By: Kara Gavin
Submitted by: Marsha Harman, Rush Center for Clinical Skills and Simulation

People who take opioid medications for chronic pain may have a hard time finding a new primary care clinic that will take them on as a patient, according to a new “secret shopper” study of hundreds of clinics in nine states across the country. Simulated patients who said their doctor or other primary care provider had retired were more likely to be told they could be accepted as new patients, compared with those who said their provider had stopped prescribing opioids to them for an unknown reason. Stigma against long-term users of prescription opioids, likely related to the prospect of taking on a patient who might have an opioid use disorder or addiction, appears to play a role.

By: Timothy M. Smith

Submitted by: Michael Maury, UC-San Diego

Some of the most adverse patient outcomes are caused by poor communication, so medical schools are adopting improv—improvisational theater training—to help students live more in the moment and better empathize with patients. A study published prior to the pandemic found that students used the skills they learned from it, but the gravity of COVID-19 now supplies the ultimate proving ground.

By: Eric Widera and Alex Smith

Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

The Emergency Department (ED) is a hard place to have serious illness discussions, whether it be goals of care or code status discussions, or whether or not to consider intubation for a seriously ill patient. Emergency physicians often don't have the time for in-depth discussions, nor have been trained on how to do so. There often is limited information about the patient, their functional status, or their prognosis. These are some of the most challenging and some of the most important conversations in medicine, as 75% of older adults visit the ED during the last 6 months of life (data thanks to this Alex Smith publication in Health Affairs!) So how do we have these urgent conversations in a time of crisis to ensure that patients receive care that aligns with their goals? We have Naomi George, researcher and ED physician extraordinaire from the University of New Mexico, and Kai Romero from UCSF and Hospice by the Bay join our podcast to discuss.

The Social Construction of Race and its Impact on Medicine and Biomedical Research by John Chenault, PhD

By Dan Brown, Emory University

As mentioned in my recap of the opening plenary from the 2020 ASPE virtual conference, Dr. Chenault had to rush through the end of his plenary speech “Medicine and the Black Body,” and attendees were hungry for more, so as we’d hoped, he was invited to do a webinar. The webinar took place on Oct. 30, 2020, and the full webinar is available at the ASPE site. The discussion centered on three questions: What is race? What does medicine and biomedical research tell us about race? How useful are racial categories in biomedical research and practice?

By: Jamie Bartosch

Submitted by: Michael Maury, UC-San Diego

While describing a simple exercise known as One-Word-Story, Jamie Bartosch writes “It’s a fun activity, but it serves an important purpose for these future doctors. It forces them to listen. This exercise, like the many others they engage in, makes them realize they don’t know where the story is going to go, so they must pay attention to verbal and non-verbal cues.” Skills like these are vital to successful patient care in medicine. While improv can provide some extra laughs, it ultimately “has nothing to with comedy” as University of Chicago Medicine pediatrician Nikki Orlov, MD states. “It’s all about improving advanced communication skills.”

By: Brian James

Submitted by: Todd Lash, The Ohio State University

Imagine a medical student sitting in the room across from a 50-year-old female standardized patient who presents with fatigue and vague abdominal pain. It’s their second year of medical school, and they know generally how to conduct a patient interview. They eventually reach the family history, concerned that any incidence of pancreatic cancer in the family may mean the standardized patient is in for a long, scary and painful journey of diagnosis and treatment. The question finally arises: any family history of a cancer diagnosis? The standardized patient, without skipping a beat, coldly tells you that her father passed away from pancreatic cancer over 10 years ago at age 59. The student knows what to do; they have been trained extensively in the ways of empathy. They pause, say “I’m sorry to hear that,” then pause again for dramatic effect.

By: Zeke Hernandez

Submitted by: Michael Maury, UC-San Diego

“Stagnation happens when we adopt one of two extreme mentalities. On one extreme is overconfidence, which arises from underestimating the complexity of the situation and overestimating our own ability. On the other extreme is fear, which arises from overestimating the complexity of the situation and underestimating our own ability. In between the two extremes is humility. ”In these times of such extremes and great uncertainty, it is helpful to be reminded of humility. Can we approach each new moment and experience with curiosity and a beginner’s mindset? Perhaps even the act of tying our shoes could be performed differently as to yield better results.

5 Ways the Health-Care System Can Stop Amplifying Racism
Lead Author: Ezekiel J. Emanuel
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

The coronavirus pandemic didn’t create the health disparities among Americans, but it has exposed once again how stark the problem is. Black and Latino patients are two to three times as likely as white patients to be diagnosed with COVID-19, and more than four times as likely to be hospitalized for it. Black patients are more than twice as likely to die from the virus. They also die from it at younger ages. COVID-19 has exacerbated long-standing trends: Black and Latino Americans have lower rates of insurance coverage, a higher prevalence of chronic diseases, worse health outcomes, and a lower life expectancy. People in the health-care world sometimes speak of these patterns as if they are inevitable facts of life—something the industry is powerless to change. More doctors and hospitals need to acknowledge and address how the U.S. health-care system is rife with structural racism. For decades, American medicine has discriminated against people of color.

By: Sari Harrar
Submitted by: Michael Maury, UC-San Diego

Feeling good may be the last thing on your mind as the coronavirus pandemic grinds into its sixth month in America. As we struggle to revive after arguably one of the world’s worst health and economic calamities, is even talking about happiness self-absorbed and inappropriate?

