By: A. Jacobsen, Y. Khiew, S. Murphy, C. Lane, & B. Garibaldi
Submitted by Kathy Herzberger, Loma Linda School of Medicine

As someone who teaches clinical skills, I have always advocated that a hypothesis driven physical exam can improve patient/physician relationships and provide better patient outcomes. Ireland relies on high standards of physical exam skills due to their resource-limited health system. Physical exam skills in the U.S., however, have declined due to the “high-tech transformation of health care and a more litigious society”. Medical errors and physician burnout increased as physical exam declined. Reading this article validated my beliefs that teaching and assessing physical exam skills is imperative to quality patient care.

Published in cooperation with the Federation of American Societies for Experimental Biology (FASEB)
Submitted by: Kerensa Peterson, NBOME

“When the pandemic rapidly developed in the US in mid-spring of this year (2020), it impacted all teaching programs from early childhood to professional schools and many stop-gap changes were introduced to allow virtual instruction to replace face-to-face teacher-student contact across this spectrum. With the time engendered by the summer months in 2020, many teaching programs/curricula have fine-tuned these changes made to accommodate the virtual format. In this Special Collection, the approaches taken by several medical schools, ranging from individual courses to the full curricula, are described. It is our intention to revisit these programs over the next year to evaluate what worked well and what did not.  

Lead author: Samuel Zverev
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

“She squirmed, sobbing hysterically, grabbing onto the railing of the inpatient hospital bed with IVs still bound to her arm. A grown woman was shouting and crying, not because of physical pain or injury, but out of fear. The sea of medical professionals surrounding her bed only seemed to exacerbate her dismay. She refused to acknowledge any of them, consciously omitting the small army of physicians and nurses crowding her room. She would only speak with one person … me.”

By: J. Talwalkar, K. Cyrus, A. Fortin
Submitted by Kathy Herzberger, Loma Linda School of Medicine

The authors have placed into twelve succinct steps what is required to tackle a new project utilizing standardized patients. This will be a review for some, but for newcomers to the realm of SP work, this is a good outline to utilize to create successful activities.

Lead Author: Shane A. Pritchard, BPhysio, et al
Submitted by: Kerensa Peterson, NBOME

Using an interpretivist research paradigm and qualitative design, these researchers from Australia considered simulated patients’ self-identified role within healthcare education. The researchers engaged 18 SPs in frank discussion about the SPs’ role in order to explore their experiences, perspectives and practices within their SP programs. The researchers have a rich discussion of themes that emerged from those SP conversations. They offer SP Educators ways to further benefit SPs and engage in quality educational experiences for learners with input from the professionals performing the simulation – the Simulated Patients themselves.

By: Leanne Picketts, Marika Dawn Warren, Carrie Bohnert
Submitted by: Marsha Harman, Rush Center for Clinical Skills and Simulation

Healthcare learners can gain necessary experience working with diverse and priority communities through human simulation. In this context, simulated participants (SPs) may be recruited for specific roles because of their appearance, lived experience or identity. Although one of the benefits of simulation is providing learners with practice where the risk of causing harm to patients is reduced, simulation shifts the potential harm from real patients to SPs. Negative effects may be amplified when SPs are recruited for personal characteristics or lived experience. Educators have an ethical obligation to promote diversity and inclusion; however, we are also obliged to mitigate harm to SPs.

Submitted By: S. Barry Issenberg, M.D.

Full Center Name: Michael S. Gordon Center for Simulation and Innovation in Medical Education

Submitted By: Dan Brown

Full Center Name: Clinical Skills Center
Center Location: Atlanta, GA, USA
Year Opened: 2001
Center Mission Statement: Not our mission statement, but our "Why": We enhance human interaction.

By: Kaitlin Descutner
Submitted by Kerensa Peterson, NBOME

This is part of the SP Voices series we have been running since June 2020: The pandemic has certainly set us all back extremely. However, the outcome has been positive for me in a way. I decided to move back home to Pennsylvania in June 2020 with no jobs lined up. Because Ohio State University pursued holding events virtually, I was able to keep my job as an SP. I am the first SP at Ohio State to work from another state remotely. I’ve always been gracious to be in the SP world – expanding medical training and communication. I continue to be gracious to be an SP in a new, virtual world so that we can all learn how to communicate through telehealth.

