Standardized Patients &  Simulations


Interprofessional Simulation Cases for Cultural Competence - The Center for International Rehabilitation Research Information & Exchange (CIRRIE) presents simulated clinical encounters with manikins and standardized patients for cultural competence training of rehabilitation students or providers. (link)

The Culturally Competent Care Education Committee (CCCECat Harvard Medical School (HMS) - CCCEC created this on-line resource center to share resources and information on initiatives in cross cultural education. They have a compilation of Case Studies (link) that present dilemmas in the delivery of Culturally Competent Care.

Eastern Virginia Medical School (EVMC)Live Humble: Practicing with Cultural Humility. The primary goal of this QEP is to improve students’ knowledge, skills, and values in cultural humility and
structural inequity. This, in turn, will improve quality of care, particularly for those who have been stigmatized.

Eastern Virginia Medical School (EVMC)  - Theresa A. Thomas Professional Skills Teaching and Assessment Center mission is to teach and assess clinical competencies in medical interviewing, clinical reasoning, ethical dilemmas, communication skills, physical examination, and the application of clinical knowledge. To accomplish their objectives, they use the services of standardized patients (SPs) from the community who are trained to present a clinical scenario, assess performance, and provide feedback to learners. They have developed SPs that address cultural issues. For more information contact: Gayle Gliva-McConvey; Email:

Maimonides Medical Center Department of Pediatrics - Dr. Altshuler was previously Co-Director of Developmental and Behavioral Pediatrics and Director of the Kids Weight Down Program and led an interdisciplinary team to deliver training and patient care. In 1998, she headed the Maimonides Department of Pediatrics Objective Structured Clinical Exam (OSCE) Training Committee. This group developed the first Culture OSCE in 1999, and has been implementing formative OSCEs for residents at Maimonides Medical Center and other teaching institutions since then. Contact: Lisa Altshuler, PhD; mail:

Hablamos Juntos Educational Partners Website - The University of California, Irvine, College of Medicine (UC Irvine) has developed an extension and implementation of their standardized patient program to include the Latino Standardize Patient Program for conditions present in the Latino Community. This program focuses on clinical conditions, which have a high level of incidence and prevalence in the Latino community. This information will be available to other interested educational programs.

Culture Learning: Simulations & Exercises - This website, compiled by the Intercultural Studies Project, is comprised of cultural simulations, exercises, films, and videos related to culture, that can be incorporated into the curriculum as starting points for classroom discussions of such issues. (link)


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Altshuler, L. and Kachur, E. (2001). A Culture OSCE: Teaching Residents to Bridge Different Worlds. Academic Medicine, 76(5), 514.

Bahreman, N. and Swoboda, S. (2016). Honoring Diversity: Developing Culturally Competence Communication Skills Through Simulation.  Journal of Nursing Education, 55(2), 105-108.

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Bertelsen, N., DallaPiazza, M., Hopkins, M., and Ogedegbe, G. (2015). Teaching global health with simulations and case discussions in a medical student selective al. Globalization and Health, 11(28), 1-8.

Bobianski, K., Aselton, P.,  and Cho, K. (2016). Home Care Simulation to Teach Culturally Based Competencies in End-of-Life Care. Journal of Transcultural Nursing, 55(1), 49-52.

Bolstad, A., Xu, Y., Shen, J., Covelli, M., & Torpey, M. (2012). Use of standardized patients and inter-rater reliability in a study on communication competence of international nurses. Nursing & Health Sciences, 14: 67-73.

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Foisy-Doll, C. (2013). Developing cultural competency in life and simulation: A year in Qatar as an exemplar. Clinical Simulation in Nursing, 9:63–69.

Garcia, B., Lu, F., and Maurer, K. (2013). Cultural Empathy: Implications of Findings from Social Work Objective-Structured Clinical Observation for Field Education. Field Educator, 2.3, 1-8.

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Green, A., Miller, E., Krupat, E., White, A., Taylor, W., Hirsh, D, Wilson, R. and Betancourt, J. (2007). Designing and Implementing a Cultural Competence OSCE: Lessons Learned from Interviews with Medical Students. Ethnicity & Disease, 17(2), 344-350.

Grossman, S., Mager, D., Opheim. H. and Torbjornsen, A. (2012). A Bi-national Simulation Study to Improve Cultural Awareness in Nursing Students. Clinical Simulation in Nursing, 8(8), e341-e346.

Guiton, G., Hodgson, C., May, W., Elliott, D., and Wilkerson. L. (2004). Assessing Medical Students Cross-Cultural Skills in an Objective Structured Clinical Examination. Center for Educational Development and Research. University of California, Los Angeles, CA. Paper presented at the American Educational Research Association Annual Conference, San Diego.

