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

Several studies have found that exams consisting of multiple-choice questions—particularly the United States Medical Licensing Examination—are not the best or only evaluation method for postgraduate residency selection. To that end, Dr. Senthil Rajasekaran and the team at Eastern Virginia Medical School is developing video vignettes of standardized patient encounters. He believes they are a practical, effective option for assessing a student’s clinical acumen.

By: Jan Hoffman
Submitted By: Michael Maury, UC-San Diego

According to the Centers for Disease Control and Prevention, addiction — whether to tobacco, alcohol or other drugs — is a disease that contributes to 632,000 deaths in the United States annually. But comprehensive addiction training is rare in American medical education. A report by the National Center on Addiction and Substance Abuse at Columbia University called out “the failure of the medical profession at every level — in medical school, residency training, continuing education and in practice” to adequately address addiction.

By: Joshua Niforatos
Submitted by: Mary Launder, Rosalind Franklin University of Medicine and Science

After introducing myself as a first-year medical student working with the attending physician, I went through the medical history with the patient to ascertain his chief complaint and the history of present illness. Since this was only a six-month follow-up appointment in an internal medicine outpatient clinic, there was not much to cover besides checking whether his medications were up-to-date and how he had been managing his chronic conditions. As this was my last patient of the day, I asked if I could practice various aspects of the physical exam that were not necessary for his appointment. Typical of my experience in longitudinal clinic, the patient obliged and thought it was great that he would get some “additional care.” “Are you a fellow or something?” he asked during the exam. “No, no. I’m a first-year medical student,” I reminded him.  It seems that “fellow” and “medical student” were synonymous to this individual. Part of the curriculum of my medical school includes various readings in both the social sciences and the humanities. We recently reflected upon the titles we are known by, such as medical student, student physician or student doctor. More specifically, what is meant by the names and titles we are known by? After contemplating how to introduce myself to patients, I offer the following reflection.

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.

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.”

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?

General Interest: Words Matter When Talking About Pain With Your Doctor
By: Patti Neighmond, as heard on Morning Edition
Submitted by: Todd Lash, Publications Committee Chair

If you're in the hospital or a doctor's office with a painful problem, you'll likely be asked to rate your pain on a scale of 0 to 10 – with 0 meaning no pain at all and 10 indicating the worst pain you can imagine. But many doctors and nurses say this rating system isn't working and they're trying a new approach. The numeric pain scale may just be too simplistic, says Dr. John Markman, director of the Translational Pain Research Program at the University of Rochester School of Medicine and Dentistry. It can lead doctors to "treat by numbers," he says and as a result, patients may not be getting the most effective treatment for their pain.

General Interest: How Pretending to be Sick Could Help You Make Money
By: Catherine Alford
Submitted by: Dan Brown, Emory University School of Medicine

If you ever wonder where some of your “internet-referred” applicants come from, this article may be enlightening. The Penny Hoarder describes itself as “one of the largest personal finance websites. We help millions of readers worldwide earn and save money by sharing unique job opportunities, personal stories, freebies and more.”

Article: Meet the Robot Helping to Save Real Lives
By: Nushrat Rahman
Submitted By: Michael Maury, UC-San Diego

In this article, the author, Nushrat Rahman, writes of the rapidly evolving technology of simulation mannequins and their positive effect on medical education. Rahman writes about Dr. Craig Reickert, director of the center and division of Colon and Rectal Surgery at Henry Ford Hospital in Detroit who notes, “Whether via mannequins or standardized patients participants can be more emotionally invested and mentally active during simulation exercises.” The author goes on to write, “With real-time feedback from monitors and patients, they’re more capable of recognizing the gravity of situations and responding accordingly. This realism allows content to “stick” better for adult learners, and when it does, it means better care for actual patients with authentic symptoms.” As SP Educators, we understand the importance of giving learners a situation in which they can safely fail and make mistakes which lead to understanding.

General Interest: Improving Communication Among Surgeons
By: Geri Kelley
Submitted by: Michael Maury, UCSD School of Medicine

Michigan State University researcher Cheryl Anderson has found a better way for veteran surgeons to provide feedback to their aspiring surgeon counterparts during their residencies. In a new study, Anderson, director of quality improvement and surgical education in the College of Human Medicine, shows that formative feedback and the communication between teacher and student improved under a more-structured process using proven educational models. Formative feedback is input that helps students identify strengths and weaknesses, as well as focus on areas that need work.

