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General Interest: The word is out! ASPE Standards of Best Practice publication receives praise from Advances in Simulation Journal

General Interest: The word is out! ASPE Standards of Best Practice publication receives praise from Advances in Simulation Journal
By: Valerie Fulmer, ASPE President

Many of you know of our recent Standards of Best Practice (SOBP) publication in the international journal Advances in Simulation. These standards establish a baseline for best practice in SP methodology essential to this new field and all programs working with SPs. A living document, the SOBP will continue to blossom and grow to serve this community of SP educators and others around the world.

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Media Article: Comparing Physical Exam Education at U.S. Medical Schools

Media Article: Comparing Physical Exam Education at U.S. Medical Schools
By: Anna Williams
Submitted by: Valerie Fulmer, ASPE President

The resources used to teach the physical exam to pre-clerkship medical students vary widely across U.S. medical schools, according to a new study published in the journal Academic Medicine. Toshiko Uchida, MD, director of Clinical Skills Education, was the first author of the study. “The physical exam is a crucial skill for physicians, and several studies suggest that poor physical exam skills can lead to lower-quality care and medical errors,” said Uchida, also an associate professor of Medical Education and of Medicine in the Division of General Internal Medicine and Geriatrics. “But every medical school curriculum is unique, and very little is actually known about how medical schools teach the physical exam.” Read the media article in the Northwestern Medicine News Center here, or read the research article in the Journal of the Association of American Medical Colleges here.

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Research Article: The Influence of Physician and Patient Gender on Risk Assessment for Lung Cancer Resection

Research Article: The Influence of Physician and Patient Gender on Risk Assessment for Lung Cancer Resection
Lead author: Mark K. Ferguson MD
Submitted by: Todd Lash, Publications Committee Chair

Patient gender was evaluated for treatment recommendations regarding surgical therapy for lung cancer. Gender-neutral vignettes representing low-risk, average-risk, and high-risk candidates for lung resection were paired with concordant videos of standardized patients (SPs). Cardiothoracic trainees and practicing thoracic surgeons read a vignette, provided an initial estimate of the percentage risk of major adverse events after lung resection, viewed a video (randomized to male or female SP), provided a final estimate of risk, and ranked the importance of the video in the final risk estimate. There was a significant difference between male and female physicians in the absolute change in estimated risk with male physicians having larger changes than female physicians. Differences in estimating complication risk for lung resection candidates are related to physician and patient gender that may create inequities in treatment recommendations. Read the research article in the Annals of Thoracic Surgery here.

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Research Article: An Informed Consent Program Enhances Surgery Resident Education

Research Article: An Informed Consent Program Enhances Surgery Resident Education
Lead author: Sarah E. Koller MD
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

At teaching institutions, informed consent for an invasive procedure is often obtained by first-year residents. However, trainees commonly do not receive formal instruction in this area before residency, relying on observation of other residents. The authors at Temple University created an informed consent educational program, which included a didactic component, a role-play about informed consent, and a simulation exercise using standardized patients. Residents became more confident in their ability to obtain informed consent after participating in this program. Read the full article in the Journal of Surgical Education  here.

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General Interest: UofL School of Medicine to Host IMPROV FOR CLINICIANS Clinic with The Second City

General Interest: UofL School of Medicine to Host IMPROV FOR CLINICIANS Clinic with The Second City
By: Rob Stein, NPR
Submitted by: Michael Maury, UCSD School of Medicine

Here is another example of how theatrical improvisation is being used to help clinicians improve their communications skills. This article calls attention to students at the University of Louisville School of Medicine who teamed up with a Second City comedy troupe to partake in its “improv for Clinicians” workshop. "Improv for Clinicians" is meant to mirror the clinical experience that students, residents and faculty experience at the UofL School of Medicine, but with an entertaining and humorous twist.”  Might all medical schools benefit from similar workshops? Read about the event that occurred last fall at Broadwayworld.com here and let the creative ideas flow.

