By: Mia Pattillo
Submitted by: Michael Maury, UC-San Diego

Being in Standardized Patient Education gives us the wonderful opportunity to better the world by helping future doctors navigate medicine empathically through reflective listening with a patient-centered focus. In this article, author Mia Pattillo points out different ways in which the Alpert Medical School at Brown University is working with their students to foster the skills necessary to connect with patients through the care they need. As Steven Rougas, assistant professor of medical science and emergency medicine points out in the article, “Brown has taken a lead in thoughtfully incorporating critical topics that have previously been neglected into curricula, such as LGBTQ+ patient care, racism and transgender medicine.” Many positive ideas are shared in this article including an annual Ceremony of Gratitude which is given each May to thank the families who have donated bodies to help the students understand human anatomy. Pattillo writes, “During the ceremony, students express their gratitude through poetry and speeches, dances and hand-written cards.” Please read further for potentially positive inspiratory ideas that could support our wonderful efforts in medical education.

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.

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.”

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.

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?

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.

Lead author: Hartley Jafine
Submitted by: Michael Maury, UCSD

In this article author Hartley Jafine articulates the idea that “Medicine… is a performance. And the skills actors and improvisers learn are equally important for any health-care role.” Jafine relays his experiences as a facilitator of theatre courses within undergraduate health sciences and medical education to enhance the clinical skills of students and train better health-care professionals. Throughout this reflection piece, Jafine highlights the importance of using Applied Theatre arts programs in healthcare education. Jafine says, “Acting cuts through stereotypes” and improvisational play gives learners a safe place where they are free to fail without consequence.

By: Kim Tingley
Submitted by: Dyan Colpo, Cleveland Clinic, Simulation and Advanced Skills Center

In October 2014, my father was startled to receive a letter announcing the retirement, in a month’s time, of our family physician. Both he and his doctor were in their late 60s by then, and their relationship went back about 30 years, to the early 1980s, after my father followed his father and paternal grandparents, all from the Midwest, to Southwest Florida. How they began seeing the doctor is beyond memory, but as my father’s grandparents grew increasingly frail, his father frequently drove them to their doctor for checkups. At one of them, in the mid-’80s, the doctor suggested that it might be less strenuous for my great-grandparents if he met them in the parking lot. From then until they died, he came downstairs from his seventh-floor office with his black bag and climbed into the back seat of their yellow Oldsmobile 88 to give them their physicals. 

By: Blake Farmer
Submitted by: Todd Lash, Publications Committee Chair

Nursing requires hands-on training. But research has found that university curriculum often goes light on one of life's universal experiences — dying. So some colleges have gone to new lengths to make the training more meaningful. There's a sound near the end — the death rattle. People stop swallowing. The lungs fill up. There can be involuntary moaning. "So you get all that noise. And that's really distressing for family members," Professor Sara Camp of Nashville's Belmont University says.

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.

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.