Six formats in simulated and standardized patients use, based on experiences of 13 undergraduate medical curricula in Belgium and the Netherlands

Background: In Belgium and the Netherlands, 13 medical schools collaborate with regard to the use of simulated patients (SPs) and standardized patients in their undergraduate curricula. All schools use SPs in their curriculum but schools differ in (a) the timing or placement of the SPs and (b) the way they are used. Aim: To give an overview of the formats used most in undergraduate medical education with SPs, including a description of the impact of these formats on the different aspects of SPs. Methods: Representatives of all medical schools in Belgium and The Netherlands all provided a structured overview of their use of SPs. We then collectively made a description of the main working formats. For each format we identified salient consequences on the SP level, including whether the format requires simulated or standardized patients or patient-actors, what is the impact of a format on the selection of SPs, content and duration of SP training, whether or not to use checklists in role training, feedback training or not, debriefing of training, impact on the case (role) description (e. g. free or structured), the number of SPs needed, and the selection criteria for SPs. Conclusion: The working format with SPs more or less determines the whole process of selection, training, performance, and logistics of SPs.