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Media Article: Med School's “SP Dave” Wins Growing Bolder Award for Improving Community Health

Media Article: Med School's “SP Dave” Wins Growing Bolder Award for Improving Community Health
Submitted by: Todd Lash, Publications Committee Chair

A standardized patient who has helped educate medical students since University of Central Florida’s medical school opened in 2009 was honored December 6 for helping build a healthier community. David Shaheen, a retired NASA bookkeeper known at the medical school as “SP Dave,” received a “Boldy” award from Growing Bolder, an Orlando-based media group dedicated to inspiring people to live extraordinary lives as they age. Growing Bolder promotes bold, healthy aging in multiple media platforms, including television, radio, magazine and social media. Read the full article in UCF Todayhere.

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Media Article: Standardized Patients Teach Skills and Empathy

Media Article: Standardized Patients Teach Skills and Empathy
By: Dinah Wisenberg Brin
Submitted by: Valerie Fulmer, ASPE President-elect

From his first month as a student at the University of Arkansas for Medical Sciences (UAMS) in Little Rock, Ark., Grant Cagle learned how to drape a patient, take a medical history, perform physical exams, deliver bad news, and more. And he was able to learn and practice these clinical skills—and make mistakes—without affecting actual patients. Read the full article in at AAMC Newshere.

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General Interest: Words That Keep Mental Health Stigma Alive

General Interest: Words That Keep Mental Health Stigma Alive
By: Angela E. Gambrel
Submitted by: Dan Brown, Emory School of Medicine

This is a companion/follow-up post to the blog entry posted on December 18 regarding the misuse of mental health terms. This piece delves into an interested historical perspective on how “lunatic,” “imbecile,” and other words now used exclusively as insults were once medical terms. Read the full article at HealthyPlace.com  here.

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Research Article: Effect of a Simulation-based Workshop on Breaking Bad News for Anesthesiology Residents - An Intervention Study

Research Article: Effect of a Simulation-based Workshop on Breaking Bad News for Anesthesiology Residents - An Intervention Study
Lead author: Vanda Yazbeck Karam
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

Breaking bad news (BBN) to patients and their relatives is a complex and stressful task. The ideal structure, training methods and assessment instruments best used to teach and assess BBN for anesthesiology residents remain unclear. The purpose of this study at the Lebanese American University and the University of Illinois at Chicago was to evaluate the effectiveness of an education intervention for BBN based on immersive experiences with a high fidelity simulator and role-play with standardized patients (SPs). A secondary purpose was to gather validity evidence to support the use of a GRIEV_ING instrument to assess BBN skills. Anesthesiology residents’ communication skills when BBN in relation to a critical incident may be improved with educational interventions based on immersive experiences with a high fidelity simulator and role-play with SPs. Read the full article in BMC Anesthesiology here.

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Research Article: Training and Validation of Standardized Patients for Assessing Communication and Counseling Skills of Pharmacy Students - A Pilot Study

Research Article: Training and Validation of Standardized Patients for Assessing Communication and Counseling Skills of Pharmacy Students - A Pilot Study
Lead author: Mahboobeh Khabaz Mafinejad
Submitted by: Todd Lash, Publications Committee Chair

Investigators at the Tehran University of Medical Sciences and the Karolinska Institute, Stockholm described a cross sectional and correlation study to determine the process of training valid simulated patients (SPs) for assessing communication and counseling skills of pharmacy students' performance. Three scenarios, along with corresponding checklists, were developed based on the usual medications of different diseases consisting of asthma, respiratory infections, and osteoporosis. The SPs' role-play performance was video-recorded and rated independently by two experts according to an observational rating scale to assess validity. Study validity was evaluated by statistical analysis. The role-play was repeated after 1 week with the same scenario and the same doctor, to assess test-retest reliability. The investigators concluded that trained SPs can be used as an effective tool to assess pharmacy students' communication and counseling skills. Read the full article in the Journal Research in Pharmacy Practicehere.

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General Interest: You, Me and Them - Experiencing Discrimination in America - Scientists Work To Overcome Legacy of Tuskegee Study, Henrietta Lacks

General Interest: You, Me and Them - Experiencing Discrimination in America - Scientists Work To Overcome Legacy of Tuskegee Study, Henrietta Lacks
By: Rob Stein, NPR
Submitted by: Michael Maury, UCSD School of Medicine

This article gives us good food for thought. That is, what are we doing as Standardized Patient Educators to take a stand for equality in health care? Are we creating SP cases that represent all people of various ethnicities and cultural backgrounds? Or, are we only creating cases that are easier for us to cast based on our current SP pools?

