The Use of Standardized Patients to Minimize Anxiety in Undergraduate Nursing Students in the Clinical Setting

Anxiety in undergraduate nursing students in the clinical setting is caused by many factors, including fear of harming patients, difficulty transitioning, and unsupportive relationships. This has negative effects which include compromised student learning, decreased clinical performance, increased risk for patient harm, and a long term effect of worsening of the nursing shortage. The issue of student anxiety in the clinical setting must be addressed by nurse educators. Implementing the use of standardized patients (SPs) is one strategy that may minimize anxiety while preparing students to enter the clinical setting. Standardized patients are trained to portray an illness or a scenario, while interacting with students to create a realistic, low-risk learning experience. Advantages of SPs for students include the realistic clinical experience in a non-threatening, low-risk environment; the integrative learning experience; the positive, meaningful experience; constructive feedback; and common learning experience for students. Advantages for faculty include control and consistency, versatility and practicality, and the constructive feedback faculty gain. The large expenses and increased faculty workload associated with SPs continue to create barriers for their implementation within nursing education; these barriers are compounded by the lack of evidence supporting the use of SPs to decrease student anxiety. Further research is needed to support the use of SPs as a strategy to decrease undergraduate nursing student anxiety in the clinical setting. Standardized Patients and Student Anxiety 3 Undergraduate nursing students face many challenges as they work through the difficult and often stressful nursing curriculum. The clinical experience is a critical part of this curriculum because it helps students apply their knowledge through actual patient care (Yoo & Yoo, 2003). Unfortunately, the clinical setting is also what students frequently state as a major source of anxiety (Melo, Williams, & Ross, 2010; Penn, 2008; Shaban, Khater, & Akhu-Zaheya, 2012). Although anxiety in the clinical setting is not a new phenomenon in undergraduate nursing, little has been done by nurse educators to address the issue (Moscaritolo, 2009). The need to manage student anxiety in the clinical setting will always exist, but minimizing its negative effects is still a possibility. A potential strategy to minimize the negative effects of anxiety in the clinical setting is through the implementation of standardized patients (SPs). Standardized patients are trained to portray an illness or a scenario, while interacting with students to create a realistic, low-risk learning experience (Becker, Rose, Berg, Park, & Shatzer, 2006). Although new to undergraduate nursing education, SPs are widely accepted in medical schools and nurse practitioner programs and have been used for decades as methods of teaching and evaluation.