Lead Author: Erwin Jiayuan Khoo, MRCPCH, MBBS
Submitted by: Dan Brown, Emory University School of Medicine

Unique ethical concerns arise when using minors as standardized patients. In this article, the four authors each take a turn discussing the ethical implications of a particular case wherein a 6-year-old boy in Indonesia was used for two days of SP work. Each author also discusses principles at large, generally agreeing that standards need to be established and upheld when hiring child SPs, borrowing from established standards in research or film. They argue that considerations need to be made for the child’s benefit-to-burden balance, ability to revoke assent, potential trauma, and preference for active participation.

Lead author: Carmen N. Spalding
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

The ability to disclose medical errors (DME) effectively is crucial in Emergency Medicine (EM). The 2010 American College of Emergency Physicians Policy Statement on Disclosure of Medical Errors directs emergency physicians who determine an error has occurred to provide timely information about the error and its consequences to patients and their families. Despite this mandate, a disclosure gap exists in EM.

Lead authors: Anthony L. Back, MD
Submitted by: Mary Launder, Rosalind Franklin University of Medicine and Science

Few studies have assessed the efficacy of communication skills training for postgraduate physician trainees at the level of behaviors. We designed a residential communication skills workshop (Oncotalk) for medical oncology fellows. The intervention design built on existing successful models by teaching specific communication tasks linked to the patient's trajectory of illness. This study evaluated the efficacy of Oncotalk in changing observable communication behaviors.

Research Article: Nursing and Social Work Trauma Simulation: Exploring an Interprofessional Approach
Lead Author: Sara Manning, M.S.
Submitted by: Amber Snyder, University of Pittsburgh

Individual competencies in the fields of Nursing and Social Work are essential to be successful in the profession. Equally as important is the competence to work successfully interprofessionally. This article describes an interprofesional training strategy which combined nursing and social work programs to create one simulation.

Research Article: “I need to know what makes somebody tick …”: Challenges and Strategies of Implementing Shared Decision‐Making in Individualized Oncology
Lead author: Joschka Haltaufderheide
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

Shared decision‐making (SDM) has been advocated as an ethical framework for decision‐making in cancer care. When using SDM, patients make decisions in light of their values and based on the available evidence. However, SDM is difficult to implement in cancer care. This empirical‐ethical study explores current difficulties in translating the concept of SDM into clinical practice. SP methodology is an excellent tool to help prepare practitioners to explore patients’ values and preferences before making decisions.

Research Article: Assessing Mental Health First Aid Skills Using Simulated Patients
Lead Author: Sarira El-Den
Submitted by: Kerensa Peterson, Northwestern University

Many of us who work in simulation recognize the temptation of learners to say, “I already know how to do this.” When learners must self-assess their skills and then perform those skills, there is sometimes inaccuracy in that reflection. A group of researchers at the University of Sydney tackled the question of self-assessment in regards to mental health first aid skills. By utilizing a self-evaluation followed by two simulated patient roleplays with each participant, the researchers were able to find some startling results in the confidence levels versus the observed performance of those learners’ skills.

Research Article:  Standardized Patients in Psychiatry – the Best Way to Learn Clinical Skills?
Lead author:  Monika Himmelbauer
Submitted by:  Dyan Colpo, Cleveland Clinic

At the Medical University of Vienna, SPs portray four different patient roles in psychiatry depicting depression/suicidal tendencies, somatoform disorder, anxiety disorder, or borderline disorder. Instructor and SP give constructive feedback to the student afterwards. The aim of this study was to evaluate the quality of the SP’s roleplay and feedback. Students and teachers evaluated SPs’ performance and feedback very well; however, the SP’s quality of roleplaying was evaluated as the poorest while playing the psychiatric disorder “depression/suicidal tendencies.”

