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Podcast: Conversations About Death and Dying with Dr. Michael Wilson

Hosts: Tom Shives, MD and Tracy McCray, Mayo Clinic Radio
Submitted by: Mary Launder, Rosalind Franklin University of Medicine and Science

Dr. Michael E. Wilson, a critical care specialist at Mayo Clinic, offers suggestions on how to have conversations about death and dying. This interview originally aired via Mayo Clinic Radio Aug. 25, 2018.

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Research Article: Efficacy of Communication Skills Training for Giving Bad News and Discussing Transitions to Palliative Care

Lead authors: Anthony L. Back, MD
Submitted by: Mary Launder, Rosalind Franklin University of Medicine and Science

Few studies have assessed the efficacy of communication skills training for postgraduate physician trainees at the level of behaviors. We designed a residential communication skills workshop (Oncotalk) for medical oncology fellows. The intervention design built on existing successful models by teaching specific communication tasks linked to the patient's trajectory of illness. This study evaluated the efficacy of Oncotalk in changing observable communication behaviors.

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General Interest: How Theatre Training Can Boost Your Doctor’s Empathy

Lead author: Hartley Jafine
Submitted by: Michael Maury, UCSD

In this article author Hartley Jafine articulates the idea that “Medicine… is a performance. And the skills actors and improvisers learn are equally important for any health-care role.” Jafine relays his experiences as a facilitator of theatre courses within undergraduate health sciences and medical education to enhance the clinical skills of students and train better health-care professionals. Throughout this reflection piece, Jafine highlights the importance of using Applied Theatre arts programs in healthcare education. Jafine says, “Acting cuts through stereotypes” and improvisational play gives learners a safe place where they are free to fail without consequence.

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Media Article: Trying to Put a Value on the Doctor-Patient Relationship

By: Kim Tingley
Submitted by: Dyan Colpo, Cleveland Clinic, Simulation and Advanced Skills Center

In October 2014, my father was startled to receive a letter announcing the retirement, in a month’s time, of our family physician. Both he and his doctor were in their late 60s by then, and their relationship went back about 30 years, to the early 1980s, after my father followed his father and paternal grandparents, all from the Midwest, to Southwest Florida. How they began seeing the doctor is beyond memory, but as my father’s grandparents grew increasingly frail, his father frequently drove them to their doctor for checkups. At one of them, in the mid-’80s, the doctor suggested that it might be less strenuous for my great-grandparents if he met them in the parking lot. From then until they died, he came downstairs from his seventh-floor office with his black bag and climbed into the back seat of their yellow Oldsmobile 88 to give them their physicals. 

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Podcast: Using simulation to teach holistic competence: Interview with Marion Bogo and Toula Kourgiantakis

Interview By: Jonathan Singer, Ph. D., LCSW
Submitted by: Amber Snyder, University of Pittsburgh

This episode of the Social Work Podcast features an interview with Marion Bogo and Toula Kourgiantakis from the University of Toronto Factor-Inwentash Faculty of Social Work. The podcast discusses using simulation in social work education.

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Research Article: Preparing Emergency Medicine Residents to Disclose Medical Error Using Standardized Patients

Lead author: Carmen N. Spalding
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

The ability to disclose medical errors (DME) effectively is crucial in Emergency Medicine (EM). The 2010 American College of Emergency Physicians Policy Statement on Disclosure of Medical Errors directs emergency physicians who determine an error has occurred to provide timely information about the error and its consequences to patients and their families. Despite this mandate, a disclosure gap exists in EM.

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Journal Article: Ethical Concerns When Minors Act as Standardized Patients

Lead Author: Erwin Jiayuan Khoo, MRCPCH, MBBS
Submitted by: Dan Brown, Emory University School of Medicine

Unique ethical concerns arise when using minors as standardized patients. In this article, the four authors each take a turn discussing the ethical implications of a particular case wherein a 6-year-old boy in Indonesia was used for two days of SP work. Each author also discusses principles at large, generally agreeing that standards need to be established and upheld when hiring child SPs, borrowing from established standards in research or film. They argue that considerations need to be made for the child’s benefit-to-burden balance, ability to revoke assent, potential trauma, and preference for active participation.

