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Co-Constructive Patient Simulation as an Experiential Tool for Continuing Professional Development in Healthcare

Lead Author: Marco Antonio de Carvalho Filho
Submitted by: Sharon Baker, Grand Valley State University

The authors of this study examined how to use an educational method called Co-Constructive Patient Simulation (CCPS) to improve professional development in healthcare. They participated in simulated scenarios aligned with their developmental stages and needs. This method integrates learning opportunities in clinical practice, amplifies learners’ critical reflection and autonomy and harnesses real-life challenges.
Read more about the study here.

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Virtual Patient Simulation Offers an Objective Assessment of CME Activity by Improving Clinical Knowledge and the Levels of Competency of Healthcare Providers

Lead Author: Igal Iancu
Submitted by: Laura Harris and Carys Fritz, OHSU

This article describes how the authors utilized an innovative virtual patient simulation platform to develop successful impact measurement of the educational activities that can be applied to Continuing Medical Education (CME). The new platform is designed to assess learners’ knowledge and competency in the management of type 2 diabetes, high cholesterol, and high blood pressure.

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Are Evaluations in Simulated Medical Encounters Reliable among Rater Types? A Comparison between Standardized Patient and Outside Observer Ratings of OSCEs

Lead Author: Easton N. Wollney
Submitted by: Amy Lorion, NBOME

This article purports to be a comparison between two types of raters, SPs and “outside observers with training in healthcare communication,” with the evidence demonstrating that the SPs were more lenient in their scoring on both subjective items (e.g., “used effective body language”) and objective items (e.g., “The resident told the patient she should not start smoking again”). However, as the authors acknowledge partway through the article, there was another glaring factor: the SPs only scored the encounters live, based on memory, and the non-SP observers only scored the encounters via recorded videos; hence, “evaluator type was tied to evaluator method in this study.” This article is worth reading—the differences between the groups’ scores are telling and support several of the discussion points (e.g., cognitive load)—despite the mixed approach which undercuts the assertion that it’s a comparison of rater types per se.

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Perspective matters: assessment of medical students’ communication and interpersonal skills by simulated patients from the internal and external patient perspective

Lead Author: Sarah Prediger
Submitted by: Nicholas Gonzalez, Gordon Center for Simulation and Innovation in Medical Education, University of Miami Miller School of Medicine

In the realm of SP work, there may come variation in perspective. What one might determine is an effective patient encounter, another may interpret as one that was less effective or poor in nature. Sarah Prediger and Sigrid Harendza, of the University Hospital of Hamburg-Eppendorf, sought to shine a light on this and many other possible discretions in SP evaluation of communication and interpersonal skills. They had SPs assess medical learners from an internal- and external-patient perspective and discuss their findings of interest.

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Simulation Training in Suicide Risk Assessment and Intervention: a Systematic Review and Meta-analysis

Lead Author: Océane Richard
Submitted by: Michelle Fernandez, University of Miami

“The present study suggests that simulation-based training may be effective to change attitudes and skills for suicide risk assessment and crisis intervention, with promising preliminary results regarding changes in behaviors and patients’ outcomes. However, numerous limitations must be acknowledged, and many challenges remain. More research of higher methodological quality must be developed.”

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Proof of Concept: Using ChatGPT to Teach Emergency Physicians How to Break Bad News

Author: Jeremy J. Webb, M.D.
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

The author suggests that ChatGPT can be used to teach physicians how to break bad news. This is a skill that has been taught effectively through a combination of didactics and practice with simulated patients. The author has ChatGPT create a scenario, have a written dialogue with the physician and then offer feedback based on how his words aligned with the SPIKES framework for breaking bad news. Does this come close to the impact of human interaction and SP methodology? Read for yourself here. 

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Comparison of Primary Care Patients’ and Unannounced Standardized Patients’ Perceptions of Care

By: Lisa Altshuler
Submitted by: Marsha Harman, Rush Center for Clinical Skills and Simulation

In my own conversations with SPs and other SP educators, we have often discussed how SP work alters our perceptions of our real-life patient experience and makes us better advocates for ourselves and our family members when navigating the healthcare system. This article takes a more concrete look at the difference between SPs’ and real patients’ perceptions of care. 

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ASPE Awards Ceremony 2022 Article

ASPE Scholar Certificate

The awards ceremony started with the ASPE Scholars Certificate presented by Jacqueline R. Klevan
ASPE Scholars complete the required Basic of Scholarship session, as well as requirements in qualitative and/or quantitative measurement and electives, either from the ASPE conference itself or relevant, comparable content from other conferences.

