Poster Winners: 2018 ASPE Conference

Poster Winners: 2018 ASPE Conference
Compiled by: Todd Lash, Publication Committee Chair

Each year eligible posters are judged using criteria based on Glassick criteria for scholarship (Glassick CE et al, San Francisco, CA: Jossey-Bass, 1997) and first-place and honorable mention prizes are awarded. Details regarding the winning posters, as provided along with all poster submissions on the conference website, follow below. Congratulations to the winners!

1st Prize: PO D4 - A simulation for continuity in patient care. Amy Shanks and Karen Szauter

Introduction: Our School of Medicine curriculum provides multiple opportunities during the preclinical years for learning and practicing full medical interviews. However, opportunities to practice follow-up patient encounters are lacking. Adapted from published models, (refs 1-3) we piloted a longitudinal patient encounter project, providing a cohort of first year medical students a simulated continuity patient care experience.

Project Description: Our first-year medical students learn how to take a full medical history in a structured manner, and each student participates in one of nine simulated patient encounters that are recorded and shared in small groups. This core foundation for history taking is a vital skill that students draw upon throughout their medical careers. To integrate the longitudinal patient experience into the existing curriculum, we selected four of these cases featuring chief complaints with which one person could conceivably visit the clinic over time. Reworking the simulated patient (SP) scripts required careful crafting to maintain the integrity of the cases’ learning objectives. We first developed the patient’s narrative. To allow both biomedical and psychosocial issues to develop, a fictional timeline (with 12-24 month gaps between visits) was created, requiring additional supporting material to be developed to more authentically simulate the interpersonal nuance of a follow-up visit conversation. Timeline gaps were filled with medical history and patient charts were developed for review before the patient encounter. An SP was recruited and trained for the four cases to give students a more complete simulated follow-up visit experience.

Outcomes: Three small-groups of students were selected to pilot this curricular enhancement. After the initial case experiences we were able to observe how this activity provided unique challenges to students. We also noted how varied approaches to follow-up visits might be for these early learners.

Conclusions / Discussion Overview: Early in medical training, students tend to focus on the “disease” rather than the “person with an illness.”(ref 4) Our longitudinal patient experience attempts to bridge this gap by tying together a single person’s story with several unique presenting problems. We believe this project takes an innovative approach to enriching an existing medical interviewing curriculum with the differentiated learning objective of conducting a follow-up patient visit.

Honorable Mention: PO A1 - Addressing issues of social justice with standardized patient based education curriculum and programming. Cate Nicholas, Edith Kilmoski, Pat McKittrick, Rachel DiSanto, Christina Melvin, and Emily Reed

Introduction: Health care disparities are differences in health and health care among groups based on race/ethnicity, socioeconomic status, age, location, gender, disability status, and sexual orientation. Whether is it lesbian, gay, bisexual, transgender or queer (LGBTQ) individuals or victims of human trafficking or vulnerable adults, standardized patient (SP) based curriculum and programing can be one approach to address these social justice issues.

Project Description: The Clinical Simulation Laboratory at the University of Vermont (CSL-UVM), having successfully created curriculum and programming to address LGBTQ issues, was approached by students and faculty members to create SP based curricula and programming to address health care disparities for victims of human trafficking. Using a multidisciplinary/interprofessional approach within a human rights framework, we created the Anti-Human Trafficking Collaborative at the University of Vermont in 2014. The group includes advocates, survivors, healthcare providers and students, faith groups, law enforcement, simulation and IT experts.

Outcomes: After performing a literature review to identify best practices, the working group created policies and procedures and customizable SP based modules. Each module includes a PowerPoint presentation with facilitator guidelines, and discussion questions. SP cases, developed from actual labor and sex trafficking cases, can be presented live in small or large group settings or can be seen in video taped encounter with a wide range of healthcare providers and law enforcement. Over the last 2 years, these sessions have been offered over a dozen times in uni/multiprofessional grand rounds, medical/ nursing student presentations, in continuing education formats and community based events. The number of participants ranged from 10-400. Learner feedback has been very positive reporting a better understanding of how to recognize, respond and refer. Seeing the video tapes or a live SP encounter was invaluable in building their confidence.

Conclusions / Discussion Overview: SP based module allows learners across the healthcare continuum to increase their knowledge, skills and behaviors when facing possible trafficking situations. The human rights framework shows the learner how to provide resources without putting the patient at risk or re-traumatizing them. This model has worked so well we are applying the same process to addressing vulnerable adult abuse, neglect or exploitation.

Honorable Mention PO B5 - enhancing de-escalation training with standardized patients. Emma Vick and John Leopold

Introduction: Behavioral health (BH) clinicians must frequently de-escalate patients in crisis. It is critical that this be done effectively to prevent harm to patients and/or staff. Formal de-escalation training is often lecture-based and sometimes role play based. Generally most staff learning takes place on the job. The Behavioral Health Department manager, of a regional teaching hospital, proposed using standardized patient (SP) based simulation to enhance training for her staff.

Project Description: Together with the Behavioral Health Department’s Safety Council, the sim team designed two escalating patient cases. Each included an encounter with an escalating patient, then subsequent self-evaluation, and feedback from the SP, a member of the council, as a faculty, and a facilitating member of the sim team. The council—composed of doctors, nurses, and social workers—completed the pilot simulation both as participants and as peer faculty. Council members also received two training sessions on peer feedback. After the pilot, training was provided to the multiprofessional BH staff. Over a four-month period in Spring 2017, 51 registered nurses, social workers, and nursing aids participated in the simulation.

Outcomes: A majority of participants (84%) agreed or strongly agreed that the simulations provided skills, knowledge or insight that will affect how they perform their jobs. All participants reported that the simulation impacted the way they will approach their practice while: 63% felt the impact would be “significant”. Learners also reflected on the importance of hearing feedback from the SP: one stated “The feedback of what effect my intervention had was very helpful in prioritizing how and why I do the things I do.” Moreover, all members of the safety council reported heightened confidence in their ability to intervene and help their colleagues during challenging patient encounters; enhancing their role on the unit. Anecdotally, there was a significant improvement in staff morale following the program.

Conclusions / Discussion Overview: The simulation helped the department develop de-escalation skills, gain confidence, and raise team morale. By training the safety council as faculty, the simulation also trained the council to be more proactive with de-escalations in the department. Participants requested further training with security collaboration and patient restraint techniques.

Publications Committee Mission: “To bring high quality reporting of current research, trends, techniques and information regarding SP methodology and other relevant industry articles to the attention of the membership through the web-based ASPE eNews blog.”

Please provide comments, questions or suggestions about the ASPE eNews Blog here.

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