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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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From Medical Education to Medical Controversies, Humanities Are Key, New Chair Says

By: Carolyn Kimmel
Submitted by: Michael Maury, UC-San Diego

At Penn State College of Medicine, Bernice Hausman is fortunate to be the Chair of the Department of Humanities. As she says, “Generally, medical schools may have one course in the humanities. Not many have an entire department.” And, perhaps more medical schools ought to consider growing their humanities in medicine programs. In this article, author Carolyn Kimmel reports on the importance of the humanities in medical education. She writes, “as Dr. Graig Hillemeir, Penn State College of Medicine dean, Penn State Health CEO and Penn State senior vice president for health affairs” puts it “Since its inception in 1967, the College of Medicine’s Department of Humanities has been a pioneering model for the importance of cultivating physicians who can bridge science with a sophisticated understanding of community, ethics and the whole person.” With our world transforming and ever-changing, it is important for our future doctors to be well versed in treating the whole person by connecting with their patients human to human. As Hausman states, “Doctors aren’t just dealing with biochemical pathways and biological diseases. They’re dealing with human beings who have lives, and they need to understand motivations and behaviors that are culturally based — linked to belief systems, traditions and social networks.” Classes in the humanities is a great way to cultivate such lessons in our medical students.

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OUWB’s Standardized Patients help train next generation docs

By: Andrew Dietderich
Submitted by: Todd Lash, Publications Committee Chair

During a recent presentation, Jeanne Schulte, coordinator, OUWB Clinical Skills Training & Simulation Center, acted like a doctor who asked a mock patient the wrong questions at the wrong times — and in doing so, did her job just right. The reason? Schulte and the “patient” were demonstrating the purpose of the 35 Standardized Patients (SPs) employed by Oakland University William Beaumont School of Medicine. Their presentation took place during OUWB’s Mini-Medical School, held at the beginning of the year for parents of first-year med students.

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How Can Doctors Find Better Ways to Talk – and Listen – to Patients Close to Death?

By: Michael Erard
Submitted by: Marsha Harman, Rush University

Two brothers are combining palliative care expertise, linguistics and AI to encourage more effective conversations between doctors and people receiving end-of-life care. Bob Gramling received over $1 million from the American Cancer Society to undertake what became the most extensive study of palliative care conversations in the US. The resulting database contains over 12,000 minutes and 1.2 million words of conversation involving 231 patients. This is the basis of the Vermont Conversation Lab, which Bob created to analyze these data and find features of those conversations that make patients and family members feel heard and understood.

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It’s Not All Brain Surgery: Future Doctors Should Be Tested for Empathy, Study Says

By: Kate Thayer
Submitted by: Kerensa Peterson, Northwestern University

Standardized patient educators understand the importance of empathy and the role it plays in patient-doctor relationships.  Many SPEs believe that empathy can be taught, and medical educators throughout the world have acknowledged empathy’s role in the healing process of their patients.  A researcher from Thomas Jefferson University in Philadelphia now poses the question should we be assessing for empathy as part of the medical school admissions process?  This article discusses some of the debate around this provocative question.

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St. Luke’s Unveils Mobile Simulation Lab and Other Company News

By: The Morning Call
Submitted by: Michael Maury, UC-San Diego

What if we could take this Simulation show on the road? Maybe it’s time to go mobile. St. Luke’s University Health Network has just unveiled a customized 2020 Freightliner M2 truck to serve as a mobile training unit. The 34-foot-long truck, called the Simulation in Motion Medical Education Lab, will bring training sessions to network campuses and sites, allowing staff to practice hands-on skills with state-of-the-art technology in a realistic and safe environment.

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Dementia Education Workshops to Support Caregivers

By: Diane Weidner
Submitted by: Loïc Simard-Villeneuve, McGill University

A new workshop was created in September 2017 at the Steinberg Centre for Simulation and Interactive Learning (McGill University, Montreal, Canada). The goal of the workshops is to give caregivers information on the progression of the illness explained by either a neurologist or a geriatrician, to help them navigate the health system through the different stages of the illness and to provide a simulation that portrays the physical and psychological risks of living at home with dementia.