Research Article: A Prenatal Standardized Patient Experience for Medical Students on Their Family Medicine Clerkship
Lead author: Sarah E. Stumbar
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

Students on their family medicine clerkship at Herbert Wertheim College of Medicine were getting little clinical exposure to obstetric care, which is not commonly provided by family physicians in urban settings. To address this, the program added a 2-hour SP session to their didactic curriculum. The SP was collectively interviewed by the student group during four simulated prenatal visits, each of which presented a different complication of pregnancy. Data from this study suggests that this session increased students’ self-confidence with obstetrics management, filled in gaps in their clinical exposure to full-spectrum family medicine, and addressed a perceived learning need.

Original Content: Diversity Hiring – What We Can Learn from the NFL
By Dan Brown
Emory University School of Medicine

At an open forum at the ASPE conference in Kansas City the topic of diversity among ASPE membership arose. While there was some difference of opinion on whether we’re diversifying enough over time, there was general agreement that the membership would like to see more diversity. This discussion got me thinking about the National Football League’s famous “Rooney Rule,” and how it applies to our work. The main question ASPE and the NFL have in common is:

Research Article: Standardized Patients in Clinical Psychology and Psychotherapy: a Scoping Review of Barriers and Facilitators for Implementation
Lead author: Franziska Kühne
Submitted by: Jackson Szeto, University of North Carolina at Chapel Hill

Use of standardized patients is an emerging discipline in the field of psychology and psychotherapy. Through filters using content-analysis techniques, the authors have included 41 publications relevant to use of standardized patients in clinical psychology and psychotherapy. This review system considers barriers and facilitators used to consider implementation of SP interventions in this field. Through various literature searches, these barriers and facilitators were categorized and authors were able to display a variety of recommendations for implementing Standardized Patient programs.

Research Article: Medical Education and Human Trafficking: Using Simulation
Lead Author: Hanni Stoklosa
Submitted by: Janice Radway and Michael Maury

At the 2016 ASPE conference, I was privileged to view Carrie Bohnert’s snapshot presentation on the University of Louisville’s human trafficking education module using SPs. Bohnert and her co-authors have published their research outlining the development of their SBME (Simulation Based Medical Education) curriculum to prepare third year medical students to recognize trafficking victims and intervene on their behalf. Read about this fascinating and much-needed program in Medical Education Online here.

Research Article: Challenging Conversations with Simulated Patients
Lead Author: Diane Dennis
Submitted by: Kerensa Peterson, Northwestern University Feinberg School of Medicine

A lot of discussion has been dedicated in recent years to figuring out how the millennial mind works and what makes them excited to learn. In this article, the investigators use simulation with physiotherapy students to engage them in the learning process. Their results are very positive and show us a unique structure for incorporating simulation scenarios with a very large group of learners. Read the full article in The Clinical Teacher here.

Research Article: Experiential Learning: Critical Analysis of Standardized Patient and Disability Simulation
Lead Author: Laura VanPuymbrouck
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

This paper champions the use of patients with disabilities as SP Educators, or SPWDs in OT education. Traditionally, SPs without disabilities would be used in Disability Simulation, which proved problematic in many ways. The authors offer recommendations such as developing long-term partnerships with disability organizations and involving people with disabilities in the development, implementation, and evaluation of experiential learning opportunities. Together, these recommendations can help ensure that students have access to evidence-based educational approaches and best practices that accurately reflect the self-identified needs, concerns, and priorities of intersectional disability communities. Read the full article in the Journal of Occupational Therapy Education here.

Research Article: Increasing Confidence and Changing Behaviors in Primary Care Providers Engaged in Genetic Counseling
Lead author: Michael S. Wilkes
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

Screening and counseling for genetic conditions is an increasingly important part of primary care practice, particularly given the paucity of genetic counselors in the United States. However, primary care physicians (PCPs) often have an inadequate understanding of evidence-based screening; communication approaches that encourage shared decision-making; ethical, legal, and social implication (ELSI) issues related to screening for genetic mutations; and the basics of clinical genetics. This study explored whether an interactive, web-based genetics curriculum followed by sessions with Standardized Patients helped make positive change in PCP knowledge and behaviors. Read the full article in BioMed Central Medical Education here.

