Lead Author: Shelley Zhang
Submitted by: Kerensa Peterson, Northwestern University

As other clinical professions enter the world of simulation, their questions and development are catalogued in research. The pharmacy profession is an example of a clinical profession that is evolving to include a larger emphasis on communication skills and collaborative care. New simulation practitioners are asking how to assure quality in their newly developed standardized patient (SP) programs. This article focuses on the authors’ recommendations and applications for quality assurance in SP programs through a thematic analysis of the current scholarly literature.

Lead author: Cynthia L. Foronda
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

There has been increased focus on the need to combat inequities in healthcare by teaching cultural humility. As SPEs, we know SPs are a fantastic tool to teach this skill. However, this review of literature shows there is a lack of studies published involving the use of simulation to teach cultural humility. The authors point out that “current international simulation standards lack an emphasis on diversity and cultural humility; thus, simulation curricula may be missing this essential component.” The study identified the need for more robust research on the subject. Let’s get cracking.

Lead Author: Mary Ann Forgey
Submitted by: Amber Snyder, University of Pittsburgh

Assessment in intimate partner violence (IPV) is an essential component to determine the course of interventions and support provided. This study used Standardized Clients (SC) to train eight Army civilian social workers to implement an evidence-based assessment protocol of IPV.

Authors: Richelle K Marracino, MD and Robert D Orr, MD
Submitted by: Mary Launder, Rosalind Franklin University of Medicine and Science

Oscar Thompson, a third-year medical student on a shift in the emergency department, is eager to participate in as many procedures as possible. According to the triage nurse's history, the next patient to be seen is a 58-year-old man who has had fever, headache, and neck stiffness. Anticipating his first lumbar puncture, Oscar approaches the room with enthusiasm. The nurse whispers that the patient is irritated and can't wait to see the doctor. The student pauses, draws back the curtain, and says, “Hello, I'm Dr. Thompson, how can I help you today?”

Lead author: Christine Bradway, PhD, GNP-BC
Submitted By: Michael Maury, UC-San Diego

This pilot study aimed to compare a group of interprofessional health professions students' self-reported level of confidence in communication, explore behavior change and professional identity, and identify areas for future interprofessional education. Students participated in a simulated team meeting with a standardized family member of an older adult patient hospitalized with an acute aspiration pneumonia and a chronic, progressive illness.

Conference: ASPE Town Hall Report
By: Valerie Fulmer, President, ASPE

The June ASPE conference in Kansas City was a rewarding time to connect with many ASPE members in person; however, I realize that it probably feels like a distant memory at this point. Many members were not able to attend, which may leave some feeling “out of the loop.” Let us start with some conversations the membership had with the executive committee (EC) during a “Town Hall” meeting at the conference. 

General Interest: International perspective on word describing symptoms - Use of Onomatopoeia to Enhance Emotional Expression during Medical Encounters in Asian Countries
By: International Committee work
Submitted by: Keiko Abe, International Committee Chair, Aichi Medical University

Onomatopoeia is a term that comprehensively refers to "mimetic word." Examples of onomatopoeia in English include “cuckoo,” “sizzle,” “hiccup,” or “buzz,” in that the words imitate the sounds they describe.

Research Article: Nursing and Social Work Trauma Simulation: Exploring an Interprofessional Approach
Lead Author: Sara Manning, M.S.
Submitted by: Amber Snyder, University of Pittsburgh

Individual competencies in the fields of Nursing and Social Work are essential to be successful in the profession. Equally as important is the competence to work successfully interprofessionally. This article describes an interprofesional training strategy which combined nursing and social work programs to create one simulation.

General Interest: Medical School – Learning More Than Just Facts
By: Adam Nessim
Submitted by: Anna Lank, C3NY – Clinical Competence Center of New York

Here is a link to a terrific blog post by an Albert Einstein College of Medicine students about his work with the C3NY Standardized Patients at the end of his second year.

General Interest: Right Coat Ceremony
By: Shadi Ahmadmehrabi
Submitted by: Dyan Colpo, Cleveland Clinic Simulation and Advanced Skills Center

It was my first day of orientation at medical school. In a hallway stood a coat rack overflowing with white garments. I set down my accumulated papers, reached for a hanger and, for the first time ever, shrugged first one arm and then the other into a white coat. It was too large, but I had no other options. The unisex coats ran from XXS to XXL, but the smallest had all been claimed.

General Interest: Avoiding Jargon, Building Empathy Will Be Focus at New Fort Worth Medical School
By: Bill Zeeble
Submitted By: Michael Maury, UC-San Diego

A new medical school will be opening next year in Fort Worth, Texas as a joint effort by Texas Christian University and the University of North Texas Health Science Center. This new school is taking a different approach to medical education as it “will feature a four-year curriculum in communication, a program believed to be the first of its kind in the country.” The school’s assistant dean for Narrative Reflection and Patient Communication, Dr. Evonne Kaplan-Liss believe that “by injecting regular lessons in communication as early as the first semester, graduates and their patients should emerge healthier.” She goes on to say that the difference in this new school is that the communications education is “embedded throughout their four years of curriculum. It’s not labeled as ‘communications.’ It’s part and parcel of everything that they’re doing.”

