An Objective Structured Clinical Exam on Breaking Bad News for Clerkship Students: In-Person Versus Remote Standardized Patient Approach
Lead Author: Lona Prasad, MD
Submitted by: Amy Lorion, National Board of Osteopathic Medical Examiners

This article describes what happened when a breaking-bad-news OSCE was moved from in-person to virtual delivery due to COVID restrictions. The OSCE involves a miscarriage case, a distressing situation that, as the authors note, “calls for communication that incorporates patience and empathy.” The authors understandably wondered what would happen when moving such a scenario to what can be an impersonal technological tool.

IMSH 2024 Plenary Session: Duncan Wardle, The Michael S. Gordon Center Lecture on Medical Education
By: Samantha Syms, University of Miami Gordon Center

Duncan Wardle, Former Head of Innovation & Creativity at Disney began his plenary by asking the audience members to raise their hands if they considered themselves “creatives.” For those who did not raise their hands, he states that for adults, not being creative is an accepted fate. He then tasked participants to assume subject matter experts and exert our stance on eccentric issues: parachutes for elephants and sex therapy for bees and explain to our partners the importance of this topic. This activity illustrated the ability for us lean into our creativity without bounds and to be playful when developing big ideas.

By: Amy Rush and Mary Launder

During the past year, many people contributed to the work of ASPE and our profession in several ways. At the 2023 ASPE Conference, we recognized some of these contributions with two award ceremonies.

By: Amy Rush, Center for Healthcare Improvement and Patient Simulation at University of Tennessee Health Science Center

We all remember preparing for our first ASPE conference. What sessions will I attend? Will I be overwhelmed with too much to do? What if nobody talks to me? What if I don’t like the hotel coffee?

Lead Author: Marco Antonio de Carvalho Filho
Submitted by: Sharon Baker, Grand Valley State University

The authors of this study examined how to use an educational method called Co-Constructive Patient Simulation (CCPS) to improve professional development in healthcare. They participated in simulated scenarios aligned with their developmental stages and needs. This method integrates learning opportunities in clinical practice, amplifies learners’ critical reflection and autonomy and harnesses real-life challenges.
Read more about the study here.

By: Samantha Syms, University of Miami Gordon Center 

Belinda Fu, MD, is a family physician, educator, and performing artist based in Seattle. During the ASPE 2023 opening plenary session, Dr. Fu asked us to consider how we can thrive in this uncertain world. She shared her experiences with improvisation as a physician, patient, educator, and actor, and explained the power of improv to transform the way we move through the world.

Lead Author: Easton N. Wollney
Submitted by: Amy Lorion, NBOME

This article purports to be a comparison between two types of raters, SPs and “outside observers with training in healthcare communication,” with the evidence demonstrating that the SPs were more lenient in their scoring on both subjective items (e.g., “used effective body language”) and objective items (e.g., “The resident told the patient she should not start smoking again”). However, as the authors acknowledge partway through the article, there was another glaring factor: the SPs only scored the encounters live, based on memory, and the non-SP observers only scored the encounters via recorded videos; hence, “evaluator type was tied to evaluator method in this study.” This article is worth reading—the differences between the groups’ scores are telling and support several of the discussion points (e.g., cognitive load)—despite the mixed approach which undercuts the assertion that it’s a comparison of rater types per se.

Lead Author: Igal Iancu
Submitted by: Laura Harris and Carys Fritz, OHSU

This article describes how the authors utilized an innovative virtual patient simulation platform to develop successful impact measurement of the educational activities that can be applied to Continuing Medical Education (CME). The new platform is designed to assess learners’ knowledge and competency in the management of type 2 diabetes, high cholesterol, and high blood pressure.

Lead Author: Sarah Prediger
Submitted by: Nicholas Gonzalez, Gordon Center for Simulation and Innovation in Medical Education, University of Miami Miller School of Medicine

In the realm of SP work, there may come variation in perspective. What one might determine is an effective patient encounter, another may interpret as one that was less effective or poor in nature. Sarah Prediger and Sigrid Harendza, of the University Hospital of Hamburg-Eppendorf, sought to shine a light on this and many other possible discretions in SP evaluation of communication and interpersonal skills. They had SPs assess medical learners from an internal- and external-patient perspective and discuss their findings of interest.

Lead Author: Océane Richard
Submitted by: Michelle Fernandez, University of Miami

“The present study suggests that simulation-based training may be effective to change attitudes and skills for suicide risk assessment and crisis intervention, with promising preliminary results regarding changes in behaviors and patients’ outcomes. However, numerous limitations must be acknowledged, and many challenges remain. More research of higher methodological quality must be developed.”