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LGBTQ Patients Reveal their Exhausting, Infuriating, and Surprisingly Common Struggles at the Doctor’s Office

By: Caroline Praderio
Submitted by Kathy Herzberger, Loma Linda School of Medicine

INSIDER interviewed a group of individuals from the LGBTQ community to explore their experiences with the healthcare system, in particular, doctor visits. Unfortunately, it is apparent that all too often these individuals are receiving inadequate healthcare, if they receive healthcare at all, as some providers refuse to treat them. As medical educators, we have a powerful platform to address these health disparities and biases with our students. Although there are many frustrating and heartbreaking experiences reflected upon in this article, The National LGBT Health Education Center and The Gay and Lesbian Medical Association offer hope of future change providing education and a database of LGBTQ-welcoming physicians.

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NPR - Hidden Brain; You 2.0: The Empathy Gym

Author: Shankar Vedantam
Submitted by: Catherine Hagele, Perelman School of Medicine at the University of Pennsylvania

Some people are good at putting themselves in another person's shoes. Others may struggle to relate. But psychologist Jamil Zaki argues that empathy isn't a fixed trait. On this episode of Hidden Brain, they talk about calibrating our empathy so we can interact with others more mindfully. This podcast focuses on how to exercise our empathetic muscles and cultivate one of our most precious human abilities. Empathy, at a deep level, is the understanding that someone else's world is just as real as yours. Empathy is like a muscle — it can be strengthened with exercise and it can atrophy when idle. The pros and cons of empathy in the medical profession are discussed.

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Undercover in a Hospital Bed: Secret Shoppers Pretend to be Sick to Help Make Hospitals Safer for Everyone Else

By: Tim Lahey, M.D.
Submitted by: Marsha Harman, Rush University

The woman on the gurney held the scratchy emergency room blanket closer to her chin. “What’s in the syringe?” she asked. The nurse frowned. “Don’t you want the medicine your doctor ordered?” The woman took a deep breath and kept asking questions. She had more than just self-interest on the line. She was a “secret shopper,” a consultant pretending to be a patient in order to evaluate the quality and culture of care in a hospital.

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"Does Your Knee Make More Of A Click Or A Clack?" Teaching 'Car Talk' To New Docs

Lead author: Paul Chisholm
Submitted by: Mary Launder, Rosalind Franklin University of Medicine and Science

Ray and Tom Magliozzi, better known as "Click and Clack, the Tappet Brothers," stopped recording new episodes of NPR's Car Talk in 2012.  Tom passed away shortly thereafter, in 2014. But the spirit of the show lives on. And if you visit a doctor's office, you just might benefit from it.

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How Theatre Training Can Boost Your Doctor’s Empathy

Lead author:  Hartley Jafine
Submitted by: Dyan Colpo, Cleveland Clinic, Simulation and Advanced Skills Center

I teach improvisational theatre to health scientists and trainee doctors. When I tell people this, they are often confused because theatre and medicine appear to be separate fields. Medicine, however, is a performance. And the skills actors and improvisers learn are equally important for any health-care role. For more than 10 years now, I have been facilitating theatre courses within undergraduate health science and medical education — to enhance the clinical skills of students and train better health-care professionals.

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Ohio State Active Shooter Drill Also Trains Medical Students for Mass Casualties

By: Geoffrey Redick
Submitted by: Todd Lash, Publications Committee Chair

At a school that's already seen weapon-wielding attackers, active shooter drills are not uncommon. The Ohio State University's College of Medicine has also staged its own educational mass casualty events in the past, with actors wearing fake blood and simulating dangerous situations. The latest active shooter drill held Wednesday was different: medical students and residents became the simulated victims, and caregivers, all at once — while facing down an actual gunman shooting loud, blank rounds from a handgun.

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The Case for Medical Improv: Using Theatre Techniques to Improve Patient Care

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.

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When Inmates Need A Specialist, They Often See The Doctor By Video

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.

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How to Die Well, According to a Palliative Care Doctor: Preparing for Death by Making Peace With It

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.

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