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Telemedicine Key to US Health Care Even After Pandemic Ends

By: Gopal Ratnam
Submitted by: Janice Radway, University of Pennsylvania

As thousands of patients struck by COVID-19 rushed to seek treatment in overcrowded New York City hospitals, intensive care specialists more than 350 miles away at the University of Pittsburgh Medical Center stepped up to provide remote assistance to beleaguered colleagues in New York. Since the public health emergency and the relaxation of rules, the use of telehealth services has exploded across the country, according to the American Telemedicine Association, which represents hospitals, technology companies and others.

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The Emotional and Behavioral Impact of Delivering Bad News to Virtual Versus Real Standardized Patients: A Pilot Study

Lead Author: S. O’Rourke
Submitted by Kathy Herzberger, Loma Linda School of Medicine

I am personally not a big fan of virtual patients, but the findings in this study have given me pause to rethink my attitude toward virtual vs real patients. Their findings add credence for the use of virtual SPs even when dealing with difficult scenarios such as delivering bad news.

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In The Spotlight: Rush University

Submitted By: Marsha Harman

Full Center Name: Rush Center for Clinical Skills and Simulation

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No Joke: The Serious Role of Improv in Medicine

Author: Sarah Mahoney
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

Ajay Paul Singh, a second-year student at the University of Wisconsin School of Medicine and Public Health, felt a little nervous enrolling in a medical improv elective. But he says one exercise alone made the sweaty palms worthwhile.

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Association of Simulated Patient Race/Ethnicity with Scheduling of Primary Care Appointments

Lead Author: Janna M. Wisniewski, PhD; Brigham Walker, MS
Submitted by: Dan Brown, Emory University School of Medicine

This study used seven Simulated Patients belonging to three ethnic groups (self-reported as white, black, Hispanic) to call 804 randomized physician offices to attempt to schedule an appointment. All patients, if asked, would report being uninsured and paying out of pocket. The black and Hispanic patients were asked about their insurance significantly more frequently than the white patients. They also had a longer average wait time until their appointment.

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Belonging, Respectful Inclusion, and Diversity in Medical Education

By: Roberts, Laura
Submitted by Kathy Herzberger, Loma Linda School of Medicine

Laura Roberts, in a well-written piece, reminds us that many of our students, tragically, still face bias, discrimination, microaggressions, and exclusionary practices in medical school. She includes results from the 2019 Medical School Graduate Questionnaire that should make all of us take notice and work hard to help each student we interact with feel respected and valued.

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Nobody Wants to Have End-of-Life Conversations, But...

Lead Author: Christopher Magoon
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

Family members should understand their loved ones’ goals and wishes for treatment in the event of critical illness. The COVID era has heightened the need for these conversations, as initial studies show that intubated COVID-19 patients often do not survive.

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M Simulation Pivots to Online Delivery to Meet Critical Clinical Training Needs During the COVID-19 Pandemic

By: Jennifer Syltie Johnson
Submitted by: Todd Lash, The Ohio State University

When the University of Minnesota announced on March 12, 2020, that all in-person classes at its five campuses were moving to online learning, it was a first in the University’s history. Campus Public Health Officer and Vice President for Clinical Affairs Jakub Tolar, MD, PhD, had announced that all in-person instruction, including clinical rotations, was suspended and moving to alternative instruction a day earlier. On March 13, Tolar’s update included a challenge to colleagues: “Leadership is not measured by meetings or committees,” he wrote. “It is the ability and willingness to stand up to the challenge and deliver a rational, measured, effective response. Over and over again.”

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Telemedicine Training Proves Vital During Covid-19 Crisis, Increasing Access to Care

Author: Weill Cornell Medicine, Office of External Affairs
Submitted by: Catherine Hagele, Perelman School of Medicine at the University of Pennsylvania

The doctor will see you now – virtually.

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Doctors Are Scrambling to Learn "Webside" Manner

By: Ashley Abramson
Submitted by: Marsha Harman, Rush University

As patients turn to telemedicine, doctors must learn to convey empathy over screens. This short article includes some tips and tricks from the medical director of a telehealth service, as well as a discussion of what is gained and lost on video vs. in-person visits. One hospital uses video calls for COVID patients while they are in the hospital so that doctors and nurses can converse with them without wearing PPE, so the patients can see the providers’ facial expressions instead of just seeing a mask. As we are all preparing to offer more “telesim” learning opportunities, I found this article helpful in articulating some of the challenges and opportunities for our learners and our SPs.