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General Interest: Morphine, And A Side Of Grief Counseling: Nursing Students Learn How To Handle Death

By: Blake Farmer
Submitted by: Todd Lash, Publications Committee Chair

Nursing requires hands-on training. But research has found that university curriculum often goes light on one of life's universal experiences — dying. So some colleges have gone to new lengths to make the training more meaningful. There's a sound near the end — the death rattle. People stop swallowing. The lungs fill up. There can be involuntary moaning. "So you get all that noise. And that's really distressing for family members," Professor Sara Camp of Nashville's Belmont University says.

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MEDIA: Can a Nice Doctor Make Treatments More Effective?

By: Lauren Howe and Kari Leibowitz
Submitted by: Kerensa Peterson, Northwestern University

Two social psychologists from Stanford share some insights from their research about patient treatment outcomes in this short piece.  According to their research, it turns out that a doctor’s demeanor and the way in which they engage their patients can have a significant effect on their health.  The elements of communication that are often stressed during simulated patient encounters with medical students are the very things discussed in their research.

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Media Article: Could Undertaking Qualitative Research Serve to Develop Clinical Empathy at Undergraduate Level?

Lead author: Karen Mulligan
Submitted by: Dyan Colpo, Cleveland Clinic, Simulation and Advanced Skills Center

Clinical empathy is essential to the practice of medicine and is linked inextricably to the competence of a physician. It benefits both patient care and physician satisfaction yet the concept is often ill-defined. Recent studies have also shown that it is taught ineffectually at the undergraduate level and suggest that new methods be sought. Conducting interviews for qualitative research could provide the opportunity for medical students to explore patient experience, develop clinical empathy and compassion as well as gain research experience. Even the exercise of designing questionnaires for qualitative research could encourage students to engage with clinical empathy. 

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Media Article: Acute Care Simulation builds Samford Students’ Interprofessional Health Care Skills

By: Sarah Waller
Submitted by: Todd Lash, Publications Committee Chair

In the hallway of Samford University’s Experiential Learning and Simulation Center, a “standardized” patient stumbled to the ground to simulate a patient experiencing cardiac arrest. The Doctor of Physical Therapy student who was with him jumped into action and called a code. Within seconds, an interprofessional team of students gathered. Undergraduate nursing students took over CPR, Doctor of Pharmacy students prepared the needed medications and Master of Social Work students attended to the patient’s family. This is just one scenario that students were able to experience together during the College of Health Sciences’ annual Acute Care Simulation.

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General Interest: Med Students Learn Empathy Through Improv

By: Helen Wilbers
Submitted By: Michael Maury, UC-San Diego

Gina Shannon, associate director at the Emory University School of Medicine’s Clinical Skills Center and ASPE member, spoke at Westminster College’s Hancock Symposium on Tuesday, September 11th, 2018, about the purpose of simulated patients in Medical Education. As Wilbers lays out in this article, Shannon points out the importance of using SPs “to teach doctors to empathize and communicate with patients.” Wilbers writes that Shannon contemplated, "If a health care provider is with a patient and they aren't in agreement, where can that relationship go?" Wilber discusses how Shannon relies on her 7 years of theatre teaching and applying the rules of improv to the clinical setting. With an emphasis on the important improv tenet of ‘yes-and’ Shannon successfully guides doctors toward an acceptance and mutual agreement of what is being laid out by a patient. Shannon says, "If we're in a scene together the only way we can elevate the scene and keep it going is by agreeing."

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General Interest: How Standardized Patient Videos Can Change Assessment in Med Ed

Lead author: Brendan Murphy
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

Several studies have found that exams consisting of multiple-choice questions—particularly the United States Medical Licensing Examination—are not the best or only evaluation method for postgraduate residency selection. To that end, Dr. Senthil Rajasekaran and the team at Eastern Virginia Medical School is developing video vignettes of standardized patient encounters. He believes they are a practical, effective option for assessing a student’s clinical acumen.

