Author: Neal Buccino
Submitted by: Catherine Hagele, Perelman School of Medicine at the University of Pennsylvania

For time-crunched medical students, taking a two-hour introductory class on mindfulness may be just as beneficial for reducing stress and depression as taking an eight-week meditation course, a Rutgers study finds. Researchers say many medical students would like to use meditation to avoid burnout and provide better medical care, but are daunted by the prospect of making time for a daily meditation routine. While this article focuses on medical students, there are many parallels between their stress and time-crunch that Standardized Patient Educators also experience.

Lead Author: Ellen H. Eisenberg
Submitted by: Marsha Harman, Rush University

This article describes a workshop for first-year residents that used standardized patients to practice responding to patients exhibiting bias against members of the health care team. The workshop included a didactic session and four scenarios in which standardized patients portrayed patients with bias based on gender, class, or race.  Learners received feedback from a trained facilitator, peers, and the standardized patients. One hundred percent of the 19 learners who participated agreed that the simulated exercises were realistic and improved their readiness to address patient bias.

By: Gillian Rutherford, University of Alberta
Submitted by: Michael Maury, UC-San Diego

In her talk entitled “Co-Creating Care to Improve Medicine”, University of Alberta endocrinologist Rose Yeung shares that, “Miscommunication, or under communication, happens regularly between patients and their doctors, nurses, dietitians and even naturopaths.” Those of us in Medical Education understand this truth all too well. In this article, Gillian Rutherford points out why it may be difficult for most to speak with their doctor and lays out four ways in which we can overcome this challenge. Yeung mentions, “The patient and the professional are supposed to deliberate and come up with an acceptable treatment plan together.” Remembering that physicians and patients are in this health care experience together as a team, is just one piece to the solution. Please press on for more insights and ideas.

Lead Author: Brownsyne Tucker Edmonds
Submitted by: Kerensa Peterson, NBOME Chicago

Shared Decision Making (SDM) has been widely endorsed as a favorable practice for patient-centered care.  However, it is underutilized in clinical practice and has lacked tools for assessment.  There are studies which support the use of shared decision-making tools in advanced care planning, but few tools for SDM have been tested in a periviable setting.

Author: Michelle M. Kittleson, M.D., Ph.D.
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

“I recently cared for a 45-year-old man for over a month and never spoke to him.” This moving reflection from Dr. Kittleson details her realization about the lack of communication with her patient awaiting a heart transplant who is also deaf. “I fell into a complacency born of pragmatism and confidence in my abilities: I knew I was providing the best medical care, so I ignored the importance of direct communication.” This personal story highlights the need for direct doctor-patient communication no matter what perceived barriers exist – a concept for which SP educators continue to advocate.

By: Wu Jiansheng
Submitted by: Todd Lash, Publications Committee Chair

As one of the first generation of Standardised Patients in China, perhaps Asia as well, I have been working in the clinical skills training center in West China Medical School of Sichuan University for 25 years. I would like to share with you how I joined this little-known and somewhat mysterious field, participated in this form of teaching, and progressed from a normal SP to a SP trainer. It is noted that the Standardised Patient (SP) was first introduced by Howard Barrows in 1963. In 1993, West China School of Clinical Medicine, Sichuan University was the first to do the training courses and trained the first group of SPs. In 2003, China Medical Board (CMB) America organized a “Student Evaluation Plan Program”; 8 Chinese medical schools joined and imported the training program to China.

Author: Cleveland Clinic Health Essentials
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

Has your mind ever gone blank after leaving your doctor’s office? You may be trying to remember the specific instructions or the answers to your “what if questions” - “What if I don’t feel better after a couple of days?” “What if I miss a dose of my medication?” “What if I feel worse in the middle of the night?”

Lead author: Lauren Block
Submitted by: Mary Launder, Rosalind Franklin University of Medicine and Science

Background: Longitudinal standardized patient (LSP) experiences mimic clinical practice by allowing students to interact with standardized patients (SPs) over time. LSP cases facilitate practice, assessment, and feedback in clinical skills and foster an appreciation for the continuum of care.

By: Christopher Connelly
Submitted by: Michael Maury, UC-San Diego

“Medical school is draining. It’s a mix of sleepless nights spent studying, a lot of student debt, massive pressure to succeed, and learning to treat difficult patients over long hours at the hospital. This recipe for mastering medicine been used to train generations of physicians, but it bakes in a problem: Over the course of their studies, medical students tend to become less empathetic. The issue is that empathy is increasingly valued as an essential tool for physicians, says Dr. Danika Franks, assistant dean of students for the Texas Christian University-University of North Texas Health Science Center School of Medicine in Fort Worth.” Author Christopher Connelly reports how Dr. Franks and her school are looking to foster more empathy within their students as they progress through their studies.

Lead author:  Joseph O. Lopreiato, MD, MPH
Submitted by:  Dyan Colpo, Cleveland Clinic, Simulation and Advanced Skills Center

Health care simulation programs have spread to many parts of the United States health care system, including hospitals, medical and nursing schools, community college programs, and clinics. Many educational and training units use simulation to help teach new skills, refresh old skills, and promote teamwork in the delivery of health care.