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Using Simulation-based Learning to Provide Interprofessional Education in Diabetes to Nutrition and Dietetics and Exercise Physiology Students Through Telehealth

Lead Author: Marie-Claire O’Shea
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

This study describes a telehealth interprofessional simulation-based learning experience with nutrition and dietetics and exercise physiology students. The common practice area of interacting with patients who have type 2 diabetes was targeted, and the simulation was delivered in partnership with simulated patients via a telehealth platform to allow interprofessional teams to work collaboratively in remote locations.

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Relaxation Techniques for Anxiety

Medically Reviewed By: Wendy M. Yoder, PH.D.
Submitted by: Kathy Herzberger, Loma Linda School of Medicine

These are trying times. I am sure everyone is feeling more anxiety during this period of uncertainty. We are concerned for the health of our loved ones and ourselves. Those of us still working are under more stress trying to develop innovative techniques to continue our jobs. I know I am feeling anxious and tense. This article provides techniques that we have probably heard of before, but it is a nice reminder to know there are positive skills we can insert into our lives to help us remain mentally and physically healthy.

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How RPG Logic and Simulations Are Changing the Game in Healthcare

Author: Gadjo Sevilla
Submitted by: Kerensa Peterson, National Board of Osteopathic Medical Examiners

Role-playing games (RPG) are as old as time, but software developers are integrating RPG logic into many different technologies used within healthcare simulations. As Natural Language Processing and augmented reality technologies become more sophisticated, so do their uses in healthcare simulations. Organizations like the Center for Disease Control and the Robert Wood Johnson Foundation are investing resources in the development of these training tools which allow learners to try, fail and learn from their mistakes over and over again. Take a look at the article for a link to one of the simulations made public through a grant from the Robert Wood Johnson Foundation.

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In The Spotlight: Elon University

Submitted By: Nita Skillman

Full Center Name: School of Health Sciences

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SP Practice From My Corner of the World

Author: Louise Schweickerdt, SP Facilitator, Skills Centre, Sefako Makgatho Health Sciences University, South Africa

My corner of the world is a country, renowned to be one of the most diverse and beautiful places on earth. It is also a country that is plagued by realities like planned power outages (load shedding), precarious internet, violence, strikes, horrific roads and a constant and intense awareness that safety, security and/or efficient health services are not a given.

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She Didn’t Want a Pelvic Exam. She Received One Anyway.

By: Emma Goldberg, The New York Times
Submitted by: Todd Lash, The Ohio State University

Janine, a nurse in Arizona, checked into the hospital for stomach surgery in 2017. Before the procedure, she told her physician that she did not want medical students to be directly involved. But after the operation, Janine said, as the anesthesia wore off, a resident came by to inform her that she had gotten her period; the resident had noticed while conducting a pelvic exam. “What pelvic exam?” Janine, 33, asked. Distressed, she tried to piece together what had happened while she was unconscious. Why had her sexual organs been inspected during an abdominal operation, by someone other than her surgeon? Later, she said, her physician explained that the operating team had seen she was due for a Pap smear.

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Hidden Brain – When Everything Clicks: The Power of Judgment-Free Learning

Author: Shankar Vedantam,
Submitted by: Dan Brown, Emory University

Hidden Brain is a podcast that “reveals the unconscious patterns that drive human behavior, and the biases that shape our choices.” Nearly every episode illuminates our work in Human Simulation in some way, but the episode “When Everything Clicks” is particularly applicable. The episode is an exploration of how we learn, and the environments in which we’re expected to learn, and the keys to success and failure as a learner.

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IMSH 2020 Plenary Speaker: Cary Lohrenz

Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

I had the good fortune to attend the 2020 International Meeting on Simulation in Healthcare conference in San Diego this past January. Not only did I enjoy beautiful San Diego and the warm weather, but I took in a variety of keynote speakers and a number of inspiring workshops and talks.

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Three-Dimensional Needs of Standardized Patients in Nursing Simulations and Collaboration Strategies: A Qualitative Analysis

Lead Author: Hye-Rim Jin
Submitted by: Kerensa Peterson, NBOME Chicago

The authors of this study in Korea have asked what drives Standardized Patients to do great simulation work.  Their results give further explanation to studies that have been conducted since the 1990s, offering examples of how SPs find meaning in their work, are shown empathy for their work, and participate in the education process.

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Reliability of Scores Obtained from Standardized Patient and Instructor Assessments

Lead Author: Gulsen Tasdelen Teker
Submitted by: Kathy Herzberger, Loma Linda School of Medicine

We all know how hard it is to recruit instructors to participate in OSCE assessment. One alternative is to use standardized patients as raters. However, are they as reliable as instructors are? Although not a large study, I found the results very interesting.

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