By Dan Brown, Emory University

At the 2020 ASPE virtual conference, Towanda Underdue, an SP Educator at Johns Hopkins Medicine and an ASPE member since 2016, presented a Snapshot titled Setting Boundaries: What SP’s Should Not Say at Work or Post on Social Media. I reached out to her via email for an interview.

Here is a snippet of her abstract for the presentation: “We as SP educators must be vigilant to provide a safe environment for our medical learners and standardized (simulated) patients to grow and succeed.
When SPs say and do inappropriate things, it can not only jeopardize our program, but create a hostile work environment where SPs don’t want to work.
In the age of social media, we must be ever mindful how our SPs communicate not only amongst themselves outside of the encounter but also online, setting boundaries so that they do not say or post things that could compromise the integrity of our program, our cases, student privacy laws, HIPPA rules, and other SPs.”

DB: What led you to this topic? TU: I started hearing more and more incidences of SPs either posting confidential center information online amongst themselves and incidences of onsite ignorance of what personal space and verbal boundaries are. This started to create an uncomfortable work environment.)

DB: In what ways might this topic be unique to your institution and in what ways is it generally applicable to most SP programs? TU: I believe the topic generally applies to all SP programs, but specific to Johns Hopkins because of the scope of our program with over 150 SPs, GUTAs and PETAs on our active roster. 

DB: You say that SPs can jeopardize programs by what they post online. Have you had examples of this happening? TU: Yes. Our staff was informed by an SP that several SPs from different institutions in our geographic area had set up an unauthorized Facebook group to share and discuss cases. No matter how well meaning, that could jeopardize the integrity of our program broadly and our cases specifically. 

DB: You say your SPs should not post offensive content online. Where do you draw the line? TU: Racism, sexism, and other forms of discrimination should have no place in our work life. Even if you're joking, think twice before sharing something that could be seen as bigotry. And then don't share it or do it.

DB: All your SPs have mandatory trainings on diversity & inclusion and sexual harassment. Have there been challenges implementing or enforcing this? TU: The major hurdle has been technology based. All of our SPs are not technology savvy and needed help logging in to their institution account username which they forgot or passwords which change every so many months for security reasons. The little pushback was from those wondering why they had to take the tests every year. It’s a requirement of continued employment at our institution so it’s non-negotiable. 

DB: What’s the biggest takeaway you want for participants after viewing your presentation? TU: SP’s just like SP Educators have a duty to protect information that is in their possession and do their best to keep it safe from harm and beholden to not jeopardize their job, our program, their colleagues’ trust or the medical learners we serve.

I’d like to thank Towanda for her contribution and for putting so much thought and effort into this issue, where so many of us are prone to make thoughtless mistakes with little effort, and reminding us to have these conversations with our SPs.

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