Author: Bonnie North
Submitted by: Dan Brown, Emory University School of Medicine

In a January 18, 2018 interview, Lake Effect host Bonnie North spoke to Prof. Katherine Watson, a lawyer, ethicist, and improviser about her work in medical improv. In this summary of the interview, Watson defends the need for medical improv, saying that providers “need to be trained…to not just respond to what they think is going to happen, but to respond to what is actually happening,” and expounds on how improv training helps providers think the way a doctor needs to.

By: Michelle Andrews
Submitted by: Todd Lash, Publications Committee Chair

When an inmate needs to see a medical specialist, getting that care can be complicated. Prisons are often located in rural areas far from medical centers that have experts in cancer, heart and other disease treatments. Even if the visit just involves a trip to a hospital across town, the inmate must be transported under guard, often in shackles. The whole process is expensive for the correctional facility and time-consuming for the patient. Given the challenges, it's no wonder many correctional facilities have embraced telemedicine. They use video conferencing to allow inmates to see medical specialists and psychiatrists without ever leaving the facility.

Lead author: Mark Starmach
Submitted by: Dyan Colpo, Cleveland Clinic, Simulation and Advanced Skills Center

First, you withdraw.
Life shrinks down to the size of your home, then to your bedroom, then to your bed—sometimes over months, but more often over weeks.
Old joys stop having the same pull.
You eat less, drink less. Have less interest in speaking.
As your body’s systems start shutting down, you have less and less energy.
You sleep more and more throughout the day.
You start to slip in and out of consciousness and unconsciousness for longer periods of time.
Staying alive starts to feel like staying awake when you are very immensely tired.
At some point, you can’t hold on any longer.
And then you die.
A calm fall into a cosmic sleep.
But that’s not even the half of it.
“There are four ways people tend to die,” the older woman opposite me says as she reaches for a napkin and a ballpoint pen.

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

When I was a third year medical student on my pediatric inpatient rotation, I thought I had mastered family centered rounds. I would stand in the patient’s room, position myself in front of the patient and family, and present from my notes to the attending physician, occasionally glancing at the family. At the very end, I would turn to the family and say something along the lines of, “Any questions, Ms. Lopez?” It was not until years later that I realized how flawed my model of family centered care was.

By: Sarah Waller
Submitted by: Todd Lash, Publications Committee Chair

In the hallway of Samford University’s Experiential Learning and Simulation Center, a “standardized” patient stumbled to the ground to simulate a patient experiencing cardiac arrest. The Doctor of Physical Therapy student who was with him jumped into action and called a code. Within seconds, an interprofessional team of students gathered. Undergraduate nursing students took over CPR, Doctor of Pharmacy students prepared the needed medications and Master of Social Work students attended to the patient’s family. This is just one scenario that students were able to experience together during the College of Health Sciences’ annual Acute Care Simulation.

By: Helen Wilbers
Submitted By: Michael Maury, UC-San Diego

Gina Shannon, associate director at the Emory University School of Medicine’s Clinical Skills Center and ASPE member, spoke at Westminster College’s Hancock Symposium on Tuesday, September 11^th, 2018, about the purpose of simulated patients in Medical Education. As Wilbers lays out in this article, Shannon points out the importance of using SPs “to teach doctors to empathize and communicate with patients.” Wilbers writes that Shannon contemplated, "If a health care provider is with a patient and they aren't in agreement, where can that relationship go?" Wilber discusses how Shannon relies on her 7 years of theatre teaching and applying the rules of improv to the clinical setting. With an emphasis on the important improv tenet of ‘yes-and’ Shannon successfully guides doctors toward an acceptance and mutual agreement of what is being laid out by a patient. Shannon says, "If we're in a scene together the only way we can elevate the scene and keep it going is by agreeing."

Media Article: Using Simulation in Dietetics Education
By: Christen Cupples Cooper
Submitted by: Todd Lash, Publications Committee Chair

A nutrition and dietetics student sits before a 45-year-old female patient who complains of chronic weakness. The student has reviewed the patient's chart and considered her self-reported body weight and ideal body weight. The student begins discussing the duration of the patient's weakness and appetite changes.

Media Article: New ways actors can benefit your doctors-in-training
By: Lisa Mulcahy
Submitted by: Dysn Colpo, Cleveland Clinic Simulation and Advanced Skills Center

You're no doubt familiar with "standardized patients" — professional actors who role-play with medical students and residents to simulate real-life patient interactions. Often, these interactive experiences teach doctors-in-training how to handle basic communication situations, such as how to prescribe medication or explain a diagnosis. New research initiatives, however, are greatly expanding the knowledge medical students and residents can glean from working with actors, leading to more emotional insight when they work with real patients, as well as better effectiveness at sharing medical information with those real patients.

Media Article: It’s Hard for Doctors to Unlearn Things. That’s Costly for All of Us.
By: Aaron E. Carroll
Submitted by: Kerensa Peterson, Northwestern University Feinberg School of Medicine

This article, which appeared recently in the New York Times, highlights some of the dangers to patients in continuing medical practices that have been deemed unnecessary through research.  An interesting, tangential article that might make simulator educators think about how simulation education could help to “unlearn” habits that have been created in the medical world.