Limitations
’ mobility
Enlisting graduate students with certain medical knowledge as SSP for teaching has many advantages in medical education. However, some limitations of this study warrant consideration. First, this study was performed in a single institution, and the potential systematic differences in the characteristics of trainees implied reduced external generalizability of the findings. Second, the medical background of SSP-TCMs would inevitably affect their performance in a pretend scenario. For instance, the use of medical terms in role-play simulations is frequent in the initial imitation but gradually decreases as they become more proficient at what they do. Third, the personnel has limited scope and quick turn-round. Graduate students’ mobility is so high that retraining a new batch of SSPs to cope with the graduation of the previous SSPs is required. Finally, the inevitable age limitations of the graduate students make the imitation of age-appropriate standardized patients difficult. The lack of diverse characters (like the elderly, infants, and pregnant women) reduces extrapolation to real-life scenarios. Therefore, well-trained occupational SPs need to be recruited to address these shortcomings.