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Telemedicine Key to US Health Care Even After Pandemic Ends

By: Gopal Ratnam
Submitted by: Janice Radway, University of Pennsylvania

As thousands of patients struck by COVID-19 rushed to seek treatment in overcrowded New York City hospitals, intensive care specialists more than 350 miles away at the University of Pittsburgh Medical Center stepped up to provide remote assistance to beleaguered colleagues in New York. Since the public health emergency and the relaxation of rules, the use of telehealth services has exploded across the country, according to the American Telemedicine Association, which represents hospitals, technology companies and others.

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Med Students Face Unsure Future During Pandemic

By: Nicole Lou
Submitted by: Todd Lash, The Ohio State University

Medical schools are preparing students for an uncertain future as the COVID-19 pandemic rages on across the U.S., upending a traditionally rigid cycle of admissions, coursework, and exams. Among the hardest-hit are second-year medical students, many of whom have had their United States Medical Licensing Examination (USMLE) Step 1 exams suspended, according to Paul George, MD, MHPE, associate dean for medical education at Warren Alpert Medical School of Brown University in Providence, Rhode Island.

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M Simulation Pivots to Online Delivery to Meet Critical Clinical Training Needs During the COVID-19 Pandemic

By: Jennifer Syltie Johnson
Submitted by: Todd Lash, The Ohio State University

When the University of Minnesota announced on March 12, 2020, that all in-person classes at its five campuses were moving to online learning, it was a first in the University’s history. Campus Public Health Officer and Vice President for Clinical Affairs Jakub Tolar, MD, PhD, had announced that all in-person instruction, including clinical rotations, was suspended and moving to alternative instruction a day earlier. On March 13, Tolar’s update included a challenge to colleagues: “Leadership is not measured by meetings or committees,” he wrote. “It is the ability and willingness to stand up to the challenge and deliver a rational, measured, effective response. Over and over again.”

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No Joke: The Serious Role of Improv in Medicine

Author: Sarah Mahoney
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

Ajay Paul Singh, a second-year student at the University of Wisconsin School of Medicine and Public Health, felt a little nervous enrolling in a medical improv elective. But he says one exercise alone made the sweaty palms worthwhile.

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Nobody Wants to Have End-of-Life Conversations, But...

Lead Author: Christopher Magoon
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

Family members should understand their loved ones’ goals and wishes for treatment in the event of critical illness. The COVID era has heightened the need for these conversations, as initial studies show that intubated COVID-19 patients often do not survive.

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Telemedicine Training Proves Vital During Covid-19 Crisis, Increasing Access to Care

Author: Weill Cornell Medicine, Office of External Affairs
Submitted by: Catherine Hagele, Perelman School of Medicine at the University of Pennsylvania

The doctor will see you now – virtually.

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Doctors Are Scrambling to Learn "Webside" Manner

By: Ashley Abramson
Submitted by: Marsha Harman, Rush University

As patients turn to telemedicine, doctors must learn to convey empathy over screens. This short article includes some tips and tricks from the medical director of a telehealth service, as well as a discussion of what is gained and lost on video vs. in-person visits. One hospital uses video calls for COVID patients while they are in the hospital so that doctors and nurses can converse with them without wearing PPE, so the patients can see the providers’ facial expressions instead of just seeing a mask. As we are all preparing to offer more “telesim” learning opportunities, I found this article helpful in articulating some of the challenges and opportunities for our learners and our SPs.

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How RPG Logic and Simulations Are Changing the Game in Healthcare

Author: Gadjo Sevilla
Submitted by: Kerensa Peterson, National Board of Osteopathic Medical Examiners

Role-playing games (RPG) are as old as time, but software developers are integrating RPG logic into many different technologies used within healthcare simulations. As Natural Language Processing and augmented reality technologies become more sophisticated, so do their uses in healthcare simulations. Organizations like the Center for Disease Control and the Robert Wood Johnson Foundation are investing resources in the development of these training tools which allow learners to try, fail and learn from their mistakes over and over again. Take a look at the article for a link to one of the simulations made public through a grant from the Robert Wood Johnson Foundation.

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She Didn’t Want a Pelvic Exam. She Received One Anyway.

By: Emma Goldberg, The New York Times
Submitted by: Todd Lash, The Ohio State University

Janine, a nurse in Arizona, checked into the hospital for stomach surgery in 2017. Before the procedure, she told her physician that she did not want medical students to be directly involved. But after the operation, Janine said, as the anesthesia wore off, a resident came by to inform her that she had gotten her period; the resident had noticed while conducting a pelvic exam. “What pelvic exam?” Janine, 33, asked. Distressed, she tried to piece together what had happened while she was unconscious. Why had her sexual organs been inspected during an abdominal operation, by someone other than her surgeon? Later, she said, her physician explained that the operating team had seen she was due for a Pap smear.

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Girl Scouts Teach Budding Doctors How to Communicate with Young Patients

Author: Mari A. Schaefer
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

Have you had difficulty finding pediatric patients for your SP programs? The Philadelphia College of Osteopathic Medicine found a great collaboration in their local Girl Scouts troupe. These scouts were trained as SPs to give osteopathic students a chance to practice their interpersonal and communication skills with pediatric patients. The scouts also benefited from the experience, noted Renee Cree, spokesperson for the college. They learned what to ask of doctors when dealing with their own health.

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Saving the Family Physician One Doctor at a Time through ‘Lifestyle Medicine’

Author: Melissa Chefec
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

Physician burnout, especially among family doctors who often labor long hours with little support, is a major problem in the United Sates, contributing to a growing nationwide shortage of practitioners. Bethlehem, Pennsylvania-based St. Luke’s University Health Network has launched an innovative residency program to stop burn-out before it happens. The new program promotes “lifestyle medicine” not only for patients, but also for doctors themselves.

