General Interest: Words That Keep Mental Health Stigma Alive
By: Angela E. Gambrel
Submitted by: Dan Brown, Emory School of Medicine

This is a companion/follow-up post to the blog entry posted on December 18 regarding the misuse of mental health terms. This piece delves into an interested historical perspective on how “lunatic,” “imbecile,” and other words now used exclusively as insults were once medical terms. Read the full article at HealthyPlace.com  here.

Research Article: Effect of a Simulation-based Workshop on Breaking Bad News for Anesthesiology Residents - An Intervention Study
Lead author: Vanda Yazbeck Karam
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

Breaking bad news (BBN) to patients and their relatives is a complex and stressful task. The ideal structure, training methods and assessment instruments best used to teach and assess BBN for anesthesiology residents remain unclear. The purpose of this study at the Lebanese American University and the University of Illinois at Chicago was to evaluate the effectiveness of an education intervention for BBN based on immersive experiences with a high fidelity simulator and role-play with standardized patients (SPs). A secondary purpose was to gather validity evidence to support the use of a GRIEV_ING instrument to assess BBN skills. Anesthesiology residents’ communication skills when BBN in relation to a critical incident may be improved with educational interventions based on immersive experiences with a high fidelity simulator and role-play with SPs. Read the full article in BMC Anesthesiology here.

Research Article: Training and Validation of Standardized Patients for Assessing Communication and Counseling Skills of Pharmacy Students - A Pilot Study
Lead author: Mahboobeh Khabaz Mafinejad
Submitted by: Todd Lash, Publications Committee Chair

Investigators at the Tehran University of Medical Sciences and the Karolinska Institute, Stockholm described a cross sectional and correlation study to determine the process of training valid simulated patients (SPs) for assessing communication and counseling skills of pharmacy students' performance. Three scenarios, along with corresponding checklists, were developed based on the usual medications of different diseases consisting of asthma, respiratory infections, and osteoporosis. The SPs' role-play performance was video-recorded and rated independently by two experts according to an observational rating scale to assess validity. Study validity was evaluated by statistical analysis. The role-play was repeated after 1 week with the same scenario and the same doctor, to assess test-retest reliability. The investigators concluded that trained SPs can be used as an effective tool to assess pharmacy students' communication and counseling skills. Read the full article in the Journal Research in Pharmacy Practicehere.

General Interest: You, Me and Them - Experiencing Discrimination in America - Scientists Work To Overcome Legacy of Tuskegee Study, Henrietta Lacks
By: Rob Stein, NPR
Submitted by: Michael Maury, UCSD School of Medicine

This article gives us good food for thought. That is, what are we doing as Standardized Patient Educators to take a stand for equality in health care? Are we creating SP cases that represent all people of various ethnicities and cultural backgrounds? Or, are we only creating cases that are easier for us to cast based on our current SP pools?

General Interest: HealthySimulation.com Relaunches Medical Simulation Resource Website and Newsletter
Submitted by: Lance Bailey

After seven months of hard work, the newly redeveloped Healthcare Simulation resource website HealthySimulation.com has finally launched! Not only has the website, newsletter, and branding been updated with a modern professional aesthetic, but also has given brand new functionality to better serve you the latest in medical simulation news, product information, conference coverage, research highlights, tutorial insights, and more! Features on the website include searching and posting for medical simulation jobs, finding healthcare simulation vendors, submitting articles to share with a global community, and subscribing to the Healthy Simulation Newsletter. Read about the relaunched website and new features here.

General Interest: Innovative UCSD Program Aims to Draw Compassion Out of Future Doctors
By: Kinsee Morlan
Submitted by: Michael Maury, UCSD School of Medicine

As Standardized Patient Educators one of our many tasks is to foster and build empathy within our student doctors. We can accomplish this in many different ways. Since many of us in the SP world come from theatrical backgrounds, we are aware of the value of the performing arts in building compassion toward others. We know that acting and theatre has a built-in empathic element which can be passed on to any learner who is open and willing to partake whole-heartedly in theatre games and improvisational exercises. What if there were other artistic endeavors that could accomplish this goal as well? In fact, there are such opportunities and in this article, author Kinsee Morlan describes an artist-in-residency program at the UC San Diego School of Medicine that has students sketch live nude models, real human skeletons and eventually cadavers helping them focus on details that build their abilities for empathy and compassion. Created by artist Joyce Cutler-Shaw and now currently taught by Larry and Debbie Kline, “the goal of the drawing class is not to turn doctors into artists, but to build empathy through art. The students will go on to be doctors, and the goal is to make them doctors who care.” Read the full article in Voice of San Diego here.

