Educational AffairsOffice of Clinical Simulation

Template for Standardized Patient Script

(Adult Patient)

The following pages outline information needed to fully develop a standardized patient script using the script format approved by the Standardized Patient Advisory committee in June 2001. 

If you are writing a new script: please fill in ALL historical information. If a physical examination is included please specify the portions of the physical examination that you anticipate the examinee will perform.

If you are reformatting an existing script: please attach the script and complete the areas of the template where the requested information is NOT present in the existing script.

While we recognize that a detailed description of the patient scenario is being requested, it is important to have this information to insure standardization of patients and accurate, reproducible portrayals. Please note: template modifications are available for the pediatric and geriatric patient. If you have any questions regarding a script, please contact:

Karen Szauter, MD
Medical Director, Standardized Patient Program
Ext: 26300

Standardized Patient Template

Thank you for your interest in the Standardized Patient Program.

Standardized Patient Tools

  • TOOLS: Sample Door Sign
  • TOOLS: Sample Script