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General Interest: HealthySimulation.com Relaunches Medical Simulation Resource Website and Newsletter

General Interest: HealthySimulation.com Relaunches Medical Simulation Resource Website and Newsletter
Submitted by: Lance Bailey

After seven months of hard work, the newly redeveloped Healthcare Simulation resource website HealthySimulation.com has finally launched! Not only has the website, newsletter, and branding been updated with a modern professional aesthetic, but also has given brand new functionality to better serve you the latest in medical simulation news, product information, conference coverage, research highlights, tutorial insights, and more! Features on the website include searching and posting for medical simulation jobs, finding healthcare simulation vendors, submitting articles to share with a global community, and subscribing to the Healthy Simulation Newsletter. Read about the relaunched website and new features here.

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General Interest: Innovative UCSD Program Aims to Draw Compassion Out of Future Doctors

General Interest: Innovative UCSD Program Aims to Draw Compassion Out of Future Doctors
By: Kinsee Morlan
Submitted by: Michael Maury, UCSD School of Medicine

As Standardized Patient Educators one of our many tasks is to foster and build empathy within our student doctors. We can accomplish this in many different ways. Since many of us in the SP world come from theatrical backgrounds, we are aware of the value of the performing arts in building compassion toward others. We know that acting and theatre has a built-in empathic element which can be passed on to any learner who is open and willing to partake whole-heartedly in theatre games and improvisational exercises. What if there were other artistic endeavors that could accomplish this goal as well? In fact, there are such opportunities and in this article, author Kinsee Morlan describes an artist-in-residency program at the UC San Diego School of Medicine that has students sketch live nude models, real human skeletons and eventually cadavers helping them focus on details that build their abilities for empathy and compassion. Created by artist Joyce Cutler-Shaw and now currently taught by Larry and Debbie Kline, “the goal of the drawing class is not to turn doctors into artists, but to build empathy through art. The students will go on to be doctors, and the goal is to make them doctors who care.” Read the full article in Voice of San Diego here.

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Research Article: Actual and Standardized Patient Evaluations of Medical Students’ Skills

Research Article: Actual and Standardized Patient Evaluations of Medical Students’ Skills
Lead Author: Amelia L. Sattler, MD
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

It may be grating for many of us SP educators to hear the term “Actual Patient” as a way to distinguish from Standardized Patient, since we are all actual patients at some point and our feelings and feedback are valid. However, it is interesting to read this study that compared medical students’ ratings from SPs and the patients the students saw in their clinical rotations (APs). The authors of the study found that “feedback from APs provides unique perspectives, complementing those of SPs, and prompts insights into incorporating patients’ voices and values into training.” Read the full article in Family Medicine here.

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General Interest: Essential Reflective Writing Resource: Pulse--Voices from the Heart of Medicine

General Interest: Essential Reflective Writing Resource: Pulse--Voices from the Heart of Medicine
By: Paul Gross, MD, as submitted to DR-ED Listserv
Forwarded with permission by: Todd Lash, Publications Committee Chair

Pulse--voices from the heart of medicine, an online publication launched by Department of Family Medicine at Albert Einstein College of Medicine in 2008, now has over 11,000 subscribers.

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General Interest: OCD, Bipolar, Schizophrenic and the Misuse of Mental Health Terms

General Interest: OCD, Bipolar, Schizophrenic and the Misuse of Mental Health Terms
By: Jon Kelly and Denise Winterman
Submitted by: Dan Brown, Emory School of Medicine

If you jokingly, metaphorically, describe yourself as “OCD,” or “schizophrenic,” or “bipolar,” you could be doing a disservice to those who are clinically diagnosed with these challenging conditions, argue Kelly and Winterman. The misuse of these terms leads to a public misunderstanding of the diagnoses, and can contribute to stigmatization of mental illness. Some sufferers appreciate the increased awareness of the conditions, even if it’s misguided, but as educators in the medical field, it’s advisable to avoid using diagnostic terms in a metaphorical sense. Read the full article at BBC News Magazine here.