Research Article: Actual and Standardized Patient Evaluations of Medical Students’ Skills
Lead Author: Amelia L. Sattler, MD
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

It may be grating for many of us SP educators to hear the term “Actual Patient” as a way to distinguish from Standardized Patient, since we are all actual patients at some point and our feelings and feedback are valid. However, it is interesting to read this study that compared medical students’ ratings from SPs and the patients the students saw in their clinical rotations (APs). The authors of the study found that “feedback from APs provides unique perspectives, complementing those of SPs, and prompts insights into incorporating patients’ voices and values into training.” Read the full article in Family Medicine here.

General Interest: Essential Reflective Writing Resource: Pulse--Voices from the Heart of Medicine
By: Paul Gross, MD, as submitted to DR-ED Listserv
Forwarded with permission by: Todd Lash, Publications Committee Chair

Pulse--voices from the heart of medicine, an online publication launched by Department of Family Medicine at Albert Einstein College of Medicine in 2008, now has over 11,000 subscribers.

General Interest: OCD, Bipolar, Schizophrenic and the Misuse of Mental Health Terms
By: Jon Kelly and Denise Winterman
Submitted by: Dan Brown, Emory School of Medicine

If you jokingly, metaphorically, describe yourself as “OCD,” or “schizophrenic,” or “bipolar,” you could be doing a disservice to those who are clinically diagnosed with these challenging conditions, argue Kelly and Winterman. The misuse of these terms leads to a public misunderstanding of the diagnoses, and can contribute to stigmatization of mental illness. Some sufferers appreciate the increased awareness of the conditions, even if it’s misguided, but as educators in the medical field, it’s advisable to avoid using diagnostic terms in a metaphorical sense. Read the full article at BBC News Magazine here.

ASPE Affiliate News: Introducing INACSL Standards of Best Practice - Simulation^SM Operations
By: The INACSL Standards Committee
Submitted by: Valerie Fulmer, ASPE President-elect

As simulation-based education (SBE) research and evidence grows exponentially, the International Nursing Association for Clinical Simulation and Learning (INACSL) Standards of Best Practice: Simulation℠ continues to develop alongside. It is with great pleasure that the INACSL Board of Directors and Standards Committee publish the new INACSL Standards of Best Practice: Simulation℠ Operations. “Operations,” as outlined in the standard, encompasses the entire infrastructure necessary to implement effective and efficient SBE programs and departments. Read the introductory announcement in Clinical Simulation in Nursinghere, and the Standards of Best Practice here.

Lead author: Frank Herbstreit
Submitted by: Todd Lash, Publications Committee Chair

The investigators compared standardized patient’s ability to transmit knowledge and skills compared with a more traditional teaching approach for emergency management skills. Medical students were randomized to receive either training on standardized patients simulating 3 emergency settings (“acute chest pain,” “stroke,” and “acute dyspnea/asthma”) or traditional small group seminars. The students were evaluated on their knowledge base before and after their respective training pathway. Teaching using standardized patients resulted in a small, but statistically significant improvement in objective structured clinical examination scores. There was no difference in the written examination scores. Read the full article in Medicinehere.

Lead author: David J. Ecker
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

Recently, a student-initiated movement to end the United States Medical Licensing Examination Step 2 Clinical Skills and the Comprehensive Osteopathic Medical Licensing Examination Level 2-Performance Evaluation has gained momentum. These are the only national licensing examinations designed to assess clinical skills competence in the stepwise process through which physicians gain licensure and certification. Therefore, the movement to end these examinations and the ensuing debate merit careful consideration. The authors, elected representatives of the Directors of Clinical Skills Courses, an organization comprising clinical skills educators in the United States and beyond, believe abolishing the national clinical skills examinations would have a major negative impact on the clinical skills training of medical students, and that forfeiting a national clinical skills competency standard has the potential to diminish the quality of care provided to patients. In this Perspective, the authors offer important additional background information, outline key concerns regarding the consequences of ending these national clinical skills examinations, and provide recommendations for moving forward: reducing the costs for students, exploring alternatives, increasing the value and transparency of the current examinations, recognizing and enhancing the strengths of the current examinations, and engaging in a national dialogue about the issue. Read the full article in the Journal of the Association of American Medical Colleges here.

