This study's primary aim is to assess the use of different types of standardized patients (SPs) during formative simulation activities on summative objective structured clinical exams (OSCE) in a PharmD curriculum.Randomized-controlled study with first-year pharmacy students in a Pharmacist Patient Care Lab (PCL) course. Students were randomized into groups with either hired actors or their peers as SPs for virtual simulation activities. All students then completed a virtual teaching OSCE (TOSCE) and virtual OSCE. A mixed effects analysis was done to compare TOSCE and OSCE scores between the two groups.There were no significant differences between the two groups in their TOSCE or OSCE scores for the analytical and global rubrics.This study demonstrates that peers may be as effective as having hired actors as SPs in preparing students for virtual skills exams.