Guvenc, G., Unver, V., Basak, T., Yuksel, C., Ayhan, H., Kok, G., Konukbay, D., Kose, G., Aslan, O., Tastan, S., and Iyigun, E. (2016). Turkish Senior Nursing Students'Communication Experience With English-Speaking Patients. Journal of Nursing Education, 55(2), 73-81

Hamilton, T. (2016).  "The Influence of Transcultural Humility Simulation Development Activities on the Cultural Competence of Baccalaureate Nursing Students" (2016). Theses and Dissertations. Paper 1270.

Hark, L., DeLisser, H. and Morrison, G. (2009). Achieving Cultural Competency: A Case-Based Approach to Training Health Professionals: Chichester, UK: Wiley-Blackwell.

Hass, B., Seckman ,C. and Rea, G. (2010). Incorporating cultural diversity and caring through simulation in a baccalaureate nursing program. Journal of Human Caring, 14(2), 50-51.

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Ho, M., Lee, K. and Green, A. (2008). Can Cultural Competency Self-Assessment Performance? Predict OSCE. Medical Education, 42(5), 525.

Johnson, K., Guillet, N., Murphy, L., Horton, S. and Todd, A. (2015). “If Only We Could Have Them Walk a Mile in Their Shoes”: A Community-Based Poverty Simulation Exercise for Baccalaureate Nursing Students. Journal of Nursing Education, 54(9), S116-S119.

Kutob, R. M., Bormanis, J., Crago, M., Harris, J. M., Senf, J. and Shisslak, C. M. (2013), Cultural Competence Education for Practicing Physicians: Lessons in Cultural Humility, Nonjudgmental Behaviors, and Health Beliefs Elicitation. J. Contin. Educ. Health Prof., 33: 164–173.

Kim, J., Park, I. & Shin, S. (2013). Systematic review of Korean studies on simulation within nursing education. The Journal of Korean Academic Society of Nursing Education, 19: 307–319.

Koskinen, L., Abdelhamid, P., & Likitalo, H. (2008). The simulation method for learning cultural awareness in nursing. Diversity in Health & Social Care, 5(1), 55-63.

Lau, P., Woodward-Kim, R., Livesay, K., Elliot, K. and Nicho, P. (2016). Cultural Respect Encompassing Simulation Training: Being Heard About Health Through Broadband. Journal of Public Health Research, 15(1).

Livesay, K., Lau, P., McNair, R. and Chiminello. (2017). The Culturally and Linguistically Diverse SPs' Evaluation of Simulation Experience. Clinical Simulation in Nursing, 13(5), 228-237.

Lie, D., Boker, J., Bereknyei, S., Ahearn, S., Fesko, C., and Lenahan, P. (2007). Validating Measures of Third Year Medical Students’ Use of Interpreters by Standardized Patients and Faculty Observers. J Gen Intern Med. 22(Suppl 2): 336–340.

Maguire, M. (June,2017). Using a Poverty Simulation in Graduate Medical Education as a Mechanism to Introduce Social Determinants of Health and Cultural Competency. Journal of Graduate Medical Education, pp. 386-387.

Menzel, N., Willson, L. H., & Doolen, J. (2014). Effectiveness of a poverty simulation in Second
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Merrill, A., and Hummel, F. (2010). Simulation: A bridge to culture care. Communicating Nursing Research, 43:471.

Meltzoff, N., and Lenssen, J. (2000). Enhancing Cultural Competence Through Simulation Activities. Multicultural Perspectives, 2(1), 29-34.

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Moussa, F. (2018). Using Simulation and Cultural Competency skill to improve quality care to patients in Saudi Arabia. Journal of Health Sciences and Nursing, 3(7), 12-26.

Ndiwane, A., Koul, O., and Theroux, R. (2014). Implementing standardized patients to teach cultural competency to graduate nursing students. Clinical Simulation in Nursing, 10:87–94.

Noone, J., Sideras, S., Gubrud-Howe, P., Voss, H., and Mathews, L. (2012). Influence of a Poverty Simulation on Nursing Student Attitudes Toward Poverty. Journal of Nursing Education, 51(11), 617-622.

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Phillips, J., Grant, J., Milligan, G. and  Moss, J. (2012). Using a multicultural family simulation in public health nursing education. Clinical Simulation in Nursing, 8:e187–e191.

Roberts, S., Warda, M., Garbutt, S., and Curry, K. (2014). The use of high-fidelity simulation to teach cultural competence in the nursing curriculum. Journal of Professional Nursing, 30:259–265.

Robins, S., White, C., Alexander, G., Gruppen, L. & Grum, C. (2001). Assessing Medical Students’ Awareness of and Sensitivity to Diverse Health Beliefs Using a Standard Patient Station. Academic Medicine, 76(1), 46-80.

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Swartz, M., Colliver, J., and Robs, R. (2001). The Interaction of Examinee’s Ethnicity and Standardized Patient’s Ethnicity: An Extended Analysis. Academic Medicine, 76(10):S96-S98, 2001.

Thiagarajan, S. (2006). Barnga 25th Anniversary Edition: A Simulation Game on Cultural Clashes (3rd ed.). Boston, MA: Intercultural Press.