Published by: Academic Medicine
Submitted by: Kerensa Peterson, NBOME
Academic Medicine has released a collection of articles that address race and racism in Medical Education. The collection is geared toward a variety audiences within the Medical Education Community from medical students to simulation educators to faculty physicians to program directors.
The Social Construction of Race and its Impact on Medicine and Biomedical Research by John Chenault, PhD
By Dan Brown, Emory University
As mentioned in my recap of the opening plenary from the 2020 ASPE virtual conference, Dr. Chenault had to rush through the end of his plenary speech “Medicine and the Black Body,” and attendees were hungry for more, so as we’d hoped, he was invited to do a webinar. The webinar took place on Oct. 30, 2020, and the full webinar is available at the ASPE site. The discussion centered on three questions: What is race? What does medicine and biomedical research tell us about race? How useful are racial categories in biomedical research and practice?
Submitted By: Todd Lash
Full Center Name: Clinical Skills Education and Assessment Center
By: Jamie Bartosch
Submitted by: Michael Maury, UC-San Diego
While describing a simple exercise known as One-Word-Story, Jamie Bartosch writes “It’s a fun activity, but it serves an important purpose for these future doctors. It forces them to listen. This exercise, like the many others they engage in, makes them realize they don’t know where the story is going to go, so they must pay attention to verbal and non-verbal cues.” Skills like these are vital to successful patient care in medicine. While improv can provide some extra laughs, it ultimately “has nothing to with comedy” as University of Chicago Medicine pediatrician Nikki Orlov, MD states. “It’s all about improving advanced communication skills.”
Lead author: Young Soon Park
Submitted by: Kathy Herzberger, Loma Linda University
Establishing major competencies and training for clinical performance in medical education has been prevalent in Korea for only the last 15 years. This is due to the clinical skills test that was added to the paper-based Korean Medical Licensing Examination (KMLE) in 2009. This crucial change in the KMLE has strengthened clinical performance in Korean medical schools. This interesting study emphasizes how evaluator factors as well as the type of scale utilized can influence physician-patient interaction scores.
By: Brian James
Submitted by: Todd Lash, The Ohio State University
Imagine a medical student sitting in the room across from a 50-year-old female standardized patient who presents with fatigue and vague abdominal pain. It’s their second year of medical school, and they know generally how to conduct a patient interview. They eventually reach the family history, concerned that any incidence of pancreatic cancer in the family may mean the standardized patient is in for a long, scary and painful journey of diagnosis and treatment. The question finally arises: any family history of a cancer diagnosis? The standardized patient, without skipping a beat, coldly tells you that her father passed away from pancreatic cancer over 10 years ago at age 59. The student knows what to do; they have been trained extensively in the ways of empathy. They pause, say “I’m sorry to hear that,” then pause again for dramatic effect.
By: Zeke Hernandez
Submitted by: Michael Maury, UC-San Diego
“Stagnation happens when we adopt one of two extreme mentalities. On one extreme is overconfidence, which arises from underestimating the complexity of the situation and overestimating our own ability. On the other extreme is fear, which arises from overestimating the complexity of the situation and underestimating our own ability. In between the two extremes is humility. ”In these times of such extremes and great uncertainty, it is helpful to be reminded of humility. Can we approach each new moment and experience with curiosity and a beginner’s mindset? Perhaps even the act of tying our shoes could be performed differently as to yield better results.
By: Hamilton Sage, SP at Emory University
Interviewed by: Mary Launder, Rosalind Franklin University of Medicine and Science, and edited by Kerensa Peterson, NBOME
How has your experience as an SP changed since the pandemic? Well, it’s definitely changed quite a bit as far as just shifting over from in person to Zoom, and actually, I think it was a very tall task considering the size of some of these events. There’s like 60 plus learners sometimes and [the staff’s] ability to set up different rooms and get it all logistically running smoothly, it’s been pretty cool. It’s been a blessing for me because I’ve been able to continue to have some income from home without having to put myself or my family at risk by going out and interacting with people. I’ve been really grateful for that.
Submitted by: Kerensa Peterson, NBOME
I will try my best to give my input into what it has been like to be a SP during this pandemic. I am at a bit of disadvantage as I had just started as a SP in February and only had one live interaction before the shutdown occurred. So, I don't have a lot of experience with the pre-pandemic routine.
By: Bill Goldsmith, SP and Theatre Artist
Submitted by: Todd Lash, The Ohio State University and Kerensa Peterson, NBOME
Submitted By: Cory Krebsbach
Full Center Name: Center for Advanced Simulation in Healthcare
ASPE Annual Conference Poster Winners
Submitted by: Todd Lash, The Ohio State University
The ASPE 2020 Annual Conference featured 10 innovation and 6 research poster submissions. Kevin Hobbs announced the winners during the Awards Ceremony on Friday, August 14, 2020. Poster judges included Kerry Knickle, Nancy McNaughton, Karen Szauter, Jane Miller, Cate Nicholas, Temple West, Emma Vic and Jackie Klevan.
5 Ways the Health-Care System Can Stop Amplifying Racism
Lead Author: Ezekiel J. Emanuel
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania
The coronavirus pandemic didn’t create the health disparities among Americans, but it has exposed once again how stark the problem is. Black and Latino patients are two to three times as likely as white patients to be diagnosed with COVID-19, and more than four times as likely to be hospitalized for it. Black patients are more than twice as likely to die from the virus. They also die from it at younger ages. COVID-19 has exacerbated long-standing trends: Black and Latino Americans have lower rates of insurance coverage, a higher prevalence of chronic diseases, worse health outcomes, and a lower life expectancy. People in the health-care world sometimes speak of these patterns as if they are inevitable facts of life—something the industry is powerless to change. More doctors and hospitals need to acknowledge and address how the U.S. health-care system is rife with structural racism. For decades, American medicine has discriminated against people of color.