Author: Jeremy J. Webb, M.D.
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

The author suggests that ChatGPT can be used to teach physicians how to break bad news. This is a skill that has been taught effectively through a combination of didactics and practice with simulated patients. The author has ChatGPT create a scenario, have a written dialogue with the physician and then offer feedback based on how his words aligned with the SPIKES framework for breaking bad news. Does this come close to the impact of human interaction and SP methodology? Read for yourself here. 

By: Lisa Altshuler
Submitted by: Marsha Harman, Rush Center for Clinical Skills and Simulation

In my own conversations with SPs and other SP educators, we have often discussed how SP work alters our perceptions of our real-life patient experience and makes us better advocates for ourselves and our family members when navigating the healthcare system. This article takes a more concrete look at the difference between SPs’ and real patients’ perceptions of care. 

By: Lance Baily | Submitted by: Darrell Brock, University of Pittsburgh

Medical Simulation is being practiced to train the next wave of crews in space! 

ASPE Scholar Certificate

The awards ceremony started with the ASPE Scholars Certificate presented by Jacqueline R. Klevan
ASPE Scholars complete the required Basic of Scholarship session, as well as requirements in qualitative and/or quantitative measurement and electives, either from the ASPE conference itself or relevant, comparable content from other conferences.

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

I had the privilege to attend the 2022 International Meeting on Simulation in Healthcare (IMSH), held in Los Angeles from January 15-19. I felt grateful to attend a conference in-person, and I felt fairly comfortable with the many protections taken to keep conference attendees safe. One of the most inspiring aspects of the conference is The Lou Oberdorff Lecture on Innovation and Healthcare Simulation. This year’s speaker was no exception. Erica Dhawan is the author of Get Big Things Done: The Power of Connectional Intelligence and Digital Body Language: How to Build Trust and Connection, No Matter the Distance.She asks the question: how do we create a better normal than pre-pandemic times? How do we connect more intelligently when 75% of face-to-face collaboration is non-verbal and currently, collaboration in teams is 70% virtual? When non-verbal cues are missed, we misunderstand quickly, argue more and walk away faster. She highlighted her idea of Connectional Intelligence, which is the capability to unlock new and unrealized value by fully maximizing the power of networks and relationships. She cited projects such as The Granny Project and Task Rabbit as ways that people have collaborated in new ways, across previously untapped communities, to solve a problem.

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

I had the pleasure of attending the International Meeting on Simulation in Healthcare in January in Orlando. One of the highlights was attending the Lou Oberndorf Lecture on Innovation in Healthcare Simulation, featuring Ryan Leak. Leak is an executive coach, best-selling author, and motivational speaker. He spoke about Chasing Failure (the name of his book and humorous documentary about his attempt to qualify for the Phoenix Suns NBA team.) His message was to embrace failure, because we learn from our mistakes, and it brings us closer to our goals. We hold ourselves back when we fear failure, but failure is how we move forward. He made the audience of 4,000 attendees laugh and inspired us to chase some failure of our own.

Lead author: Angelina Fluet | Submitted by: Erin Walsh, Rosalind Franklin University of Medicine and Science 

To gather Standardized Patients perspectives on bias the authors designed a qualitative interview study and conducted semi-structured interviews with 16 SPs. The interviews were conducted from July to September of 2020. It was concluded that bias occurs in multiple directions including SP-to student. student-to SP, student-to character, and SP- to -character. Additionally, SPs shared they feel there is bias during scenario development and SP recruitment and training. The authors determined that identifying areas where bias occurs can help simulationists alleviate bias. 

By: Timothy Rogers, MD et al | Submitted by: Marsha Harman, Rush Center for Clinical Skills and Simulation

Experiential learning through active participation is thought to be a key benefit of simulation-based education. Recent research has challenged this assumption, suggesting that active participants learn just as well as observers. Studies report that active participants experience stress and anxiety during simulation, which may hamper learning by active participants. We undertook the current study to examine whether active participation results in different emotional arousal than observing during simulation.

“I Have Actually not Lost any Adolescent Since I Started Engaging Them one on one:” Training Satisfaction and Subsequent Practice among Health Providers Participating in a Standardized Patient Actor Training to Improve Adolescent Engagement in HIV Care

Lead Author: Hellen M. Okinyi, BSN
Submitted by: Amy E. Lorion, National Board of Osteopathic Medical Examiners

By: Kerensa Peterson, University of California, Riverside School of Medicine

Tan Le is an internationally recognized innovator and entrepreneur. She gave the final keynote speech at IMSH this past January. While gaining recognition for her pioneering work in the emerging field of brain-computer interface, she is also known for her work as a social activist and public speaker. At the IMSH Conference, Tan Le focused on the bravery of her family and how her life experiences as an immigrant shaped her into the person she has become. Her story was inspiring and I was eager to learn more about her and her work after seeing her speak.