By: Allison Aubrey
Submitted by: Michael Maury, UCSD School of Medicine

As we fearlessly roller skate through our busy everyday lives, it is good to remember that there are great practices that can help us manage any stress that may invade our body and mind. Meditation has long been an important relaxing practice that helps individuals remain present and calm in the moment. As of late, Mindfulness Meditation has been a hot topic for many to help cope with the raucous rumblings that our world is witnessing. In this NPR news segment, Allison Aubrey makes note of some helpful downloadable Apps that may help us connect to our calming breath bringing us closer to a state of simple being. It is pointed out in this piece that there are “documented benefits of mindfulness meditation” which “can include better management of chronic pain, an increase in self-awareness, improved digestion and higher immune function.” It is understood that we all are busy with our jobs and personal lives. It is a good reminder, as the Zen proverb states, “You should sit in meditation for twenty minutes every day – unless you’re too busy. Then you should sit for hour.” Read on here for some potentially influential and uplifting guidance.

Lead author: Joachim Graf
Submitted by: Todd Lash, Publications Committee Chair

The aim of this study was to analyze gender differences in communication skills of medical students in the context of an OSCE exam. A longitudinal trend study based on seven semester-cohorts, was analyzed to determine gender differences in medical students’ communication skills. The students (self-perception) and standardized patients (SP) (external perception) rated the communication skills using uniform questionnaires. Statistical analysis was performed by using frequency analyses and t-tests. Across all ratings in the self- and the external perception, there was a significant gender difference that favored female students performing better in the dimensions of empathy, structure, verbal expression and non-verbal expression. The results of male students deteriorated across all dimensions in the external perception over time. Recommendations were made regarding gender-specific teaching that considered the reported differences between female and male students. Read the full article in BioMed Central Medical Educationhere.

Research Article: Standardized Patients' Perspectives on Workplace Satisfaction and Work-Related Relationships - A Multicenter Study
Lead author: Claudia Schlegel, MME, RN
Submitted by: Valerie Fulmer, ASPE President Elect

From the article: The use of standardized patients (SPs) in health care education has grown in the last 50 years. In addition, the requirements for SPs have increased steadily, and thus, the work of SPs has become more difficult and demanding. It has been claimed that SP programs are highly contextualized, having emerged from local, institutional, professional, and national conditions, but their effects on SPs have not been investigated. We have studied the effects of this job development on SPs and their programs. Read the full article in Simulation in Healthcarehere.

General Interest: NASA Program Aims to Prepare Astronauts to Become Space Doctors
Submitted by: Scott Winfield, The Ohio State University

NASA and Brigham and Women’s Hospital have teamed up to create a first-of-its-kind simulator to teach astronauts how to deal with medical emergencies. Watch the NBC Nightly News feature on YouTube here.

Editorial: Creating a quality improvement culture in standardized/simulated patient methodology - the role of professional societies
Lead author: Debra Nestle
Submitted by: Karen Lewis, George Washington University, ASPE Standards of Practice Committee Chair

An editorial about the ASPE Standards of Best Practice has been written and published in Advances in Simulation. Read the editorial here.

Research Article: Tracing the Prescription Journey - a Qualitative Evaluation of an Interprofessional Simulation-based Learning Activity
Lead Author: Caoimhe Cooke
Submitted by: Michael Maury, UCSD School of Medicine

“At Queen’s University Belfast (QUB), an innovative Interprofessional education (IPE) activity was developed for medical and pharmacy undergraduate students that aimed to develop a greater understanding of their roles and duties in community prescribing and dispensing. This study set out to evaluate the impact of such a simulation-based education (SBE) activity on students’ attitudes towards collaborative practice in prescribing and dispensing medication in the community.”

Interview with a Transgender Adolescent for Case Development
By: Dan Brown, Emory School of Medicine

Along with Stephanie Holt, M.D., I recently developed a case featuring a transgender adolescent. To ensure a fair, accurate, honest portrayal, we wanted to base the character on a specific person. I interviewed Lane Brown, my brother, and his answers were so helpful and eye-opening that I thought they would be beneficial to share with the ASPE community, for anyone else who has interest in developing a transgender case. These are some excerpts from that interview.

Research Article: Training Social Work Students to Recognize Later-life Depression - Is Standardized Patient Simulation Effective?
Lead author: Zvi D. Gellis
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

It gives me great pleasure to share this scholarly article with our ASPE membership, as the Penn Med SP Program was involved in the study. This has been a successful program for about 5 years. It involves 2nd year Master of Social Work students having discussions with geriatric SPs regarding late-life depression and chronic disease. Please see the abstract and link below for more information on this study.