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ASPE Affiliate News: Introducing INACSL Standards of Best Practice - SimulationSM Operations

ASPE Affiliate News: Introducing INACSL Standards of Best Practice - SimulationSM Operations
By: The INACSL Standards Committee
Submitted by: Valerie Fulmer, ASPE President-elect

As simulation-based education (SBE) research and evidence grows exponentially, the International Nursing Association for Clinical Simulation and Learning (INACSL) Standards of Best Practice: Simulation℠ continues to develop alongside. It is with great pleasure that the INACSL Board of Directors and Standards Committee publish the new INACSL Standards of Best Practice: Simulation Operations. “Operations,” as outlined in the standard, encompasses the entire infrastructure necessary to implement effective and efficient SBE programs and departments. Read the introductory announcement in Clinical Simulation in Nursinghere, and the Standards of Best Practice here.

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Research Article: Impact of standardized patients on the training of medical students to manage emergencies

Lead author: Frank Herbstreit
Submitted by: Todd Lash, Publications Committee Chair

The investigators compared standardized patient’s ability to transmit knowledge and skills compared with a more traditional teaching approach for emergency management skills. Medical students were randomized to receive either training on standardized patients simulating 3 emergency settings (“acute chest pain,” “stroke,” and “acute dyspnea/asthma”) or traditional small group seminars. The students were evaluated on their knowledge base before and after their respective training pathway. Teaching using standardized patients resulted in a small, but statistically significant improvement in objective structured clinical examination scores. There was no difference in the written examination scores. Read the full article in Medicinehere.

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Research Article: Step Up-Not On-The Step 2 Clinical Skills Exam - Directors of Clinical Skills Courses (DOCS) Oppose Ending Step 2 CS

Lead author: David J. Ecker
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

Recently, a student-initiated movement to end the United States Medical Licensing Examination Step 2 Clinical Skills and the Comprehensive Osteopathic Medical Licensing Examination Level 2-Performance Evaluation has gained momentum. These are the only national licensing examinations designed to assess clinical skills competence in the stepwise process through which physicians gain licensure and certification. Therefore, the movement to end these examinations and the ensuing debate merit careful consideration. The authors, elected representatives of the Directors of Clinical Skills Courses, an organization comprising clinical skills educators in the United States and beyond, believe abolishing the national clinical skills examinations would have a major negative impact on the clinical skills training of medical students, and that forfeiting a national clinical skills competency standard has the potential to diminish the quality of care provided to patients. In this Perspective, the authors offer important additional background information, outline key concerns regarding the consequences of ending these national clinical skills examinations, and provide recommendations for moving forward: reducing the costs for students, exploring alternatives, increasing the value and transparency of the current examinations, recognizing and enhancing the strengths of the current examinations, and engaging in a national dialogue about the issue. Read the full article in the Journal of the Association of American Medical Colleges here.

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General Interest: Mindfulness Apps Aim To Help People Disconnect From Stress

By: Allison Aubrey
Submitted by: Michael Maury, UCSD School of Medicine

As we fearlessly roller skate through our busy everyday lives, it is good to remember that there are great practices that can help us manage any stress that may invade our body and mind. Meditation has long been an important relaxing practice that helps individuals remain present and calm in the moment. As of late, Mindfulness Meditation has been a hot topic for many to help cope with the raucous rumblings that our world is witnessing. In this NPR news segment, Allison Aubrey makes note of some helpful downloadable Apps that may help us connect to our calming breath bringing us closer to a state of simple being. It is pointed out in this piece that there are “documented benefits of mindfulness meditation” which “can include better management of chronic pain, an increase in self-awareness, improved digestion and higher immune function.” It is understood that we all are busy with our jobs and personal lives. It is a good reminder, as the Zen proverb states, “You should sit in meditation for twenty minutes every day – unless you’re too busy. Then you should sit for hour.” Read on here for some potentially influential and uplifting guidance.

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