By: Michelle Andrews
Submitted by: Todd Lash, Publications Committee Chair

When an inmate needs to see a medical specialist, getting that care can be complicated. Prisons are often located in rural areas far from medical centers that have experts in cancer, heart and other disease treatments. Even if the visit just involves a trip to a hospital across town, the inmate must be transported under guard, often in shackles. The whole process is expensive for the correctional facility and time-consuming for the patient. Given the challenges, it's no wonder many correctional facilities have embraced telemedicine. They use video conferencing to allow inmates to see medical specialists and psychiatrists without ever leaving the facility.

Lead author: Mark Starmach
Submitted by: Dyan Colpo, Cleveland Clinic, Simulation and Advanced Skills Center

First, you withdraw.
Life shrinks down to the size of your home, then to your bedroom, then to your bed—sometimes over months, but more often over weeks.
Old joys stop having the same pull.
You eat less, drink less. Have less interest in speaking.
As your body’s systems start shutting down, you have less and less energy.
You sleep more and more throughout the day.
You start to slip in and out of consciousness and unconsciousness for longer periods of time.
Staying alive starts to feel like staying awake when you are very immensely tired.
At some point, you can’t hold on any longer.
And then you die.
A calm fall into a cosmic sleep.
But that’s not even the half of it.
“There are four ways people tend to die,” the older woman opposite me says as she reaches for a napkin and a ballpoint pen.

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

The growing need for palliative care (PC) among patients with serious illness is outstripped by the short supply of PC specialists. This mismatch calls for competency of all health care providers in primary PC, including patient-centered communication, management of pain and other symptoms, and interprofessional teamwork. Simulation-based medical education (SBME) has emerged as a promising modality to teach key skills and close the educational gap.

Lead Author:  Dixon Chibanda
Submitted by:  Dyan Colpo, Cleveland Clinic, Simulation and Advanced Skills Center

Dixon Chibanda is one of 12 psychiatrists in Zimbabwe -- for a population of more than 16 million. Realizing that his country would never be able to scale traditional methods of treating those with mental health issues, Chibanda helped to develop a beautiful solution powered by a limitless resource: grandmothers. In this extraordinary, inspirational talk, learn more about the friendship bench program, which trains grandmothers in evidence-based talk therapy and brings care, and hope, to those in need.

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

When I was a third year medical student on my pediatric inpatient rotation, I thought I had mastered family centered rounds. I would stand in the patient’s room, position myself in front of the patient and family, and present from my notes to the attending physician, occasionally glancing at the family. At the very end, I would turn to the family and say something along the lines of, “Any questions, Ms. Lopez?” It was not until years later that I realized how flawed my model of family centered care was.

By: Brendan Pauley
Submitted by: Michael Maury, UC-San Diego

Often times, when I am doing my best to explain my profession as a Standardized Patient Educator to friends or with people I meet, I am interrupted by my wife who exclaims, “Your explanation is too complicated.” She then proceeds to tell it in her own words which are much easier to understand. I was drawn to this article because it reminds me that most of the world still does not know that what we do is actually “a real thing.” In this article, author Brendan Pauley gives a wonderful summary of Simulation and Standardized Patient Education through the observation of the Interprofessional Center for Experiential Learning and Simulation (iCELS) at the University of Massachusetts Medical School in Worcester, MA. Pauley reports that Ray King, education Program Specialist at iCELS puts it well when he says, “SPs are better than reviewing cases, talking with proctors, or reading a textbook.” While many of us know and deeply understand the importance of our work as SPEs, it is nice to have a kind and simple reminder of the magic we create in medical education. If you would like another way to explain, simplistically, this SPE profession (like I certainly do) please read further.

By: Sian Leah Beilock
Submitted by: Dan Brown, Emory University School of Medicine

In this TED Talk, Sian Leah Beilock borrows from her history of playing soccer to discuss strategies for performing under pressure. As SP Educators, we are frequently working with medical students who are under immense pressure, and we often hear from their instructors that their performance on the test doesn’t reflect their skill as a student. Beilock addresses factors for “choking,” such as contagious anxiety and overthinking things that should be on autopilot, and suggests strategies for overcoming the pressure. Passing along these strategies, such as jotting down worries or practicing under performance conditions, could help the students perform more to their potential.

Authors: Derek W. Brown, Todd F. Atwood, Kevin L. Moore, Robert MacAulay, James D. Murphy, Arno J. Mundt and Todd Pawlicki
Submitted by: Michael Maury, UC-San Diego

Most of the time in the medical profession, the responsibility of patient care and empathic interaction falls mainly on the doctors and nurses. Yet, a responsibility like this must be shared by all individuals on the team. In this research study, the authors sought to “develop a training program designed to meet the specific needs of medical physicists as they transition into a clinical role with direct patient care responsibilities.” Please read on for information about the developed program that “incorporates an array of established education techniques and provides a comprehensive, accessible, means of improving medical physicists’ patient communication skills.”

General Interest: Should you stop shaking hands with your patients?
By: John Murphy
Submitted by: Anna Lank, C3NY – Clinical Competence Center of New York

What’s the polite thing to do when you meet someone? You look them in the eye and shake their hand, right? But these days, when hospitals and offices are oozing with indestructible bacteria and patients are trigger-happy with lawsuits over perceived offenses, should you still be touching your patients’ hands?

