Table 5. Backstory for the Simulated Patient.

Presented here are the vital signs and an example of a backstory for the simulated patient, in order to answer questions consistently between encounters. 

Initial Presentation
Initial Vital Signs	BP: 116/73     HR: 75      RR: 15     SpO2: 99    Temp: 97
Overall Setting and Appearance	Outpatient clinic setting, a Mexican adolescent female patient and a medical interpreter both sitting in chairs next to the exam table
Standardized Participants (and their roles in the room at case start)	Backstory for Latina actress:  You’ve lived in the United States and (insert your specific local community information as applicable) for the last year. Our goal is to have the resident address the hesitancy of the actress to answer sensitive questions (sexual health/orientation, substance abuse, etc.) with the use of an interpreter.
HPI	Be sure to answer promptly and comfortably for the initial questions that are non-sensitive. Start to show hesitancy when sensitive questions about drug/alcohol use are asked, perhaps by answering more shortly and looking at the floor. When sexual health questions are asked, there should be a noticeable demeanor change, such as being much slower to answer, or even just falling silent, and looking at both the doctor and the interpreter nervously. When the resident begins addressing your discomfort, say you are concerned about answering private questions with another person present who is not the doctor. Allow the resident to ask why that might be the case. No known COVID-19 symptoms or exposures if asked (if the simulation takes place during the COVID-19 pandemic)
Past Medical/Surgical History	Medications	Allergies	Social/Family History
No significant medical history, no major surgeries	None	None	You grew up in a rural part of Mexico. You have not yet learned English fluently since immigrating here with your family. You live with your parents and your two younger siblings in a two-bedroom home. You have no symptoms of anything, except you don’t sleep well. Because both of your parents work long hours, you take on the responsibility of caring for your younger siblings most evenings. You are actively involved at your local church. When you first started school in the United States, you found it hard to make friends. Your boyfriend of six months now was the first person to openly engage with you at school and you two are currently in a close and trusting relationship. You do not smoke but you tried alcohol once at a party. You do not currently worry about money or getting enough food. No one in your family, including you, smokes, drinks, or does drugs of any kind. You have only been sexually active with your boyfriend, and you do not use birth control or condoms. You have not been sick or had any fevers/rashes.
Physical Examination: Normal physical exam findings