In The Spotlight: University of Central Florida – College of Medicine
Submitted By: Rebecca Beiler
Full Center Name: Clinical Skills and Simulation Center
By: Mario Veen & Anna T. Cianciolo
Submitted by: Kerensa Peterson, NBOME
Philosophy is not just “the talk on a cereal box” that Edie Brickell first sang about in 1986. But it is the topic of this first in a series of thought-provoking pieces by Veen and Ciancolo. The authors write, “ Slowing down to consider context and reflect on practice are now seen as essential to medical education as we are called upon to examine carefully what we are doing to care for learners and improve their performance, professionalism, and well-being.” During this time of COVID-19, their piece seems especially relevant as we take on questions that don’t have clear answers. We are asked to approach problems in medical education with “wonder and intense, childlike curiosity, human qualities we all share.”
By Megan Mast
Submitted by: Todd Lash, The Ohio State University and Kerensa Peterson, NBOME
I can summarize what it means to be a SP during this time in one word. GRATEFUL! It is important for me to make a difference. I feel so grateful to have a position where I can help future medical personnel learn how to interact with people.
Lead Author: Greg M. Reger, PhD, et al
Submitted by: Marsha Harman, Rush Center for Clinical Skills and Simulation
What is the efficacy of training with a virtual standardized patient (VSP) compared with traditional academic study for learning motivational interviewing (MI) skills? Findings In this randomized trial of 120 health care professionals, training with a virtual standardized patient resulted in significantly greater improvements in 3 of 4 motivational interviewing composite skill scores, including the technical global score, the relational global score, and the reflection-to-question ratio, compared with academic study.
Lead author: Andrew M. Luks
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania
The authors make a compelling argument as to why clinicians should avoid using jargon: “Despite our best efforts to ensure appropriate care for patients, we often find ourselves distracted on rounds by the sometimes bewildering array of jargon during bedside presentations. Why does our team want to “sprinkle” or “hit” the patient with diuretics? Do our patients have the capacity to “fly” off the ventilator or “throw” PVCs (premature ventricular contractions)? …Perhaps the biggest challenges arise when we consider how our words sound to patients and their families. Many of our word choices run the risk of confusing them rather than clarifying the patient’s condition, diagnosis, or treatment. They may nod, but do they clearly understand what we have said? Even worse, are they offended by what they hear?”
Lead author: Doreen M. Olvet
Submitted by: Kathy Herzberger, Loma Linda University
This is an interesting article discussing near peer 4th year tutors to give feedback to 1st and 2nd year students on note writing skills. The authors found that near peers can be an asset to medical education. I too, have found near peer tutoring effective. I have used 4th year students that are remediating to help grade our 2nd year OSCE. This exercise enhances the 4th year’s skills and the 2nd years appreciate the feedback from their upper classmen.
By Valerie Snavely
Submitted by: Kerensa Peterson, NBOME and Todd Lash, The Ohio State University
I always wanted to be a doctor when I grew up. That dream died a quick death during junior high, when it became clear that any math beyond the bare basics completely eluded even the slightest grasp by my arts-loving brain. (The PEMDAS train left the station without me.) Fast-forward to college and a journalism major where – among all of us junior wordsmiths – the standard joke was that we were there because algebra wasn’t required. Cue a 40-year career as a writer, editor and PR/marketing coordinator. Yet, even as I wrote, edited and promoted, my interest in the healthcare field never dwindled. To get my “fix,” I volunteered in hospitals as well as at an inpatient hospice facility, working directly with people who were dying and their families. (The latter was an intensely meaningful privilege.) I even entertained the notion of becoming a registered nurse as a second career and took all of the prerequisite college courses – including remedial math! But my mother became ill and needed me, and I never pursued it further.