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Standardized Patients’ Perspectives on Bias in Student Encounters

Lead author: Angelina Fluet | Submitted by: Erin Walsh, Rosalind Franklin University of Medicine and Science 

To gather Standardized Patients perspectives on bias the authors designed a qualitative interview study and conducted semi-structured interviews with 16 SPs. The interviews were conducted from July to September of 2020. It was concluded that bias occurs in multiple directions including SP-to student. student-to SP, student-to character, and SP- to -character. Additionally, SPs shared they feel there is bias during scenario development and SP recruitment and training. The authors determined that identifying areas where bias occurs can help simulationists alleviate bias. 

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Standardized Patient Actor Training to Improve Adolescent Engagement in HIV Care

“I Have Actually not Lost any Adolescent Since I Started Engaging Them one on one:” Training Satisfaction and Subsequent Practice among Health Providers Participating in a Standardized Patient Actor Training to Improve Adolescent Engagement in HIV Care

Lead Author: Hellen M. Okinyi, BSN
Submitted by: Amy E. Lorion, National Board of Osteopathic Medical Examiners

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Self-Reported Emotions in Simulation-Based Learning: Active Participants v. Observers

By: Timothy Rogers, MD et al | Submitted by: Marsha Harman, Rush Center for Clinical Skills and Simulation

Experiential learning through active participation is thought to be a key benefit of simulation-based education. Recent research has challenged this assumption, suggesting that active participants learn just as well as observers. Studies report that active participants experience stress and anxiety during simulation, which may hamper learning by active participants. We undertook the current study to examine whether active participation results in different emotional arousal than observing during simulation.

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Reflection: My Simulation Journey: Making the Impossible, Possible 

By: Ignacio del Moral, PhD, MD
Submitted by: Darrell Brock, University of Pittsburgh

Dr. Ignacio’s reflections on how a life-death encounter with a patient and a chance pamphlet lead him on a journey to the heart of simulation education. In a very relatable way, the doctor stumbles upon simulation education and comes to love it. Over time, Dr.Ignacio would become one of Spain’s most notable figures in simulation education. 

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Structural Inequities in the Treatment of Standardized Patients and What That Means for Patient Care

By: Temple D. West, MMHPE
Submitted by: Marsha Harman, Rush Center for Clinical Skills and Simulation

Standardized patients (SPs) play a pivotal role in medical education. They are proxies for real patients, preparing students to meet the challenges of excellent patient care. Human simulation, with SPs, is used for teaching and assessing communication and clinical skills in medical education around the world. Standardized patients work individually with other faculty, students, or in conjunction with medical faculty to facilitate learning with feedback. In most simulation centers, SPs receive extensive training in communication and clinical skills, yet they inhabit territory often unrecognized as professional in medical education. The manner in which SPs are seen and treated by faculty and students may be a reflection of how real patients are seen and treated—not always heard, not always respected—and this tension detracts from both simulated and real patient encounters. Exploring how SPs, as proxies for real patients, are treated in medical education is a key to what we might learn and how we might close gaps in cultural respect and, ultimately, in patient care.

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Gender-Affirming Care with Transgender and Genderqueer Patients: A Standardized Patient Case

Lead author: Laura Weingartner, PhD, MS
Submitted by: Renee Wadsworth, SP-ed

Transgender and gender-diverse (TGD) people experience extreme health disparities and prejudice in health care settings. The lack of provider training around gender-affirming care for TGD patients has historically contributed to this inadequate care. Patient simulation is a crucial component of teaching medical students about gender-affirming care because it allows students to practice and become more comfortable with these skills in a low-stakes setting.

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It Is Not Just the Script that Matters: Overlooked Elements in Standardized Patient Methodology

By: Sandra Jaramillo-Rincón, MD, MHPE, Juan Manuel Potes, MD
Submitted by: Nicholas Gonzalez, The Gordon Center at University of Miami Miller School of Medicine

Standardized patients (SPs) range from individuals looking for additional work to full blown actors and actresses, to somewhere in the middle. This article entails what advantages SPs have and what skills they bring to the table regarding the teaching/learning process. The authors go into detail discussing the training and further development of acting, thematic, pedagogic, and planning and leadership skills among their SPs.