By Dan Brown, Emory University
Social Justice was a common theme throughout ASPE’s virtual conference, and Prof. John Chenault set the tone in his opening plenary, with a moving introduction by University of Louisville colleague Carrie Bohnert. In his presentation, Medicine and the Black Body, Chenault began by clarifying the definition of race as an artificial societal construct, and presented the pseudoscience that perpetuated racism, as well as the legal precedents introduced that created a divide and a definition for what level of mixed ancestry legally qualified a person as a “Negro.” He then walked the attendees through the grim history of medicine and its treatment of African slaves and their descendants: many medical advances came at the expense of Black bodies, including unethical cadaver sourcing, experimental surgeries and studies, drug trials, and more. He then connected this painful history to present day health disparities.
Lead Authors: Christine S. Park, Lou Clark, Grace Gephardt, Jamie M Robertson, Jane Miller, etc.
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania
A pandemic has sent the world into chaos. It has not only upended our lives; hundreds of thousands of lives have already been tragically lost. The global crisis has been disruptive, even a threat, to healthcare simulation, affecting all aspects of operations from education to employment. While simulationists around the world have responded to this crisis, it has also provided a stimulus for the continued evolution of simulation. We have crafted a manifesto for action, incorporating a more comprehensive understanding of healthcare simulation, beyond tool, technique or experience, to understanding it now as a professional practice. Healthcare simulation as a practice forms the foundation for the three tenets comprising the manifesto: safety, advocacy and leadership. Using these three tenets, we can powerfully shape the resilience of healthcare simulation practice for now and for the future. Our call to action for all simulationists is to adopt a commitment to comprehensive safety, to advocate collaboratively and to lead ethically.
By: An Anonymous SP from a University in the Midwest
Submitted by: Kerensa Peterson, NBOME
Q: How has your experience as an SP changed since the pandemic? Greater lulls between SP events to participate in throughout the past few months, that's for sure. I was afraid we wouldn't have any events as soon as we did. Either June or July, if memory serves. When we definitely didn't have any in the months of April and May. Even if they have been through Zoom and not in person. That's another thing. Working remotely/virtually has certainly been different. Makes my job harder, I believe. Sure, it's nice to be able to stay home and work from there, but it puts pressure on me to still be able to react properly to a learner's body language. Having that extra barrier between us makes all of that a little harder to decipher. Occasionally, I feel drained. Zoom fatigue, as it were.
Q: Have you had to look for other work? If so, what are you doing? I've certainly tried to, if I'm being honest. Steadier work with actual benefits. It's not easy. Especially considering I would prefer something like that within this line of work. I've been using sites like Indeed and LinkedIn. Just searching for stuff like creative writing positions or movie production positions. Yet, like I said, I really enjoy being a standardized patient and would really love to have steadier work hours with benefits through this program.
Author: Derek Ratliff
Submitted by: Kerensa Peterson
My name is Derek Ratliff, and I am an SP (and Event Assistant) at Emory University School of Medicine. I have been at Emory for nearly three years. It has been one of the greatest joys of my life! For some reason, I have always been drawn to the medical field. I remember fondly as a child that I wanted to be a doctor, which I know for children, that is probably one of the first things they say when asked the proverbial question “what do you want to be when you grow up.” However, when I got to college (UNC-Chapel Hill – GO HEELS!!!), I decided to become a pharmacist instead. I suppose I thought the challenges of being a doctor were just too great. But then I realized that being a pharmacist was not what I wanted to be either. So, I changed my major to music education midway through college.
Author: Felisha McNeal
Submitted by: Kerensa Peterson and Marsha Harman
Can you tell our readers a little about yourself? My name is Felisha McNeal. I’m retired from the state of Illinois. I worked there for 30 years. I’m an actress and I had been acting while I was working full time and raising my daughter, for about the same amount of time, about 30 years. Then, when I won the Jefferson Award in 2013, I was very close to retirement and I had convinced myself that I would start acting fulltime and I would retire the following year, which I did. Maybe a year or two after I retired, I auditioned at Northwestern to do standardized patient work. I was fortunate enough to be chosen. Yeah, it was 2015 when I started working there. I’m trying to get with [other places]. But I do want to expand my standardized patient work. It’s such important work, that I do want to do it more.
Author: Tamara Bodnar
Submitted by: Kerensa Peterson and Mary Lander
March 13 was the day that everything changed. Chicago’s shelter-in-place would go into effect a week later, but that Friday I watched as all of my sources of income vanished thanks to COVID-19. Everything I was doing - preparing for a spring full of standardized patient work, music directing a production of Mary Poppins for a children's theatre, rehearsing for a cabaret, and gearing up for a busy audition season - came to a screeching halt. I'll never forget that feeling of uncertainty, the loss of control, the panic settling in of how quickly everything had gone down in flames and how I was going to get through it. I remember going over to a friend and fellow SP’s apartment for a night of baking, the mood somber as we processed the news of cancelled projects, lost paychecks and a precarious future together.
Author: Mary Gray
Submitted by: Kerensa Peterson and Todd Lash
I graduated with a degree in theatre, specifically performance, from that school up north in the 1980’s. A job with a for-profit company brought me to Columbus upon the completion of my degree. The company transferred the Columbus native to the Detroit area, and me, the Detroit area kid, to Columbus. A bit of a joke on someone’s part, I suppose, and now home to me for over three decades.