Teaching Students the Art of Working with Patients with Cognitive Impairments: A Comparison between the Use of Standardized Patients vs a One-time Clinical Experience
By: Shaun Varrecchia and Carol A. Maritz
Submitted by: Marsha Harman, Rush Center for Clinical Skills and Simulation
Working with individuals with cognitive impairment can be an uncomfortable experience for students in the health professions. One-time clinical experiences are a common strategy in Physical Therapy programs, but the authors note that the variability among different clinical sites in terms of the patients seen and the assessments the students are allowed to perform means that educational outcomes vary widely. This article describes a study comparing the outcomes associated with a Standardized Patient encounter versus one-time clinical experience. Overall, when comparing the SP encounter to the one-time clinical experience, faculty found that the SP experience was more pedagogically sound.
By Jeffrey N. Siegelman, MD, Department of Emergency Medicine, Emory University
Submitted by: Dan Brown, Emory University
A baby boy was born. In the ensuing days, the post-partum mother developed edema as her blood pressure rose. Then came headaches. As the mother inched towards eclampsia, her liver and brain began to suffer. This was the setting for a simulation case designed to assess Emergency Medicine residents’ performance in decision-making, care, and communication with a postpartum patient in the emergency department. I never thought its impact would reach as far as it did.
Lead author: Denise LaMarra
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania
I am proud to share a journal article written by my manager and mentor Denise LaMarra and our colleagues at The Children’s Hospital of Philadelphia on a novel telesimulation program they began 6 years ago. Some background: the Heart And Lung Failure—Pediatric INsulin Titration study was experiencing poor subject enrollment due to low rates of informed consent. The program investigators collaborated with the Perelman School of Medicine Standardized Patient Program to explore the novel use of telesimulation with standardized parents to train research staff to approach parents of critically ill children for informed consent. We describe the feasibility, learner acceptance, and financial costs of this novel intervention and performed a post hoc analysis to determine if this intervention improved study consent rates.
By Deborah Davidson, SP for Howard University, Georgetown University and George Washington University
Submitted by: Kerensa Peterson, NBOME
This SP wrote a poem about her SP experience and transition during COVID. It begins, “To be an SP is a challenging role. We show syndromes and symptoms in body and soul. We try to recall every smile, word, and action. So our feedback’s reflective of each interaction…
Lead Author: Dara VF. Albert
Submitted by: Todd Lash, The Ohio State University
We developed nine standardized scenarios that highlighted communication challenges commonly encountered in child neurology. Child neurology trainees participated in three OSCE events with three scenarios each over three academic years. Standardized patients (SPs) portrayed patients and/or their parents. Each trainee-SP encounter was evaluated by an observing faculty member using a modified Gap-Kalamazoo Communication Skills Assessment Form, the SP who provided direct feedback, and by the participating trainee.
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.
Lead author: Daniela Keren
Submitted by: Kathy Herzberger, Loma Linda School of Medicine
Social studying and learning (SSL), according to the authors is any independent, elective, self-directed and self-organized approach to learning. The article explores what kind of SSL second year medical students developed, their viewpoints regarding the pros and cons, and their perceptions on how it affected their overall learning. How Covid has influenced SSL at this school would make for an interesting follow-up study.
By: David Weiss
Submitted by: Kerensa Peterson, NBOME
David Weiss is a Standardized Patient at Northwestern University and Rush University in Chicago, IL. David created a beautiful (and brief) sound story – listen to Corona Thoughts.
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.
Source: Cumberland Times-News
Submitted by: Todd Lash, The Ohio State University
Across the nation, many individuals who identify as transgender or gender diverse avoid accessing health care, even basic primary care, because of fear of discrimination or mistreatment — but WVU Medicine is implementing a number of strategies to improve care for that patient population.
Published by: Academic Medicine
Submitted by: Kerensa Peterson, NBOME
Academic Medicine has released a collection of articles that address race and racism in Medical Education. The collection is geared toward a variety audiences within the Medical Education Community from medical students to simulation educators to faculty physicians to program directors.
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?
Submitted By: Todd Lash
Full Center Name: Clinical Skills Education and Assessment Center