By: Lisa Rosenbaum, M.D.
Submitted by Kathy Herzberger, Loma Linda School of Medicine

I have read so many stories of individuals responding to the call-in places hit hard by COVID. I think how brave and incredible they are for setting aside their lives and jumping into the fray. As a nurse, I often feel I am not doing “enough”. I found this article hit home and addressed some of the emotions I have been struggling with during these unprecedented times.

Lead Author: Maria Baimas-George, MD, MPH
Submitted by Kathy Herzberger, Loma Linda School of Medicine

As a fan of Harry Potter, when I saw the title of this article, I just had to read it. If you are familiar with Harry, then you will enjoy this. The authors hypothesize that with each medical specialty often attracting particular personalities, the percentage of residents who self-sorted into the different Hogwarts' houses would vary depending on their chosen specialty.

By: Lou Clark, Gayle Gliva-McConvey and Cate Nicholas
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

SP Educators Gayle Gliva-McConvey, Cate Nicholas and Lou Clark wrote and edited Implementing Best Practices of Standardized Patient Methodology, part of Springer's Comprehensive Healthcare Simulation Series, and now available for preorder with a release date of September 23, 2020. The book was written by SP Educators for SP Educators framed with the ASPE Standards of Best Practices. Fueled by Gliva-McConey's vision and spirit of collaboration, they are joined by 30 U.S. and international chapter authors along with numerous interviews and samples throughout from experts globally in our community of practice.

Author: Louise Schweickerdt, SP Facilitator, Skills Centre, Sefako Makgatho Health Sciences University, South Africa

My corner of the world is a country, renowned to be one of the most diverse and beautiful places on earth. It is also a country that is plagued by realities like planned power outages (load shedding), precarious internet, violence, strikes, horrific roads and a constant and intense awareness that safety, security and/or efficient health services are not a given.

Medically Reviewed By: Wendy M. Yoder, PH.D.
Submitted by: Kathy Herzberger, Loma Linda School of Medicine

These are trying times. I am sure everyone is feeling more anxiety during this period of uncertainty. We are concerned for the health of our loved ones and ourselves. Those of us still working are under more stress trying to develop innovative techniques to continue our jobs. I know I am feeling anxious and tense. This article provides techniques that we have probably heard of before, but it is a nice reminder to know there are positive skills we can insert into our lives to help us remain mentally and physically healthy.

By: Lindsey Tanner, AP News
Submitted by: Todd Lash, The Ohio State University

Aliya Feroe recalls the flustered OB-GYN who referred her to another physician after learning she identified as queer. For Rhi Ledgerwood, who was designated female at birth, identifies as trans and doesn’t have sex with men, it was a doctor advising about condoms and pregnancy prevention. For Tim Keyes, who came out as gay at age 17, it’s when doctors automatically assumed he sleeps with women. Ask any LGBTQ patient about awkward doctor visits and chances are they’ll have a story to tell.

Author: Arthur C. Brooks
Submitted by: Dan Brown, Emory University

This article is relevant to any creative professionals; to anyone who finds their value in the quality of their work.

By: Jessica Santina
Submitted by: Loic Simard-Villeneuve, McGill University

A group of first-year medical students sits before a panel of invited guests. It’s part of a daylong Practice of Medicine workshop focused entirely on LGBTQIA health care. The first panelist, a transgender woman, starts things off. "How many of you," she begins, scanning the room, "have had to call at least a dozen different doctors’ offices just to see if anyone would even take someone like you as a patient?"

By: Tannaz Motevalli
Submitted by: Kerensa Peterson 

People get involved in standardized patient work for many reasons. Some reasons are deeply personal. Many SPs have had experiences with the medical system, either as patients or care-givers and then search for ways to give back to that community of healthcare providers. Tannaz Motevalli not only talks about what drew her to this work but also how being an SP has shaped her relationships with her current doctors.

By: Joshua Landy
Submitted by: Joe Miller, University of Minnesota

If everyone who stays at a particular hotel gets sick, you don’t need to be an epidemiologist to wonder if the hotel is the problem. So if physicians across the country are reporting record levels of burnout, we might ask if hospitals are the problem. Could the workplace itself somehow be toxic to its workers? If so, it’s probably not due to asbestos in the walls or toxic black mould. It’s because a well-intentioned effort to make things better for patients ended up making them worse for everyone.

By: Yoo Jung Kim
Submitted by: Michael Maury, UC-San Diego

Medicine has its own language. If we are not fluent in this language, we must translate before relaying or receiving any message to or from another. Much like the barriers that may come from the language of computers or of music or any foreign language that is not primary, there can be a particular communication hurdle that makes translating or conversing extra challenging. In this article, Yoo Jung Kim explores the difference between translation and communication. She says “There is much of both in medicine. Medicine has a particular language of its own, one that is accessible only to people who have dedicated years of their lives in studying its use. There is a vast knowledge gap between a typical practitioner and patient, so even when taking care of a native English speaker, it’s not enough to “translate” medical jargon in the vernacular. Instead, optimal communication requires tailoring the information to suit the patient’s needs and background.” She continues saying “Communication involves the extra step of providing just the right amount of information with the right combination words”. Communication is an art form and one that we as Standardized Patient Educators must master in order to guide medical students as they master this skill set.