Research Article: A Novel Approach to Simulation-Based Education for Veterinary Medical Communication Training Over Eight Consecutive Pre-Clinical Quarters
By: Ryane E. Englar
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

Experiential learning through the use of SPs is the primary way by which human medical schools teach clinical communication. The profession of veterinary medicine has followed suit in response to new graduates' and their employers' concerns that veterinary interpersonal skills are weak and unsatisfactory. As a result, standardized clients (SCs) are increasingly relied upon as invaluable teaching tools within veterinary curricula to advance relationship-centered care in the context of a clinical scenario. However, there is little to no uniformity in the approach that various colleges of veterinary medicine take when designing simulation-based education (SBE). Midwestern University College of Veterinary Medicine (MWU CVM) details its approach to building its SBE in the Journal of Veterinary Medical Education here.

Research Article: What can we learn from simulation-based training to improve skills for end-of-life care? Insights from a national project in Israel
Lead author: Mayer Brezis
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

This research article describes the design of interprofessional simulation-based workshops with standardized patients and family members to improve end of life (EOL) care. These simulations provided an opportunity to explore barriers and challenges for hospital staff in providing optimal care at the EOL. The workshops so were successful in highlighting the need for more training that they eventually led to an expansion of palliative care services and demand for EOL care education in nursing homes and other professional areas. Read the full article in the Israel Journal of Health Policy Research here.

Research Article: A Walk in My Shoes - Using Art to Explore the Lived Experience of Psychiatric–Mental Health Standardized Patients
Lead author: Debra Webster
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

Use of SPs to teach mental health nursing skills is increasing. Although the literature regarding the effectiveness of this teaching strategy supports its use, information regarding the effect of portraying mental illness on SPs is lacking. Using a qualitative approach incorporating art as expression, this effect was examined. Five SPs created an artistic expression to describe their work portraying an individual with mental illness while working with senior nursing students enrolled in a psychiatric–mental health clinical nursing course. Themes identified include: (a) Walking the Walk, (b) Listen to Me, (c) See Me as a Person, and (d) Letting it Get to Me. The current article offers best practice approaches to address psychological implications for SPs portraying mental illness. Read the full article in the Journal of Psychosocial Nursing and Mental Health Services here.

General Interest: Mimicking rashes - Use of moulage technique in undergraduate assessment at the aga khan university, Karachi
Lead author: Saniya Raghib Sabzwari
Submitted by: Todd Lash, Publications Committee Chair

To assess the validity and feasibility of moulage technique–where a cosmetically constructed rash is used on simulated patients–two dermatologic rashes were developed using moulage simulation on standardized patients (SPs). Dermatologists created checklists for cases that focused on history taking of a skin rash. These included a description and identification of lesions, differential diagnosis, and basic management. Sixty-four students were assessed on a Herpes Zoster case and 32 students on a Herpes Simplex case. Face validity for all groups was established through input of content experts. The investigators determined that the use of moulage technique to develop dermatologic lesions on SPs may be utilized for student assessment. Read the full article in Education in Health here.

Research Article: Performance of International Medical Students In Psychosocial Medicine
Lead Author: Daniel Huhn
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

Research shows that international students perform poorer than their local counterparts in written and oral examinations as well as in Objective Structured Clinical Examinations (OSCEs) in the fields of internal medicine and surgery. This 2017 study, which took place at the Medical Faculty of Heidelberg, Germany, is the first to examine how they compare in a psychosocial medicine OSCE. While there were no differences in their factual and practical knowledge, there were significant differences in conversational skills, on which the field relies heavily. Read the full article in the BMC Medical Education here.

Research Article: Impact of Standardized Simulated Patients on First-Year Pharmacy Students’ Knowledge Retention of Insulin Injection Technique and Counseling Skills
Lead author: Riley Bowers, PharmD
Submitted by: Robert MacAulay, Director, Standardized Patient Program UCSD School of Medicine

Objective. To compare pre- and post-intervention test scores assessing insulin injection technique and counseling skills among P1 students with (intervention) or without (control) simulated patients, and to compare counseling checklist and knowledge retention test scores between groups.