The effect of characterisation training on the congruence of standardised patient portrayals

Ina Treadwell, Louise Schweickerdt-Alker, Deidre Pretorius, Margaret Daisy Hugo


Background. Incongruence of standardised patient (SP) portrayals is worsened when SPs are given basic scenarios and too little background information on short notice. Consequently, SPs are confronted with questions they find difficult to answer owing to a lack of insight, internalisation and association with the role.

Objective. To determine whether training in characterisation enhances the congruence of SP portrayals.

Methods. SP encounters were recorded, after which the participating SPs and students reflected on the congruence of the SPs’ performances. The researchers analysed the videorecordings and reflections for incongruent behaviours. The findings were triangulated and themes of incongruency were established. The intervention comprised training of SPs in the creation of subtext (the story behind the story), characterisation, and linking to and making use of emotion memory, with the aim of rectifying the observed incongruent behaviours. Pretraining activities were repeated with Cohort 2 students.

Results. Two themes depicting congruence, i.e. internalisation of character and congruence of verbal and non-verbal communication, were identified. Post-training outcomes revealed an improvement in all subthemes. Applicable and real emotions, complementing verbal and non-verbal cues, gestures and appropriate use of voice and facial expression, led to believable/congruent role play and improved communication on various levels.

Conclusion. The post-training outcomes showed clear improvement regarding the congruence of SP portrayals. The changes can be contributed to SP training focused on 3D character development by creating subtext, providing basic clinical information, emotion memory, acting skills and managing energy levels, and not focusing on the scenario alone.


Authors' affiliations

Ina Treadwell, Skills Centre, Faculty of Health Sciences, University of Limpopo (Medunsa Campus), Pretoria, South Africa

Louise Schweickerdt-Alker, Skills Centre, Faculty of Health Sciences, University of Limpopo (Medunsa Campus), Pretoria, South Africa

Deidre Pretorius, Department of Family Medicine, University of the Witwatersrand, Johannesburg, South Africa

Margaret Daisy Hugo, Practice of Medicine, Faculty of Health Sciences, University of Limpopo (Medunsa Campus), Pretoria, South Africa

Full Text



Simulated/standardised patients; Characterisation; Subtext; Congruence

Cite this article

African Journal of Health Professions Education 2014;6(1):56-59. DOI:10.7196/AJHPE.193

Article History

Date submitted: 2012-10-04
Date published: 2014-03-11

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