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Watch Your Language!—Misusage and Neologisms in Clinical Communication

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?”

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Analysis of a Near Peer Tutoring Program to Improve Medical Students’ Note Writing Skills

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.

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When I Grow Up…I Want to Go to Medical School

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.

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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

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.

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Observations: Problems No One Looked For: Philosophical Expeditions into Medical Education

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.”

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An Unintended Learner

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.

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A Novel Framework Using Remote Telesimulation With Standardized Parents to Improve Research Staff Preparedness for Informed Consent in Pediatric Critical Care Research

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.

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The Virtual SP

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…

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An Objective Structured Clinical Exam of Communication Skills for Child Neurology Residents

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.

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How Medical Improv Training Sparks Better Communication, Teamwork

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.

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In Our Own Time: Medical Students’ Informal Social Studying and Learning

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.

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SP Stories: Corona Thoughts

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.

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Crisis Communication and Grief in the Emergency Department: A Podcast with Naomi George and Kai Romero

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.

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WVU Medicine Improving Care for Transgender Patients

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.

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Addressing Race and Racism in Medical Education

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.

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ASPE Webinar Review

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?

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In The Spotlight: The Ohio State University

Submitted By: Todd Lash

Full Center Name: Clinical Skills Education and Assessment Center

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What does improv comedy have to do with medicine?

By: Jamie Bartosch

Submitted by: Michael Maury, UC-San Diego

While describing a simple exercise known as One-Word-Story, Jamie Bartosch writes “It’s a fun activity, but it serves an important purpose for these future doctors. It forces them to listen. This exercise, like the many others they engage in, makes them realize they don’t know where the story is going to go, so they must pay attention to verbal and non-verbal cues.” Skills like these are vital to successful patient care in medicine. While improv can provide some extra laughs, it ultimately “has nothing to with comedy” as University of Chicago Medicine pediatrician Nikki Orlov, MD states. “It’s all about improving advanced communication skills.”

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A Study on Evaluator Factors Affecting Physician-Patient Interaction Scores in Clinical Performance Examinations: A Single Medical School Experience

Lead author: Young Soon Park

Submitted by: Kathy Herzberger, Loma Linda University

Establishing major competencies and training for clinical performance in medical education has been prevalent in Korea for only the last 15 years. This is due to the clinical skills test that was added to the paper-based Korean Medical Licensing Examination (KMLE) in 2009. This crucial change in the KMLE has strengthened clinical performance in Korean medical schools. This interesting study emphasizes how evaluator factors as well as the type of scale utilized can influence physician-patient interaction scores.

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Empathy or Compassion: Which is Better for Patients and Providers?

By: Brian James

Submitted by: Todd Lash, The Ohio State University

Imagine a medical student sitting in the room across from a 50-year-old female standardized patient who presents with fatigue and vague abdominal pain. It’s their second year of medical school, and they know generally how to conduct a patient interview. They eventually reach the family history, concerned that any incidence of pancreatic cancer in the family may mean the standardized patient is in for a long, scary and painful journey of diagnosis and treatment. The question finally arises: any family history of a cancer diagnosis? The standardized patient, without skipping a beat, coldly tells you that her father passed away from pancreatic cancer over 10 years ago at age 59. The student knows what to do; they have been trained extensively in the ways of empathy. They pause, say “I’m sorry to hear that,” then pause again for dramatic effect.

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