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Original Article: Values and Value in Simulated Participant Methodology: A Global Perspective on Contemporary Practices

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.

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Podcast: Breaking Bad News

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.

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ASPE Conference 2018 By the Numbers

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.

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General Interest: The Exam Room Secrecy that Puts Women at Risk

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.

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General Interest: Losing the ‘Therapeutic Gaze’

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.

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General Interest: Discover First-Year Medical Student Priorities

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.

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General Interest: What it’s Like Being Transgender in the Emergency Room

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.

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General Interest: Top 5 Lists for Kansas City

General Interest: Top 5 Lists for Kansas City
Submitted by: Julie Mack, KU School of Medicine

Julie Mack has shared some “Top 5” lists of destinations and restaurants in Kansas City.

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General Interest: My Stepfather Started Raping Me When I Was 7. It Changed The Course Of My Life Forever.

General Interest: My Stepfather Started Raping Me When I Was 7. It Changed The Course Of My Life Forever.
By: Michael Broussard
Submitted by: Denise LaMarra, Perelman School of Medicine at the University of Pennsylvania

Michael Broussard is one of the SPs at the Perelman School of Medicine at the University of Pennsylvania. When he is not working as an SP, he does a one-man show, “Ask a Sex Abuse Survivor.” It is a very powerful performance, which he does in theaters throughout the region, and now nationally. He has also performed at the medical school at the University of Pennsylvania for the past two years. Both the play and the article are strong testimonials on theater art as a healing mechanism. Read the full article at HuffingtonPost.com here.

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General Interest: 3 Methods for Teaching Communication to Radiology Residents

General Interest: 3 Methods for Teaching Communication to Radiology Residents
By: Subrata Thakar
Submitted by: Michael Maury, UCSD School of Medicine

In this short article, Subrata Thakar mentions 3 methods for teaching communication; (1) Microteaching (2) Simulation-based Training and (3) Mnemonics, Scripts and General Aids. For more details and perhaps new insight into these various communication methods read the full article at Radiology Business here.

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General Interest: Type A and Type B Personalities - Useful Measure of Personality or Conspiracy Funded by Tobacco Companies?

General Interest: Type A and Type B Personalities - Useful Measure of Personality or Conspiracy Funded by Tobacco Companies?
By: Adam Sinicki
Submitted by: Dan Brown, Emory School of Medicine

Continuing our exploration of medical and/or psychological terms that are frequently misused or misapplied, this article discusses the history of Type A and Type B personality theory. People often refer to themselves or others as “Type A” personalities, but “Type B” is much rarer in conversation. Sinicki, a writer who holds a bachelor’s psychology degree, breaks down the theory and explores its roots as an attempt to identify people who live at a higher stress level, and who are therefore more likely to suffer cardiac disease. The founders of the theory, Drs. Meyer Friedman and Ray Rosenman, were cardiologists not psychologists, and their study has been criticized for decades, partially due to its connection to the tobacco industry.

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General Interest: An ASPE Conference First-Timer’s Guide

Submitted by: Dan Brown, Emory School of Medicine

Last summer, I attended the ASPE conference for the first time. I had been an SP Educator for six months, and knew I would be learning a lot, but really had no idea what to expect. Nine months later, and having just booked my attendance at the 2018 conference, these are my lasting impressions, along with advice that did (or would have done) me some good:

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General Interest: How 'Artful Thinking' Can Improve Your Visual Intelligence

General Interest: How 'Artful Thinking' Can Improve Your Visual Intelligence
By: Teodora Zareva
Submitted by: Michael Maury, UCSD School of Medicine

In this article, author Teodora Zareva discusses “a recent study from the University of Pennsylvania” which “shows how principles from the field of visual arts can successfully be applied to medical training to increase observational and descriptive abilities.” As Zareva puts it, “observational skills are critical for medical students and yet students undergo no specific training to develop them.” According to this article, the results from this research study “were impressive”. As one 1st year medical student reflected, “After just one session, I found myself listening to a radiologist discuss the same principles we used to look at art when analyzing a CT scan. Later I found our practice of creating narratives in the art class helped guide me when interacting with standardized patients.” Read on here to learn more about the “Artful Thinking” approach and how it might benefit medical education.