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Aportes de la Simulación al Desarrollo del Razonamiento Clínico en Estudiantes de Pregrado de Medicina

Lead Author: Soledad Armijo, MD
Submitted by: Leonardo Pérez, Claudia Arancibia & Iván Silva, Clinical Skills Center, University of Chile

La simulación clínica en Latinoamérica ha ganado relevancia como herramienta formativa en las últimas décadas. En la formación de pregrado en Medicina, el cómo enseñar razonamiento clínico de la mejor manera aún requiere de consenso. Armijo-Rivera y equipo comparte en la revista de la Federación Latinoamericana de Simulación Clínica (FLASIC) una revisión del uso de simulación clínica con pacientes simulados como una excelente alternativa para “promover el desarrollo de aptitudes procesales, la comunicación con los pacientes, la entrega de los pacientes, el razonamiento ético y el trabajo en equipo” además de integrar información y ayudar a la toma de decisiones. También advierte que se requiere de estudios longitudinales que consoliden esta base de conocimiento, dado que el razonamiento clínico en medicina es un constructo complejo de enseñar y de evaluar. Así, queda abierta la invitación a investigar y socializar nuestras experiencias en simulación clínica con pacientes simulados en el mundo hispano hablante.

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Use of Standardized Patient Encounters as Predictors of Fieldwork Performance: A Pilot Study

Lead Author: Linda Frasier
Submitted by Karen Lewis, The George Washington University SMHS

Although standardized patient encounters (SPEs) are being used in occupational therapy (OT) education, limited literature exists on the value these experiences have on OT student learning outcomes and preparation for fieldwork. This study sought to examine if SPEs had the potential to predict Level II A fieldwork performance

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Quality in Standardized Patient Training and Delivery: Retrospective Documentary Analysis of Trainer and Instructor Feedback

Lead Author: Derya Uzelli Yilmaz, RN
Submitted by: Mekail Ebbert, NYIT-COM at Arkansas State University

Creating and maintaining a consistent and meaningful SP quality assurance program has always been a priority of mine, and one that I’ve learned requires a continuous approach of evaluation and monitoring. This article documents a study using the collection of 6 years worth of feedback to “determine programmatic and systematic issues in the scope of quality assurance and improvement...” With this large collection of data they were able to review the outcomes of both trainer and instructor feedback on SP performances, resulting in the emergence of four key themes.

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Barriers, Challenges, and Supports to the Implementation of Standardized Patients and Simulated Environments by Occupational Therapy Education Programs

Lead Author: Amanda Mack, OT, OTD, MS, OTR, CLC
Submitted by: Marsha Harman, Rush Center for Clinical Skills and Simulation

A national survey examined the implementation rates, barriers, challenges, and supports to implementation of two types of simulation (standardized patients and simulated environments) by entry-level occupational therapy education programs in the United States. An online survey inquiring about academic program characteristics and use of simulation was sent to all occupational therapy and occupational therapy assistant programs in the United States in 2017 prior to the implementation of the 2018 Accreditation Council for Occupational Therapy Education Standards and the onset of the COVID-19 Pandemic. Data were analyzed using both statistical and content analysis. Thirty-eight percent of responses used standardized patients and 70% used simulated environments in their didactic coursework.
Funding was the most cited support, challenge, and barrier to the use of standardized patients. Physical space was the most cited support and challenge for the use of simulated environments, with funding as the most cited barrier. This study highlights the need for additional research in the use of simulation in OT education, specifically into feasibility and outcomes of lower-cost methods of simulation. Also, the outcomes of the study indicate that OT education programs would benefit from widely available, easy to access, and low-cost or free resources to help with the development and implementation of simulation within their own curricula. Access to these resources may allow academic programs to overcome some of the institutional barriers to implementation of simulation. For simulation to become more widely implemented and to truly reduce the burden of fieldwork education on fieldwork sites and partners, academic institutions may need to provide resources to help occupational therapy education programs overcome the common barriers and challenges and strengthen existing supports.

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Enhancing the Structural Competency of Nurses Through Standardized Patient Simulation

Lead Author: Zvika Orr, PhD
Submitted by: Marsha Harman, Rush Center for Clinical Skills and Simulation

Structural competency is a new conceptual and educational framework for training health professionals to discern and respond to the impact of social, political, and economic structures on health. This article discusses a new online standardized patient simulation method that enhances the structural competency of nurses and nursing students. This method has been used to train nurse practitioner students. The article suggests that simulation-based learning can help nurses translate the theoretical comprehension of macro-level forces into clinical practices. This method expands the nurses' perspective, develops their social-political awareness, and encourages them to lead interventions. This simulation can contribute to dismantle structural racism and reduce health inequities.
The article includes a description of one of the scenarios used and a selection of the nursing students’ responses to experience.

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