A Systematic Review of Emotional, Cognitive, and Logistical Factors Influencing Simulated Patient Performance in Simulation-Based Education
Folorunsho, Evelyn F., Malabu, Usman H., Anderson, Emma, and Malau-Aduli, Bunmi S. (2025) A Systematic Review of Emotional, Cognitive, and Logistical Factors Influencing Simulated Patient Performance in Simulation-Based Education. Advances in Medical Education and Practice, 16. pp. 2229-2247.
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Abstract
Purpose: Simulated patients (SPs) are critical to simulation-based education (SBE) in developing learners’ clinical, communication, and professional skills. However, limited research has examined the factors influencing SP performance and consequent learning outcomes. Patients and Methods: We conducted a systematic review (2013–2025) using six databases, focusing on human SPs in healthcare education. Nineteen studies met the inclusion criteria and were analyzed using inductive thematic analysis. Study quality was assessed using the QATSDD tool. Results: Inductive thematic analysis identified three key domains influencing SP performance: emotional (anxiety, fulfillment), cognitive (task complexity, improvisation), and logistical (training, scheduling). SP involvement enhanced educational outcomes (empathy, communication, clinical reasoning) but was sometimes limited by SP fatigue, stress, or cognitive overload. Among the reviewed studies, 7 were high and 12 were of medium quality (no low-quality studies). Conclusion: Authentic SP portrayals enhance student learning, but factors such as emotional strain and cognitive load can limit effectiveness. We recommend structured SP training, robust feedback mechanisms, and attention to SP cognitive and cultural challenges. Future research should prioritize long-term SP outcomes, measurement of SP cognitive load, and exploration of ethical and cultural dimensions of SP engagement.
| Item ID: | 90059 |
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| Item Type: | Article (Research - C1) |
| ISSN: | 1179-7258 |
| Keywords: | cognitive load, feedback, learning outcomes, medical education, simulated patients |
| Copyright Information: | © 2025 The Author(s). This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms and incorporate the Creative Commons Attribution - Non Commercial (unported, 4.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms. |
| Date Deposited: | 19 Aug 2026 04:43 |
| FoR Codes: | 39 EDUCATION > 3901 Curriculum and pedagogy > 390110 Medicine, nursing and health curriculum and pedagogy @ 100% |
| SEO Codes: | 16 EDUCATION AND TRAINING > 1601 Learner and learning > 160102 Higher education @ 100% |
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