Using Nurses as Standardized Patients in Simulation-Based Training for Pregnancy Loss Grief Counseling: A Mixed-Methods Pilot Study

Background Effective physician communication following pregnancy loss is crucial yet challenging. Recruiting traditional standardized patients for such sensitive training is often constrained by cost, authenticity, and ethical concerns. This pilot study evaluated the feasibility and preliminary outcomes of using in-service nurses as standardized patients in simulation-based grief counseling training for pregnancy loss. Methods A mixed-methods pilot study was conducted at a tertiary hospital in China. Four obstetric/gynecological nurses served as standardized patients for 24 resident physicians across six workshops structured on Kolb’s experiential learning cycle. Quantitative data from trainee and instructor evaluations of standardized patient performance were analyzed descriptively. Qualitative data from focus group interviews with nurses serving as standardized patients were analyzed using reflexive thematic analysis. Results Quantitative evaluations were highly positive, with overall mean scores of 4.36 (standard deviation 0.48) from trainees and 4.31 (standard deviation 0.55) from instructors on a five-point scale. Thematic analysis yielded three main themes: advantages, benefits, and challenges. Nurses' clinical experience enabled authentic, nuanced portrayals and educationally insightful feedback. Participation enhanced nurses' communication skills, fostered interprofessional understanding, and provided unexpected emotional healing for some. Challenges included initial role boundary blurring, necessitating clear training protocols and emotional safety mechanisms. Conclusions Using nurses as standardized patients is a feasible and effective innovative model. Nurses competently perform this role, leveraging clinical experience for authentic simulation and meaningful feedback. Their participation yields intrinsic benefits including skill acquisition and deep professional growth, forming a sustainable driver for the model. This approach presents an economically viable and educationally valuable pathway for high emotional-load communication training in resource-limited healthcare settings.