Lead author: Dinah Wisenberg Brin
Submitted by: Mary Launder, Rosalind Franklin University of Medicine and Science

This is a great article to pass along to anyone interested in what the world of simulation is about as well as its positive outcomes.

Lead Author: Sarah E. Stumbar, MD, MPH
Submitted by: Catherine Hagele, Perelman School of Medicine at the University of Pennsylvania

Why is it that most health care practitioners do not routinely screen patients for intimate partner violence (IPV)? This third-year family medicine clerkship included a pregnancy options counseling OSCE aiming to explore students’ internal barriers to screening patients for IPV. Even though the educational module included scripted screening questions, students reported a major barrier to screening was difficulty finding the words with which to ask the questions, thereby suggesting that these kinds of practice encounters may be more effective, offering a performance model that can support skills acquisition.

Submitted by: Todd Lash, Publications Committee Chair

The ASPE Standards of Best Practice (SOBP) received a special contribution award for advancing SP methodologies in China. The award came from the China SP Practice Teaching Guidance Committee (CSPC) and the China International Association for Promotion of Science and Technology (CIAPST).

By: Gary Rotstein
Submitted by: Michael Maury, UC-San Diego

Author Gary Rotstein states in this article, “Performers in improvisational sketch comedy learn basic guidelines: Speak in positives, think of your partner, listen well, give helpful prompts” and “don’t be long-winded.” He goes on to say, “Caregivers for those with dementia rarely hear that same advice, but they should — it might ease a lot of stress on both sides.” Many of us in Medical Education have seen the benefits and value of utilizing humanitarian practices such as improvisational theatre to better communication between patients and caregivers. Could the art-form of improv be utilized to better communication with patients living with dementia? Please read on to see how improvisational theatre skills have worked for Rachael Wonderlin and Christopher Wright of the “Agreeing to Remember” workshops at Steel City Improv Theatre in Pittsburgh, PA. Read the full article in the Pittsburgh Post-Gazette here.

By: George Gillett, Fourth Year Medical Student
Submitted by Kathy Herzberger, Loma Linda School of Medicine

George Gillett, who was a fourth year medical student when he wrote this article, expressed an interesting perspective regarding empathy and standardized “fake” patients. Included in this discussion is a suggestion from Anu Atluru, MD that “improv’s fundamental principles of honesty and spontaneity” might be helpful in teaching students how to acknowledge feelings without the rote “I’m sorry to hear that…” The opinions expressed are certainly issues to ponder as we develop future communication curriculum and assessment.

Lead Author: Hasan Mohiaddin
Submitted by: Marsha Harman, Rush University

How does contact with actual patients affect how medical students develop communication skills, and how does it impact their performance in an SP encounter? First year medical students at Imperial College London learn communication skills through lectures, small group teaching, and SP encounters. This study compared two groups of first-year students; the study group experienced repeated contact with real patients as part of a volunteer organization aiming to reduce isolation in elderly inpatients, while the control group received only the formal curriculum on communication.

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

In an era of increasingly complex advances in oncology, how can health professionals help cancer patients with low health literacy better understand their diagnoses and treatment options? In an effort to improve cancer communication strategies with patients, the National Cancer Policy Forum (NCPF) convened a meeting of invited speakers in Washington, D.C. At the meeting, the point was repeatedly made that skills in cancer communication can be taught and learned, and it is the responsibility of health professionals to make sure all their patients (including those with low health literacy) truly comprehend the information they are being given. We as SP Educators know that SP methodology is an excellent tool for practicing these communication skills.

By: Shahid H. Mirani, Noor A. Shaikh, and Amber Tahir
Submitted by: Dan Brown, Emory University

This study was conducted among medical students of Ghulam Muhammad Mahar Medical College, using a self-administered and self-perceived inventory called the Jefferson Scale of Empathy-Student Version. It compared the empathy scores by gender, by year of medical school, and by career preference. Its findings were comparable to similar studies, in that empathy scores decline over the course of medical school. The study concludes that it is “very important that we pay attention to nurture our medical students to have empathy rather than lose it under the stress of academic performance.”

By: Aliyan Baruchin
Submitted by: Mary Launder, Rosalind Franklin University of Medicine and Science

Conversations about end-of-life care are among the most important interactions doctors and patients have. But for health care providers of all ages, backgrounds, and specialties, they may also prove to be the most challenging.

By: Valerie DeBenedette
Submitted by: Michael Maury, UC-San Diego

The author of this article, Valeria DeBenedette, puts it simply, “Having a lot of clinical knowledge in rheumatology is good. But a boatload of knowledge may not mean much if you aren’t getting it across to the patient so that he or she understands”. For those of us in Standardized Patient education, we know that clear communication is key to a patient’s adherence and will help boost one’s confidence in their health care. We provide opportunities for future doctors to practice these communication skills, but are our efforts enough? As DeBenedette writes, “Communication skills are taught in medical school, often with standardized patients played by actors”. She goes on to report that Dr. Susmita Pati, M.D., chief medical program advisor at the Alan Alda Center for Communicating Science at Stony Brook University, states “but those [SP encounters] are ideal situations and not real life.” Perhaps we have some questions to ponder. Is there something more we could be doing to help mold future physicians into compassionate, clear communicators as they sharpen their clinical skills?