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Assessment of Interruptive Behavior at Residency Teaching Conferences by Gender

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

In anecdotal reports from residency retreats, female residents described a high frequency and negative impact of interruptive behavior by male colleagues. The authors sought to characterize interruptions during residency teaching conferences by gender. The results are eye-opening.

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Non-Heterosexual Medical Students are Critically Vulnerable to Mental Health Risks: The Need to Account for Sexual Diversity in Wellness Initiatives

Lead Author: Daniel Suarez
Submitted by Kathy Herzberger, Loma Linda School of Medicine

This study looks at the association between sexual orientation and the mental health of medical students. One of the more heartbreaking findings was the higher rate of family dysfunction among non-heterosexual students that leads to decreased social and financial support. Once again, our vigilance is essential to help our students find the help that they need to improve their well-being.

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Comparison of Self and Simulated Patient Assessments of First-Year Medical Students’ Interpersonal and Communication Skills (ICS) during OSCEs

Lead Author: Joshua A. Roshal
Submitted by: Marsha Harman, Rush Center for Clinical Skills and Simulation

This study identified self and simulated patient (SP)-reported ratings of US first-year medical students’ interpersonal and communication skills (ICS) and the influence of age and gender on performance appraisal during the Objective-Structured Clinical Examination (OSCE). While the majority of students and SPs evaluated the students’ ICS as very good, there was a disparity in the rating of the medical students’ ability to encourage patient question-asking and answer questions; more SPs gave an “inadequate” rating in that category than students. Neither age nor gender influenced the medical students’ self-assessment of ICS. Female SPs assigned lower scores to students in regard to respecting patients and encouraging patient question-asking and answering. Older SPs were more likely to assign lower scores on all survey questions.

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In, But Out of Touch: Connecting With Patients During the Virtual Visit

Lead Author: Martina Ann Kelly
Submitted by Kathy Herzberger, Loma Linda School of Medicine

We have all realized how much touch is essential to our lives during this past year. Touch, according to the authors, expresses healing, caring, and connection. They discuss how virtual life has transformed interactions with their patients and colleagues. If telemedicine continues beyond our current pandemic, then physicians will need to find a way, other than touch, to connect with their patients to develop therapeutic relationships. 

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Prevalence of Anxiety and Depression Among Medical Students During the Covid-19 Pandemic: A Cross-Sectional Study

Lead Author: Scott Haperin
Submitted by Kathy Herzberger, Loma Linda School of Medicine

Medical students suffer from increased anxiety and depression. Add Covid isolation to an already difficult situation and these problems are exacerbated. This study assessed the mental health situation of 1,428 students from 40 U.S. medical schools. The results suggest that we should be especially vigilant in recognizing and offering help to students that require extra emotional support.

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Virtual Standardized Patients vs Academic Training for Learning Motivational Interviewing Skills in the US Department of Veterans Affairs and the US Military: A Randomized Trial

Lead Author: Greg M. Reger, PhD, et al
Submitted by: Marsha Harman, Rush Center for Clinical Skills and Simulation

What is the efficacy of training with a virtual standardized patient (VSP) compared with traditional academic study for learning motivational interviewing (MI) skills? Findings In this randomized trial of 120 health care professionals, training with a virtual standardized patient resulted in significantly greater improvements in 3 of 4 motivational interviewing composite skill scores, including the technical global score, the relational global score, and the reflection-to-question ratio, compared with academic study.

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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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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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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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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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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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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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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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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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Manifesto for Healthcare Simulation Practice

Lead Authors: Christine S. Park, Lou Clark, Grace Gephardt, Jamie M Robertson, Jane Miller, etc.
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

A pandemic has sent the world into chaos. It has not only upended our lives; hundreds of thousands of lives have already been tragically lost. The global crisis has been disruptive, even a threat, to healthcare simulation, affecting all aspects of operations from education to employment. While simulationists around the world have responded to this crisis, it has also provided a stimulus for the continued evolution of simulation. We have crafted a manifesto for action, incorporating a more comprehensive understanding of healthcare simulation, beyond tool, technique or experience, to understanding it now as a professional practice. Healthcare simulation as a practice forms the foundation for the three tenets comprising the manifesto: safety, advocacy and leadership. Using these three tenets, we can powerfully shape the resilience of healthcare simulation practice for now and for the future. Our call to action for all simulationists is to adopt a commitment to comprehensive safety, to advocate collaboratively and to lead ethically.

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Introducing Telepsychiatry to Medical Students with Simulated Patients: An Innovation by Necessity

By: Michael Miller, Dawnelle Schatte, Karen Szauter
Submitted by: Marsha Harman, Rush Center for Clinical Skills and Simulation

The abrupt discontinuation of medical student-patient contact due to the covid-19 pandemic resulted in a rapid change to virtual teaching. Student education was restructured to include online cases, small group discussions, synchronous and asynchronous lectures, and modified problem-based learning and team-based learning sessions. However, the key focus of the clerkship experience, contact with patients, was missing. This article outlines the process and outcomes of one institution’s development of a simulated telepsychiatry visit for third year medical students in the Psychiatry Clerkship.

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Perspectives of Transgender and Genderqueer Standardized Patients

Lead Authors: Emily J. Noonan, Carrie Bohnert
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

Disparities in health and healthcare for gender minorities (GMs) such as transgender people are significant, and medical educators have a responsibility to ensure trainees master the clinical skills required to provide them with quality care. The authors implemented a standardized patient (SP) scenario designed to measure students’ ability to provide gender-affirming care and sought to understand the experiences and perceptions of the GMs who served as SPs in this case. Their key research question was: how do GM SPs describe the experience of serving as an SP on a gender-affirming care clinical case?

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Twelve Tips for the Introduction of Emotional Intelligence in Medical Education

By: C. Roth, K. Eldin, V. Padmanabhan, E. Friedman
Submitted by Kathy Herzberger, Loma Linda School of Medicine

Medical Teacher has articles entitled “Twelve …” that I always find useful. This particular one provides twelve easy steps to help develop and introduce emotional intelligence into our curriculum. Developing emotional intelligence is vital to enhance patient centered care, clinical outcomes, patient safety, as well as team building.

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Impact of Standardized Patients on First Semester Nursing Students Self-Confidence, Satisfaction, and Communication in a Simulated Clinical Case

Lead Author: Kelly V. Johnson, EdD, RN
Submitted by: Marsha Harman, Rush University

Utilizing standardized patients (SPs) as a strategy to potentially improve beginning level nursing students’ confidence, satisfaction, and communication after simulated clinical cases is an innovative approach in nursing education. To examine how an SP encounter affects these three things, first semester undergraduate nursing students completed a simulation either an SP or high-fidelity manikin. Students who completed the simulation with an SP reported greater satisfaction and improved communication.

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