Abstract
Standardized patients, simulated participants, and simulated patients (SPs) are essential in emergency medicine (EM) training, offering both structured and psychologically safe opportunities for learners to develop communication and interpersonal skills. With upcoming changes to the American Board of Emergency Medicine Certifying Exam, the importance of SP-based education in residency training has further increased. Yet many programs face various constraints that preclude consistent access to professionally trained SPs, including financial, scheduling, availability, or other resource limitations. As a result, many EM educators are increasingly turning to ad hoc SPs, here defined as individuals recruited from local networks who have not undergone formal SP training. This paper draws on the collective experience of EM educators who have worked extensively with both professionally trained and ad hoc SPs across undergraduate, graduate, and continuing medical education settings, as well as best practices recommended by the Association of Standardized Patient Educators. We outline practical recommendations for recruiting, preparing, deploying, and supporting ad hoc SPs for programs with limited access to professionally trained SPs.