Identity formation of simulated participants in health professions education: A critical review

Abstract

Simulated participants (SPs) play an important role in health professions education through their involvement in teaching, assessment, and feedback. However, much of the existing literature has tended to emphasise their functional and pedagogical roles, with relatively less attention paid to how SPs develop and negotiate their professional identities. In this review, we focus on examining the processes associated with SP identity formation, drawing attention to the ways social interaction, role enactment, and theoretical perspectives intersect in simulation-based education. A critical review methodology was employed to synthesise and interpret the existing literature. Searches were conducted in PubMed, PsycINFO (Ovid), Web of Science, and Scopus using predefined keywords related to simulated participants and identity. Studies published in English or Turkish and mentioning SP identity were included. After screening the abstracts and full-texts, ten studies were identified for thematic content analysis. Three broad themes were identified. 1) The needs of simulated participants, 2) SP-related theories, and 3) The characteristics of SPs’ identities. SP identity formation is a process that is shaped through ongoing social interaction, contextual influences, and participation in simulation communities. Bringing together communities of practice and positioning theory provides a way of thinking about how SP identities are formed and how they may be better supported within simulation-based education. Recognition of SPs as identity-bearing professionals may inform ethical simulation practices, enhance SP well-being, and strengthen the overall quality of health professions education.