General Interest: ASPE eNews Blog Passes 50000 Click Milestone
By: Todd Lash, Publications Committee Chair

The ASPE eNews Blog launched on May 22, 2017, and in July 2018 surpassed the 50,000 click milestone. As of July 18, 2018, 126 articles had been published on the blog, and the total number of times readers had clicked on those entries was 54,966. Among those 126 entries, more than half (66) have been viewed more than 400 times! While we do not know if that number translates explicitly to 400 readers, since a single reader who views the same article repeatedly would count as multiple clicks, it stands to reason that we have a significant number of readers who are visiting the blog. Among the top 20 entries with the most views, the most popular content categories are entries about ASPE and its affiliates (8) and Research Articles (5). The all-time most popular entry, with 1765 views, is an essay written by an SP. The top 20 entries with the most views, with licks to the top 5, are listed below:

Original Article: Values and Value in Simulated Participant Methodology: A Global Perspective on Contemporary Practices
Lead author: Debra Nestel, Melbourne Medical School
Submitted by: Valerie Fulmer, ASPE President

Abstract: This article has been written for the 40th year of the publication of Medical Teacher. While we celebrate the contribution of simulated participants (SPs) to health professions education through values and value-based learning, we also offer critical reflection on elements of our practice, commencing with language. We argue for the use of the term simulated rather than standardized and acknowledge the dominant role of the SP as patient and the origins of the methodology. These shifts in terms and their implications in practice reflect changes in the conceptualization of SP-based methodology. Recently published standards for those who work with SPs (SP practitioners) are noted as an important milestone in our community’s development. We consider contemporary practices addressing the complex notions of values and value in SP-based learning. We simultaneously refer to the work of SPs and SP practitioners. Phases of educational design including identifying learning objectives, scenario design, implementation, feedback and debriefing are used to illustrate methodological shifts. Within each of these phases, there are relational issues that have to date often gone unchecked and are under reported in literature. Finally, using the metaphor of a murmuration, we celebrate contemporary practices of the global SP practitioner community.

Podcast: Breaking Bad News
Submitted by: Kerensa Peterson, Northwestern University Feinberg School of Medicine

As some healthcare providers move away from utilizing the SPIKES mnemonic for delivering bad news, now is the time for reflection on this framework, its originator and the circumstances that led to the development of this communication model. Dr. Rob Buckman lived a fascinating life. The combination of working as a comedian and oncologist at a time when American physicians were ending the practice of not disclosing a cancer diagnosis to their patients clearly influenced Dr. Buckman's work. Even though other frameworks, like the COMFORT model, are beginning to overtake his SPIKES model, one must recognize the rich history behind his methodology along with his empathy and charisma.

ASPE Conference 2018 By the Numbers
By: Todd Lash, Publications Committee Chair

The annual ASPE Conference, “Power of the Past, Force of the Future,” will be held in Kansas City, MO, from Saturday, June 16 – Wednesday, June 20. Each year we like to summarize some numbers to demonstrate the diversity in program offerings.

General Interest: The Exam Room Secrecy that Puts Women at Risk
By: Wendy Kline
Submitted by: Katherine Rivlin, MD, The Ohio State University

While this article was published to report about a scandal at the University of Southern California, it contains a nice history of teaching the pelvic exam. A lot of progress has been made in thoughtfully and sensitively teaching this exam, but this article also highlights the need for ongoing diligence and persistence in keeping the momentum going, especially in our current political/cultural environment. A public awareness like this makes the great work our GTAs are doing all the more important! Read the full article in the Washington Post here.

General Interest: Losing the ‘Therapeutic Gaze’
By: Howard Wolinsky
Submitted by: Dan Brown, Emory School of Medicine

A patient with several chronic diseases describes his feelings as he encounters physicians who seem increasingly focused on computer screens instead of the patient. His craving for eye contact is palpable, and it drove him to seek out a health technology expert, Enid Montague of DePaul University, who confirms the importance of “the therapeutic gaze” and how effective interfaces allow for minimal eye-to-screen time. As for our profession, this article illuminates the importance of giving feedback on learners’ eye contact while they’re still in the habit-forming stage. Read the full article in at MedPage Today here.

General Interest: Discover First-Year Medical Student Priorities
By: Cassie Kosarek
Submitted by: Dan Brown, Emory School of Medicine

A first-year student details her experience transitioning from premedical studenthood to her first year of medical school. She finds she’s had to make adjustments to her study habits, narrow her extracurricular interests, and find time to connect with herself and nature. This could be useful to any of us who find ourselves interacting with a stressed-out student who’s having trouble adjusting. Read the full article at U.S. News & World Report here.

General Interest: What it’s Like Being Transgender in the Emergency Room
By: Susmita Baral
Submitted by: Michael Maury, UCSD School of Medicine

In this National Geographic article, author Susmita Baral points out the various ways that hospitals and medical programs around the country are approaching educating current and future health professionals about transgender care. As surveys and polls have shown, inequality and mistreatment in healthcare has been a major concern for those in the transgender community. There are many in health education who are trying to change this. Baral details some of what is being done in health education. The author mentions 54 year-old- transgender advocate Kate Terrell who says “The bare minimum is for providers to be normal around their transgender patients. The most important thing doctors can learn or remind themselves,” she says, “is to treat humans like human beings.” Read the full article in National Geographic here.