Research Article: “I need to know what makes somebody tick …”: Challenges and Strategies of Implementing Shared Decision‐Making in Individualized Oncology
Lead author: Joschka Haltaufderheide
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

Shared decision‐making (SDM) has been advocated as an ethical framework for decision‐making in cancer care. When using SDM, patients make decisions in light of their values and based on the available evidence. However, SDM is difficult to implement in cancer care. This empirical‐ethical study explores current difficulties in translating the concept of SDM into clinical practice. SP methodology is an excellent tool to help prepare practitioners to explore patients’ values and preferences before making decisions.

Research Article: Assessing Mental Health First Aid Skills Using Simulated Patients
Lead Author: Sarira El-Den
Submitted by: Kerensa Peterson, Northwestern University

Many of us who work in simulation recognize the temptation of learners to say, “I already know how to do this.” When learners must self-assess their skills and then perform those skills, there is sometimes inaccuracy in that reflection. A group of researchers at the University of Sydney tackled the question of self-assessment in regards to mental health first aid skills. By utilizing a self-evaluation followed by two simulated patient roleplays with each participant, the researchers were able to find some startling results in the confidence levels versus the observed performance of those learners’ skills.

Podcast: Invisibilia – The Culture Inside
Hosts: Hanna Rosin and Alix Spiegel, NPR
Submitted by: Dan Brown, Emory University School of Medicine

At the 2018 ASPE Conference in Kansas City, Jennifer Murphy of the University of Michigan presented on “Addressing Unconscious Bias in SP Training.” At this session, she played an excerpt from NPR’s Invisibilia podcast. The episode she sampled, The Culture Inside, examines the brain’s unconscious biases, particularly relating to race, and how these biases form.

Journal Article: Considerations When Using Standardized Patients in EMS Simulation
Lead author: Timothy Whitaker
Submitted by: Dena Higbee, University of Missouri

The use of live humans as part of a simulation activity enhances realism by allowing a more realistic communication exchange that includes nonverbal cues. EMS has long used “actors” to portray an illness or injury during a simulation. Many of us can remember our paramedic school instructors often stepping in to play the part of the patient. Embracing standard language from the Healthcare Simulation Dictionary, actors come in many forms based on the need of the simulation activity: embedded participant, role player, simulated person and standardized patient.

Media Article: Using Simulation in Dietetics Education
By: Christen Cupples Cooper
Submitted by: Todd Lash, Publications Committee Chair

A nutrition and dietetics student sits before a 45-year-old female patient who complains of chronic weakness. The student has reviewed the patient's chart and considered her self-reported body weight and ideal body weight. The student begins discussing the duration of the patient's weakness and appetite changes.

General Interest: If the Doctor is Listening, You Have 11 Seconds
By: Susan Noakes
Submitted By: Michael Maury, UC-San Diego

As SP Educators, we understand the importance of good communication skills in medicine. If we study the research we know that it is a proven fact that open-ended questions are answered with more information. We use this fact to write and build cases that reward students with a more detailed history response for any open-ended questions asked. A US study found that only 36 percent of doctors started a patient visit with an open-ended question. The study also found that after an open-ended question is posed, the patient gets a median time of 11 seconds to answer before the doctor interrupts them. While it is important to continue our practices of encouraging open-ended questions, these data might make one pause to consider focusing on the aspect of listening completely to the answer that is being provided as well. Are we doing all we can as SP Educators to provide our students with the right communication skills to be the best doctors possible?

Media Article: New ways actors can benefit your doctors-in-training
By: Lisa Mulcahy
Submitted by: Dysn Colpo, Cleveland Clinic Simulation and Advanced Skills Center

You're no doubt familiar with "standardized patients" — professional actors who role-play with medical students and residents to simulate real-life patient interactions. Often, these interactive experiences teach doctors-in-training how to handle basic communication situations, such as how to prescribe medication or explain a diagnosis. New research initiatives, however, are greatly expanding the knowledge medical students and residents can glean from working with actors, leading to more emotional insight when they work with real patients, as well as better effectiveness at sharing medical information with those real patients.

Resource: Using Simulation Training to Improve Culturally Responsive Child Welfare Practice
Lead Author: Robin Leake
Submitted by: Amber Snyder, University of Pittsburgh

Child Welfare professionals work in diverse communities and manage complex factors influencing parenting, values, and worldviews of the families they support. Working across varied communities requires culture awareness and responsiveness. The project outlined in this research intended to enhance cultural awareness and responsiveness through a competency-based training program using simulation.

Research Article: Utilizing Standardized Patient Feedback to Facilitate Professional Behavior in Physical Therapist Students: A Pilot Study
Lead author: Mary Anne Riopel
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

Literature is lacking on the impact that verbal feedback from SPs may have on Physical Therapist students regarding professional behaviors. The purpose of this pilot study was to examine the use of SP feedback as a strategy for professional behavior development. Though the pilot study did not provide significant evidence on the value of this educational strategy, trends did show that stress management and problem solving improved over time from the group of PT students that received SP feedback. Future research will be beneficial to examine differences in perceptions of professional behavior between SPs, students, and faculty.