Interviewed by: Kerensa Peterson
Edited and Submitted by Marsha Harman, Rush Center for Clinical Skills and Simulation

Please tell our readers who you are and what schools you’ve worked for as an SP? My name is Armando Reyes. I’ve been with Northwestern from the beginning when I first started SP work. I do work at Rush University, as well. Those are the two main schools that I work at.SP work has been very limited. I’ve done two events so far since this whole thing started. I’ve been fortunate because I have other jobs that I juggle, as well. I was doing a lot of remote work beforehand, which has helped - well, I shouldn’t say helped. I don’t know. It’s a strange new world now that we’re living in.

Lead author: Amrapali Maitra
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

In anecdotal reports from residency retreats, female residents described a high frequency and negative impact of interruptive behavior by male colleagues. The authors sought to characterize interruptions during residency teaching conferences by gender. The results are eye-opening.

Lead Author: Daniel Suarez
Submitted by Kathy Herzberger, Loma Linda School of Medicine

This study looks at the association between sexual orientation and the mental health of medical students. One of the more heartbreaking findings was the higher rate of family dysfunction among non-heterosexual students that leads to decreased social and financial support. Once again, our vigilance is essential to help our students find the help that they need to improve their well-being.

Lead Author: Joshua A. Roshal
Submitted by: Marsha Harman, Rush Center for Clinical Skills and Simulation

This study identified self and simulated patient (SP)-reported ratings of US first-year medical students’ interpersonal and communication skills (ICS) and the influence of age and gender on performance appraisal during the Objective-Structured Clinical Examination (OSCE). While the majority of students and SPs evaluated the students’ ICS as very good, there was a disparity in the rating of the medical students’ ability to encourage patient question-asking and answer questions; more SPs gave an “inadequate” rating in that category than students. Neither age nor gender influenced the medical students’ self-assessment of ICS. Female SPs assigned lower scores to students in regard to respecting patients and encouraging patient question-asking and answering. Older SPs were more likely to assign lower scores on all survey questions.

By: Kara Gavin
Submitted by: Marsha Harman, Rush Center for Clinical Skills and Simulation

People who take opioid medications for chronic pain may have a hard time finding a new primary care clinic that will take them on as a patient, according to a new “secret shopper” study of hundreds of clinics in nine states across the country. Simulated patients who said their doctor or other primary care provider had retired were more likely to be told they could be accepted as new patients, compared with those who said their provider had stopped prescribing opioids to them for an unknown reason. Stigma against long-term users of prescription opioids, likely related to the prospect of taking on a patient who might have an opioid use disorder or addiction, appears to play a role.

Lead Author: Martina Ann Kelly
Submitted by Kathy Herzberger, Loma Linda School of Medicine

We have all realized how much touch is essential to our lives during this past year. Touch, according to the authors, expresses healing, caring, and connection. They discuss how virtual life has transformed interactions with their patients and colleagues. If telemedicine continues beyond our current pandemic, then physicians will need to find a way, other than touch, to connect with their patients to develop therapeutic relationships. 

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.

Lead Author: Scott Haperin
Submitted by Kathy Herzberger, Loma Linda School of Medicine

Medical students suffer from increased anxiety and depression. Add Covid isolation to an already difficult situation and these problems are exacerbated. This study assessed the mental health situation of 1,428 students from 40 U.S. medical schools. The results suggest that we should be especially vigilant in recognizing and offering help to students that require extra emotional support.

In The Spotlight: University of Central Florida – College of Medicine
Submitted By: Rebecca Beiler

Full Center Name: Clinical Skills and Simulation Center

Lead author: Andrew M. Luks
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

The authors make a compelling argument as to why clinicians should avoid using jargon: “Despite our best efforts to ensure appropriate care for patients, we often find ourselves distracted on rounds by the sometimes bewildering array of jargon during bedside presentations. Why does our team want to “sprinkle” or “hit” the patient with diuretics? Do our patients have the capacity to “fly” off the ventilator or “throw” PVCs (premature ventricular contractions)? …Perhaps the biggest challenges arise when we consider how our words sound to patients and their families. Many of our word choices run the risk of confusing them rather than clarifying the patient’s condition, diagnosis, or treatment. They may nod, but do they clearly understand what we have said? Even worse, are they offended by what they hear?”

Lead author: Doreen M. Olvet
Submitted by: Kathy Herzberger, Loma Linda University

This is an interesting article discussing near peer 4^th year tutors to give feedback to 1^st and 2^nd year students on note writing skills. The authors found that near peers can be an asset to medical education. I too, have found near peer tutoring effective. I have used 4^th year students that are remediating to help grade our 2^nd year OSCE. This exercise enhances the 4^th year’s skills and the 2^nd years appreciate the feedback from their upper classmen.