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For Busy Medical Students, Studying Meditation for Two Hours May Be Just as Beneficial as Longer Course

Author: Neal Buccino
Submitted by: Catherine Hagele, Perelman School of Medicine at the University of Pennsylvania

For time-crunched medical students, taking a two-hour introductory class on mindfulness may be just as beneficial for reducing stress and depression as taking an eight-week meditation course, a Rutgers study finds. Researchers say many medical students would like to use meditation to avoid burnout and provide better medical care, but are daunted by the prospect of making time for a daily meditation routine. While this article focuses on medical students, there are many parallels between their stress and time-crunch that Standardized Patient Educators also experience.

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Five Reasons It Can Be Hard to Talk to Your Doctor—And Four Ways to Do It Better

By: Gillian Rutherford, University of Alberta
Submitted by: Michael Maury, UC-San Diego

In her talk entitled “Co-Creating Care to Improve Medicine”, University of Alberta endocrinologist Rose Yeung shares that, “Miscommunication, or under communication, happens regularly between patients and their doctors, nurses, dietitians and even naturopaths.” Those of us in Medical Education understand this truth all too well. In this article, Gillian Rutherford points out why it may be difficult for most to speak with their doctor and lays out four ways in which we can overcome this challenge. Yeung mentions, “The patient and the professional are supposed to deliberate and come up with an acceptable treatment plan together.” Remembering that physicians and patients are in this health care experience together as a team, is just one piece to the solution. Please press on for more insights and ideas.

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Why We Forget What the Doctor Told Us (and What to Do About It)

Author: Cleveland Clinic Health Essentials
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

Has your mind ever gone blank after leaving your doctor’s office? You may be trying to remember the specific instructions or the answers to your “what if questions” - “What if I don’t feel better after a couple of days?” “What if I miss a dose of my medication?” “What if I feel worse in the middle of the night?”

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New Fort Worth Med School Turns to Coaches to Preserve Student Empathy

By: Christopher Connelly
Submitted by: Michael Maury, UC-San Diego

“Medical school is draining. It’s a mix of sleepless nights spent studying, a lot of student debt, massive pressure to succeed, and learning to treat difficult patients over long hours at the hospital. This recipe for mastering medicine been used to train generations of physicians, but it bakes in a problem: Over the course of their studies, medical students tend to become less empathetic. The issue is that empathy is increasingly valued as an essential tool for physicians, says Dr. Danika Franks, assistant dean of students for the Texas Christian University-University of North Texas Health Science Center School of Medicine in Fort Worth.” Author Christopher Connelly reports how Dr. Franks and her school are looking to foster more empathy within their students as they progress through their studies.

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How Does Health Care Simulation Affect Patient Care?

Lead author:  Joseph O. Lopreiato, MD, MPH
Submitted by:  Dyan Colpo, Cleveland Clinic, Simulation and Advanced Skills Center

Health care simulation programs have spread to many parts of the United States health care system, including hospitals, medical and nursing schools, community college programs, and clinics. Many educational and training units use simulation to help teach new skills, refresh old skills, and promote teamwork in the delivery of health care.

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Standardized Patients Teach Skills and Empathy

Lead author: Dinah Wisenberg Brin
Submitted by: Mary Launder, Rosalind Franklin University of Medicine and Science

This is a great article to pass along to anyone interested in what the world of simulation is about as well as its positive outcomes.

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Where Improv Meets Dementia: Play Along With Your Partner's Strange Conversation

By: Gary Rotstein
Submitted by: Michael Maury, UC-San Diego

Author Gary Rotstein states in this article, “Performers in improvisational sketch comedy learn basic guidelines: Speak in positives, think of your partner, listen well, give helpful prompts” and “don’t be long-winded.” He goes on to say, “Caregivers for those with dementia rarely hear that same advice, but they should — it might ease a lot of stress on both sides.” Many of us in Medical Education have seen the benefits and value of utilizing humanitarian practices such as improvisational theatre to better communication between patients and caregivers. Could the art-form of improv be utilized to better communication with patients living with dementia? Please read on to see how improvisational theatre skills have worked for Rachael Wonderlin and Christopher Wright of the “Agreeing to Remember” workshops at Steel City Improv Theatre in Pittsburgh, PA. Read the full article in the Pittsburgh Post-Gazette here.

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Having the Talk: When Treatment Becomes End-of-Life Care

By: Aliyan Baruchin
Submitted by: Mary Launder, Rosalind Franklin University of Medicine and Science

Conversations about end-of-life care are among the most important interactions doctors and patients have. But for health care providers of all ages, backgrounds, and specialties, they may also prove to be the most challenging.

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You’re Not as Good as You Think (at Communicating)

By: Valerie DeBenedette
Submitted by: Michael Maury, UC-San Diego

The author of this article, Valeria DeBenedette, puts it simply, “Having a lot of clinical knowledge in rheumatology is good. But a boatload of knowledge may not mean much if you aren’t getting it across to the patient so that he or she understands”. For those of us in Standardized Patient education, we know that clear communication is key to a patient’s adherence and will help boost one’s confidence in their health care. We provide opportunities for future doctors to practice these communication skills, but are our efforts enough? As DeBenedette writes, “Communication skills are taught in medical school, often with standardized patients played by actors”. She goes on to report that Dr. Susmita Pati, M.D., chief medical program advisor at the Alan Alda Center for Communicating Science at Stony Brook University, states “but those [SP encounters] are ideal situations and not real life.” Perhaps we have some questions to ponder. Is there something more we could be doing to help mold future physicians into compassionate, clear communicators as they sharpen their clinical skills?

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