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General Interest: Medical Jargon May Cloud Doctor-patient Communication

General Interest: Medical Jargon May Cloud Doctor-patient Communication
By: Mary Gillis
Submitted by: Michael Maury, UCSD School of Medicine

As Standardized Patient Educators, we understand the importance of clear communication. We encourage our students to use very little jargon or at least follow up any jargon with a clear explanation as to mitigate misunderstanding and confusion. In this article, Mary Gillis discusses a recent “survey of London oral and maxillofacial surgery clinic patients” where “more than a third of participants did not know the meaning of terms like ‘benign’ or ‘lesion’ and more than half could not define ‘metastasis’ or ‘lymph node’.” According to UK researchers, Gillis states, “when patients misunderstand commonly used medical terms, communication and decision-making may suffer.” Read the full article on Reuters Health News here.

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General Interest: Data Visualization in Medical Communication

General Interest: Data Visualization in Medical Communication
Source: 90TEN Healthcare
Submitted by: Michael Maury, UCSD School of Medicine

In the increasingly data-rich but time-poor environment of clinical practice, doctors face the escalating challenge of maintaining up-to-date clinical knowledge. By 2020, it is estimated that medical knowledge will be doubling every 73 days. How can medical communications help to meet this challenge and ensure that the content delivered is in a clear and understandable format, and can be assimilated quickly? One solution is data visualization. Read the full article at PMLiVE here.

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Essay: My Real Patients

Essay: My Real Patients
By: Lisa Simon, D.M.D.
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

In this essay, medical student Lisa Simon compares her interactions with standardized patients in a clinical exam to her work as a dentist in a local jail. She describes how both encounters are watched by an outside eye (whether by video camera or security guard) and how that observation affects the interaction. She expresses her desire to receive the same authentic feedback from her “real patients” as she receives from her SPs. Read the full essay in the New England Journal of Medicine here.

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General Interest: New Cell Phone App Improves Patient Experience and Drives Growth

General Interest: New Cell Phone App Improves Patient Experience and Drives Growth
Source: The Holvan Group
Submitted by: Michael Maury, UCSD School of Medicine

“The Holvan Group, a technology company focused on improving the patient experience and easing the burden placed on physicians, today announced the launch of two apps that complement the company's educational videos and expand patient engagement. The Holvan Group's proprietary technologies streamline the patient preparation process and improve the interaction between patients and healthcare providers.” Technology is continually expanding and being utilized in the world of medicine. We as SP Educators must be diligent in keeping up with these changes and incorporating them into our curriculums and teachings. Read for more information that may spark new ideas to incorporate into your program. Read the full article at Cleveland 19 News here.

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General Interest: Future Physician, Heal Thyself – Get Thee to a Gallery

General Interest: Future Physician, Heal Thyself – Get Thee to a Gallery
By: Tom Jacobs
Submitted by: Valerie Fulmer, ASPE President

Envision a new generation of doctors who are more compassionate toward their patients, less prone to jumping to conclusions, and less likely to feel burned out. Then imagine such characteristics could be cultivated by tweaking the physician-training program. Sound good? Well, new research suggests such a shift is entirely possible. The key is exposing our future MDs to the arts. Read the full article at Pacific Standard here.

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General Interest: Alan Alda Shares Communication Wisdom at Cooper Medical School of Rowan University

General Interest: Alan Alda Shares Communication Wisdom at Cooper Medical School of Rowan University
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

Actor Alan Alda (of M*A*S*H fame) recently spoke to the students and faculty of Cooper Medical School of Rowan University during “The Patient Will See You Now,” a special grand rounds lecture held at the school. During the past several years, Alda has been helping scientists learn to communicate more clearly with the public through his work with Stony Brook University School of Journalism’s Alan Alda Center for Communicating Science. While Alda did not specifically discuss the use of SPs, we educators know what a valuable tool SPs provide for building empathy and communication skills. Alda’s staff held workshops designed to help healthcare providers hone their communication skills with interprofessional teams as well as patients, often using improvisational theater exercises. Read the full article in Rowan Today here.

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Affiliate News: Society For Simulation in Healthcare Names Board Members

Affiliate News: Society For Simulation in Healthcare Names Board Members
Submitted by: Valerie Fulmer, ASPE President

WASHINGTON, D.C. January 20, 2018: The Society for Simulation in Healthcare (SSH) announced today its 2018 board of directors. Read the full release at PRWEB here.

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