Torkshavand G, Khatiban M, Soltanian AR. Simulation-based learning to enhance students’ knowledge and skills in educating older patients. Nurse Educ Pract. 2020;42:102678.
• 21. Çakmak B, Inkaya B. The effect of a repeated standardized patient-based end-of-life care training program on nursing students’ knowledge, attitudes, and emotions toward end-of-life patients. Am J Hosp Palliat Med. 2024;42(1):64-79.
• 22. Molloy MA, Holt J, Charnetski M, Rossler K. Healthcare simulation standards of best practiceTM simulation glossary. Clin Simul Nurs. 2021;58:57-65.
• 23. Kim E, Kim SS, Kim S. Effects of infection control education for nursing students using standardized patients vs. peer role-play. Int J Environ Res Public Health. 2021;18(1):107.
• 24. Salifu DA, Heymans Y, Christmals CD. Facilitating the development of clinical competence in a low-resource setting: perceptions and challenges of nurse educators. Nurse Media J Nurs. 2022;12(1).
• 25. Lawaetz J, Soenens G, Eiberg J, Van Herzeele I, Konge L, Nesbitt C, et al. Facilitators and barriers to implementation of simulation based education in vascular surgery in Europe. Eur J Vasc Endovasc Surg. 2023;66(3):428-36.
• 26. Antila AK, Lindblom S, Louhiala P, Pyörälä E. Creating a safe space: medical students’ perspectives on using actor simulations for learning communication skills. BMC Med Educ. 2024;24(1):1225.
• 27. Madsgaard A, Røykenes K, Smith-Strøm H, Kvernenes M. The affective component of learning in simulation-based education–facilitators’ strategies to establish psychological safety and accommodate nursing students’ emotions. BMC Nurs. 2022;21(1):91.
• 28. Elendu C, Amaechi DC, Okatta AU, Amaechi EC, Elendu TC, Ezeh CP, et al. The impact of simulation-based training in medical education: A review. Medicine (Baltimore). 2024;103(27):e38813.