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Journal Article: Beyond Knowles – What Those Conducting Simulation Need to Know About Adult Learning Theory

Lead Author: Timothy C. Clapper, MA
Submitted by: Amber Snyder, University of Pittsburgh

Understanding adult learning theory is essential for all educators who are working with adult learners. Those working in simulation often access Malcolm Knowles theory of andragogy to ensure that curriculum addresses the needs of adult learners.

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General Interest: Most Doctors Are Ill-Equipped to Deal With the Opioid Epidemic – Few Medical Schools Teach Addiction

By: Jan Hoffman
Submitted By: Michael Maury, UC-San Diego

According to the Centers for Disease Control and Prevention, addiction — whether to tobacco, alcohol or other drugs — is a disease that contributes to 632,000 deaths in the United States annually. But comprehensive addiction training is rare in American medical education. A report by the National Center on Addiction and Substance Abuse at Columbia University called out “the failure of the medical profession at every level — in medical school, residency training, continuing education and in practice” to adequately address addiction.

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Media Article: Medical Student, Student Physician or Student Doctor?

By: Joshua Niforatos
Submitted by: Mary Launder, Rosalind Franklin University of Medicine and Science

After introducing myself as a first-year medical student working with the attending physician, I went through the medical history with the patient to ascertain his chief complaint and the history of present illness. Since this was only a six-month follow-up appointment in an internal medicine outpatient clinic, there was not much to cover besides checking whether his medications were up-to-date and how he had been managing his chronic conditions. As this was my last patient of the day, I asked if I could practice various aspects of the physical exam that were not necessary for his appointment. Typical of my experience in longitudinal clinic, the patient obliged and thought it was great that he would get some “additional care.” “Are you a fellow or something?” he asked during the exam. “No, no. I’m a first-year medical student,” I reminded him.  It seems that “fellow” and “medical student” were synonymous to this individual. Part of the curriculum of my medical school includes various readings in both the social sciences and the humanities. We recently reflected upon the titles we are known by, such as medical student, student physician or student doctor. More specifically, what is meant by the names and titles we are known by? After contemplating how to introduce myself to patients, I offer the following reflection.

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Media Article: Oakland University William Beaumont School of Medicine Collaborates with University of Detroit Mercy on Interprofessional Curriculum

Submitted by: Todd Lash, Publications Committee Chair

Oakland University William Beaumont School of Medicine (OUWB) and University of Detroit Mercy School of Dentistry (Detroit Mercy) will launch a new interprofessional course to educate medical and dental students on how health care professionals collaborate for the benefit of their patients.

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Journal Article: Quality Assurance Processes for Standardized Patient Programs

Lead Author: Shelley Zhang
Submitted by: Kerensa Peterson, Northwestern University

As other clinical professions enter the world of simulation, their questions and development are catalogued in research. The pharmacy profession is an example of a clinical profession that is evolving to include a larger emphasis on communication skills and collaborative care. New simulation practitioners are asking how to assure quality in their newly developed standardized patient (SP) programs. This article focuses on the authors’ recommendations and applications for quality assurance in SP programs through a thematic analysis of the current scholarly literature.

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Journal Article: Cultural Competency and Cultural Humility in Simulation-Based Education: An Integrative Review

Lead author: Cynthia L. Foronda
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

There has been increased focus on the need to combat inequities in healthcare by teaching cultural humility. As SPEs, we know SPs are a fantastic tool to teach this skill. However, this review of literature shows there is a lack of studies published involving the use of simulation to teach cultural humility. The authors point out that “current international simulation standards lack an emphasis on diversity and cultural humility; thus, simulation curricula may be missing this essential component.” The study identified the need for more robust research on the subject. Let’s get cracking.

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Resource: Using Standardized Clients to Train Social Workers in Intimate Partner Violence Assessment

Lead Author: Mary Ann Forgey
Submitted by: Amber Snyder, University of Pittsburgh

Assessment in intimate partner violence (IPV) is an essential component to determine the course of interventions and support provided. This study used Standardized Clients (SC) to train eight Army civilian social workers to implement an evidence-based assessment protocol of IPV.

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