• Jill S Sanko, Ilya Shekhter, Richard R Kyle, Stephen Di Benedetto, and David J Birnbach.
• Center for Patient Safety, University of Miami-Jackson Memorial Hospital, Miami, USA. jsanko@comcast.net
• Simul Healthc. 2013 Aug 1; 8 (4): 215-20.

Summary StatementAmong the most powerful tools available to simulation instructors is a confederate. Although technical and logical realism is dictated by the simulation platform and setting, the quality of role playing by confederates strongly determines psychological or emotional fidelity of simulation. The highest level of realism, however, is achieved when the confederates are properly trained. Theater and acting methodology can provide simulation educators a framework from which to establish an acting convention specific to the discipline of healthcare simulation. This report attempts to examine simulation through the lens of theater arts and represents an opinion on acting in healthcare simulation for both simulation educators and confederates. It aims to refine the practice of simulation by embracing the lessons of the theater community. Although the application of these approaches in healthcare education has been described in the literature, a systematic way of organizing, publicizing, or documenting the acting within healthcare simulation has never been completed. Therefore, we attempt, for the first time, to take on this challenge and create a resource, which infuses theater arts into the practice of healthcare simulation.

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