Journal Article: Standardized patients in psychiatry – the best way to learn clinical skills?
By: Monika Himmelbauer, Tamara Seitz, Charles Seidman, and Henriette Löffler-Stastka
Submitted by: Mary Launder, Rosalind Franklin University of Medicine and Science

Standardized patients (SP) have been successfully utilized in medical education to train students’ communication skills. At the Medical University of Vienna communication training with SPs in psychiatry is a mandatory part of the curriculum. In the training, the SP plays the role of four different patients suffering from depression/suicidal tendencies, somatoform disorder, anxiety disorder, or borderline disorder while the student attempts to gather the patient’s medical history. Both the instructor and SP then give the student constructive feedback afterwards.

General Interest: The Art of Storytelling in Clinical Data Communication – What We Can Learn from Batman and the Joker?
Lead author: Angela Ward
Submitted by: Michael Maury, UCSD

Author Angela Ward asks the question, “What can we learn from Batman and the joker, the greatest hero/villain pairing of all time?” In this article she explores the impact that stories we tell ourselves and others have on our psyches and how certain narratives effect our decisions and behaviors as humans. By connecting the power of storytelling to the practice of effectively communicating clinical data, Ward lays out a foundation to connect clinical data with clinical practice successfully. She writes, “If we are to have any success in bridging this gap between clinical data and clinical practice, we have to do more than just exchange information.  Effective communication strategies should not only understand the challenges and the impact on the audience, but the solutions provided should also appeal to both hearts and minds or, to put it another way, to our behavior.”

Research Article: Exploring patient-centeredness: The relationship between self-reported empathy and patient-centered communication in medical trainees
Lead author: Marianna D. LaNoue
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

Patient-centered communication can lead to better clinical outcomes as well as greater patient satisfaction and perceived quality of care. Based on evidence suggesting a relationship between empathy and patient-centered communication, this study explored the relationship between 3rd year medical students’ self-reported empathy and their verbal performance during an OSCE in which communication was coded from audio tapes of the interactions. This study provides evidence that ‘patient-centered’ features of trainee-provider communication are related to the self-reported empathy of those same students.

General Interest:  Why Doctors Are Running Out Of Empathy:  Inside the “Sickness-Billing Industrial Complex”
Lead author:  Alex Mohseni
Submitted by:  Dyan Colpo, Cleveland Clinic, Simulation and Advanced Skills Center

Walking up to the door of the waiting room, I knew what lay behind it. The gnawing torment would start the day before, or sometimes two days prior. Three parts nausea, two parts dread, and a dash of anxiety — the recipe was always the same. Just add an organic grass-fed doctor, and you have yourself a nice little snack for the healthcare system to chew up and unceremoniously spit out.

General Interest: Stigmatizing Language in Medical Records Affects Future Treatment
By: Cecilia Pessoa Gingerich
Submitted by: Todd Lash, Publications Committee Chair

A study from Johns Hopkins University School of Medicine found that the presence of stigmatizing language in a patient’s medical records affected a physician’s clinical decision-making later on. Researchers found that reading a vignette about a hypothetical patient with sickle cell disease that contained stigmatizing language affected how study participants treated that patient’s pain, as compared to participants who read a neutral vignette of the same patient.

Journal Article: Smoking Cessation Counseling: A Simulation Enhanced Curriculum to Improve Motivational Interviewing in Pediatric Residents
Lead author: Sarah Schaefer, MD
Submitted by: Dan Brown, Emory University School of Medicine

Recognizing the lack of education and experience in smoking cessation counseling among pediatric residents, a team of doctors and educators at University of Alabama at Birmingham developed a curriculum using standardized patients to teach evidence-based counseling techniques and resources such as “The 5 A’s,” nicotine replacement therapy, telephone hotlines, and motivational interviewing.

Journal Article: Promoting Empathy Among Medical Students: a Two-site Randomized Controlled Study
Lead Author: Celine Buffel du Vaure
Submitted by: Kerensa Peterson, Northwestern University

Two universities in Paris took part in this randomized controlled trial. The results? The use of Balint groups may promote empathy among medical students. Self-reported empathy at follow-up was significantly higher among the fourth-year medical students who participated in Balint groups. There are interesting results in this study when looking at student characteristics, such as education level of parents, gender, anticipated specialty choice and living status.

Journal Article: Recruiting Participants into Pilot Trials: Techniques for Researchers with Shoestring Budgets
Lead authors: Rodney P. Joseph, Colleen Keller and Barbara E. Ainsworth
Submitted by: Michael Maury, UCSD

As pointed out in the abstract, “Limited research has focused on recruitment strategies for health promotion researchers conducting small-scale pilot studies.” The authors lay out five key recruitment techniques that can be utilized to succeed in recruitment efforts when working on a budget. These techniques are: 1) leverage existing social networks and personal contacts, 2) identify and foster collaborations with community gatekeepers, 3) develop a comprehensive list of potential recruitment platforms and venues, 4) create recruitment materials that succinctly describe the purpose of the study, and 5) build respectful and trusting relationships with potential participants. As Standardized Patient Educators, we often find ourselves in a similar situation in which time and fiscal support are minimal. These five key techniques may be utilized to assist each of us in our own programs at our various institutions.

General Interest: Let’s talk about it: Death
By: Meghan Knoedler
Submitted by: Mary Launder, Rosalind Franklin University of Medicine and Science
Recognizing the global need for improved dialogue around end of life care, Salzburg Global Seminar convened 66 leaders from 14 countries around the topic “Rethinking Care Toward the End of Life.” The highlights from the session on end of life care, co-led by Mayo Clinic and The Dartmouth Institute for Health Policy and Clinical Practice, include a need for increased education and training for medical professionals. The goal is to find a way to have difficult conversations regarding death and smoothing the transition from a more curative notion of health care to an approach driven more by palliative care and quality of life.

Read the full article in Advancing the Science/Mayo Clinic Medical Science Blog here.

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.

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.