The effect of standardized patient's for physical therapy students on behaving and communicating as a professional: a systematic review

Background: Previous systematic review and meta-analysis examining standardized patients (SPs) in Physical Therapy (PT) education yielded 14 articles describing 16 studies; 10 addressed professional behaviors (PB), and six reported providing SP feedback to students. Of those six studies, four were randomized controlled trials (RCTs) emphasizing SP feedback on clinical competencies. Only two studies examined PB or communication in PT students after receiving SP feedback. There appears to be a gap within the current literature to understand better SPs' ability to impact PT students' communication and PB as they prepare for clinical education. This systematic review aimed to synthesize and critically appraise the findings of empirical studies (qualitative or quantitative) evaluating the contribution of SPs on the student's affective learning domain (professional behavior and/or communication) in PT entry-level education. Methods: A systematic review was completed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines for Reporting Systematic Reviews on December 1, 2021, using the following electronic databases PubMed, Cochrane Central Register of Control Trials, CINAHL, ERIC, SCOPUS, and Web of Science. Article inclusion criteria: peer-reviewed, assess PT students, assess the affective learning domain, intervention using live, standardized patient learning experiences, and be written in the English language. Studies were excluded if they involved peer-role play as the (SP) or if the authors did not describe the SP process. The risk of bias was evaluated through the Critical Appraisal Skills Programme tool (CASP), given the heterogeneity of study types anticipated for this systematic review, and PEDro if the study design was a RCT. Results: There were ten included studies in this review. Two studies were RCT designs that explored Immersive Simulation-Based Learning Experience (SBE) in the clinic's impact on PB, and all used the Assessment of Physiotherapy Practice (AAP) outcome measure. The other seven studies examined SPs or SBE on PB within the classroom and had significant heterogeneity based on study design and outcomes reported. Discussion: Summative results suggest that SP or SBE has some unique attributes, if applied in the clinical environment, may improve students' PB and core values development, consistent with a PT practice. This systematic review may inform academic leadership and clinical educators in physical therapy education delivery. Integrating experiential and simulated learning experiences into a program may increase efficiency by allowing students to demonstrate clinical competence skills sooner. Limitations: Heterogeneity of study design and reported outcomes limited the results and pooling of data.