An Interactive Online Interprofessional Opioid Education Training Using Standardized Patients
By: Connie M. Remsberg et al
Submitted by: Marsha Harman, Rush Center for Clinical Skills and Simulation

Opioid pain management is complex and requires a collaborative approach. To prepare health professions students to care for patients who have chronic pain, the authors developed an interprofessional education (IPE) session for delivery using a virtual platform that featured a standardized patient (SP) interaction. The low-stakes, formative training has been developed to enable health profession students to learn from each other about how to provide collaborative care to a patient taking opioids for chronic pain. Since the widespread adoption of videoconferencing technology for teaching and learning is relatively new, this format provides a unique opportunity for IPE. This online IPE opioid education training session, which targets learners from nursing, pharmacy, medicine, physician assistant, and social work, dedicates specific time to the following elements: IP team collaboration to assess and interview an SP with chronic pain who takes opioids, IP team care planning and discussion, and development of a written IP treatment plan submitted as a formative assignment. Other programs may find this IPE training useful specifically because it addresses one of the biggest hurdles in IPE by providing a model for connecting geographically separated students through videoconferencing technology.

Which Teaching Method Is More Effective in a Communication Course – Role-Playing Versus Simulated Patients, Taught by Tutors or Faculty Staff? A Randomized Trial
Lead Author: Julia Herchenröther
Submitted by: Amy Lorion, National Board of Osteopathic Medical Examiners

The article details the results of a study created “as part of the medical history-taking course … that aimed to establish if lecturers or tutors led to better results in student performance. The study also aimed to investigate if the use of simulated patients or role-playing with fellow students led to better communication skills in the students.” The authors find that “in history-taking courses students who trained an increased number of times with SP benefited more from instruction by a university lecturer and that groups led by peer tutors benefited more from the use of RP,” with “RP” referring to the role-playing with fellow students.

An Effective Gender-Affirming Care and Hormone Prescribing Standardized Patient Case for Residents
Lead Author: Ben J. Hersh, MD
Submitted by: Amy Lorion, National Board of Osteopathic Medical Examiners

Recognizing the impact of physician inadequate training in gender-affirming care, the authors piloted a formative SP case for gender-affirming care with 20 family medicine residents. As the authors describe their results: “Self-reported knowledge and awareness increased after standardized patient case participation in multiple skill areas related to providing gender-affirming care. Faculty observers informally reported that the session increased their knowledge and comfort as well.” They recommend the use of such training to improve health care equity for transgender and gender-expansive individuals, although they caution those designing such training to “be certain to review terminology to reflect the ongoing changes specific to the LGBTQIA+ community,” noting that they had “needed to alter the language we used to reflect the changing climate” through their case development process.

Conscious Engagement within Patients’ and Simulated Participants’ Personal Space: Medical Students’ Perspective
Lead Author: Chara Banks‑McGovern
Submitted by: Amy Lorion, National Board of Osteopathic Medical Examiners

Banks-McGovern et al. capture the significance of their study in the first sentences of their abstract: “#MeToo prompted a shift in acceptable societal norms, sparking global recognition of the complexities of entering another’s personal space. Physical examinations are an integral part of medicine yet have the capacity to encroach upon patient’s personal space, whether in simulated or clinical environments. Examinations may be misconstrued as inappropriate advances, with negative effects for both patient and doctor.” As they note in the article, simulation and SPs can play a role in providing medical students with necessary “experience of and teaching on the crucial expertise behind a safe and mutually respectful physical examination.”

Social Determinants of Health: A Multilingual Standardized Patient Case to Practice Interpreter Use in a Telehealth Visit
Lead Author: Gigi Guizado de Nathan
Submitted by: Amy Lorion, National Board of Osteopathic Medical Examiners

Guizado de Nathan et al. describe a piloted simulation for teaching students the use of medical interpreters, a pilot created in recognition that the “growing diversity of the United States population and strong evidence of disparities in health care make it critically important to educate health care professionals to effectively address issues of culture.” They designed a telehealth case that includes an SP and a simulated medical interpreter, both bilingual, in a scenario that requires the student to both identify the need for an interpreter and to communicate with the patient through that interpreter.

An Objective Structured Clinical Exam on Breaking Bad News for Clerkship Students: In-Person Versus Remote Standardized Patient Approach
Lead Author: Lona Prasad, MD
Submitted by: Amy Lorion, National Board of Osteopathic Medical Examiners

This article describes what happened when a breaking-bad-news OSCE was moved from in-person to virtual delivery due to COVID restrictions. The OSCE involves a miscarriage case, a distressing situation that, as the authors note, “calls for communication that incorporates patience and empathy.” The authors understandably wondered what would happen when moving such a scenario to what can be an impersonal technological tool.

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.

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.

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.

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.

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. 

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. 

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.”

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.

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. 

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.

“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

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. 

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.

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.