Background: The use of standardized patients (SPs) to portray emotionally i
ntense roles has stimulated inquiry into the effects such roles might have
on the actors.
Purpose: Our study endeavored to obtain a rich description of the consequen
ces of highly affective psychiatric roles on SPs. We wanted to find out wha
t conditions made these consequences worse or better and what countermeasur
es, if any, SPs had evolved to address the effects of case simulation.
Methods: In a pilot phase, 16 SPs completed a survey exploring the extent t
o which they were affected by playing emotionally intense roles. Based on t
hese surveys, questions were developed for subsequent focus groups examinin
g these effects. Four focus groups of 9 SPs each (N = 36) were taped, trans
cribed, and coded by 2 independent raters.
Results: In the pilot survey 11 of 16 SPs (69%) described residual psychoph
ysiological effects. In the focus groups, all SPs reported some effect of p
ortraying emotional roles, sometimes lasting several days. Several variable
s appeared to increase or mitigate the likelihood of such residual effects.
Conclusions: Understanding the ways in which SPs are affected by portraying
emotionally intense roles, and the personal and situational variables that
increase or mitigate these effects, can lead to improved recruitment, trai
ning, and performance.