Background: Little research has examined standardized patient experiences in stressful simulation scenarios.
Methods: Qualitative, secondary data analysis.
Results: Emergent themes included: "Those kinds of things are important": The incorporation of personal experiences enhances communication accommodation experiential learning; "She was trying to buffer the bad news": How SPs recognize and address problematic divergent behaviors; and "The emotions come up": Interactions with excellent communication accommodation behaviors can lead to SP emotional and physical distress.
Conclusion: Standardized patient expertise enhances scenario realism and communication skills evaluation. To minimize distress, simulation educators should tailor safety measures specifically for the individual standardized patient and the scenario.
Keywords: Standardized patient; delivering bad news; experiential learning; qualitative research.