Effects Associated with Adolescent Standardized Patient Simulation of Depression and Suicidal Ideation

BACKGROUND: Because of common use of adolescent simulated patients (ASPs), clarification of the risk of negative effects associated with high-stress simulations is essential. This study evaluates the safety of suicidality simulations. METHOD: ASPs participated in a suicidality role or pediatric role. Explicit measures of their impact included the Suicidal Ideation Questionnaire (SIQ) and Reynolds Adolescent Depression Scale-2 (RADS-2), both of which were completed pre-/poststudy. Implicit behavioral measures of impact were also collected during training, including the Implicit Association Test. RESULTS: Three of the 24 participants had clinical RADS-2 and/or SIQ scores. None of these adolescents' mental status deteriorated with SP participation. ASPs in the suicidality role showed behavioral effects consistent with a negative reaction, and two reported brief depression. CONCLUSIONS: ASPs participated in a suicidality simulation without evidence of suicide contagion. However, ASPs' behavioral reactions and self-reported depression suggested a transient depressive reaction.