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In The Spotlight: Emory University School of Medicine

Submitted By: Dan Brown

Full Center Name: Clinical Skills Center

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Introducing the ASPE Center Spotlight

By: Todd Lash, The Ohio State University

The Publications Committee is pleased to announce an exciting new feature on the ASPE eNews Blog: The ASPE Center Spotlight. Inspired by Bob Bolyard’s member liaison project in 2018, a looping slide presentation displayed at the ASPE conference that featured photographs and statistics from multiple centers and programs, the Publications Committee sought to transform the project as a way to foster community and connection among members beyond the conference. To this point, the Publications Committee will feature one center or program per month on the ASPE eNews Blog in 2020. The mission of the ASPE Center Spotlight is to connect SP programs and simulation centers, and promote interagency and interdisciplinary collaboration in SP and simulation methodology. In addition, photographs and statistics published on the eNews Blog will be added to the slide presentation that will be displayed each year at the ASPE conference.

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Improving Lesbian, Gay, Bisexual, Transgender, and Queer/Questioning Health: Using a Standardized Patient Experience to Educate Advanced Practice Nursing Students

Lead Author: Elizabeth K. Kuzma
Submitted by: Catherine Hagele, Perelman School of Medicine at the University of Pennsylvania

Over the last few years, nursing education has begun to embrace the need for LGBTQ content in nursing curricula. When compared with their heterosexual and cisgender counterparts, individuals identifying as LGBTQ face notable health disparities including increased disease and mortality, poorer health outcomes and higher rates of certain illnesses as well as biopsychosocial disparities. This pilot project increased knowledge, comfort and skills relating to interactions with people who identify as LGBTQ.

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For Busy Medical Students, Studying Meditation for Two Hours May Be Just as Beneficial as Longer Course

Author: Neal Buccino
Submitted by: Catherine Hagele, Perelman School of Medicine at the University of Pennsylvania

For time-crunched medical students, taking a two-hour introductory class on mindfulness may be just as beneficial for reducing stress and depression as taking an eight-week meditation course, a Rutgers study finds. Researchers say many medical students would like to use meditation to avoid burnout and provide better medical care, but are daunted by the prospect of making time for a daily meditation routine. While this article focuses on medical students, there are many parallels between their stress and time-crunch that Standardized Patient Educators also experience.

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Use of Simulated Patient Encounters to Teach Residents to Respond to Patients Who Discriminate Against Health Care Workers

Lead Author: Ellen H. Eisenberg
Submitted by: Marsha Harman, Rush University

This article describes a workshop for first-year residents that used standardized patients to practice responding to patients exhibiting bias against members of the health care team. The workshop included a didactic session and four scenarios in which standardized patients portrayed patients with bias based on gender, class, or race.  Learners received feedback from a trained facilitator, peers, and the standardized patients. One hundred percent of the 19 learners who participated agreed that the simulated exercises were realistic and improved their readiness to address patient bias.

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Five Reasons It Can Be Hard to Talk to Your Doctor—And Four Ways to Do It Better

By: Gillian Rutherford, University of Alberta
Submitted by: Michael Maury, UC-San Diego

In her talk entitled “Co-Creating Care to Improve Medicine”, University of Alberta endocrinologist Rose Yeung shares that, “Miscommunication, or under communication, happens regularly between patients and their doctors, nurses, dietitians and even naturopaths.” Those of us in Medical Education understand this truth all too well. In this article, Gillian Rutherford points out why it may be difficult for most to speak with their doctor and lays out four ways in which we can overcome this challenge. Yeung mentions, “The patient and the professional are supposed to deliberate and come up with an acceptable treatment plan together.” Remembering that physicians and patients are in this health care experience together as a team, is just one piece to the solution. Please press on for more insights and ideas.

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Evaluating Shared Decision-making in Periviable Counseling Using Objective Structured Clinical Examinations

Lead Author: Brownsyne Tucker Edmonds
Submitted by: Kerensa Peterson, NBOME Chicago

Shared Decision Making (SDM) has been widely endorsed as a favorable practice for patient-centered care.  However, it is underutilized in clinical practice and has lacked tools for assessment.  There are studies which support the use of shared decision-making tools in advanced care planning, but few tools for SDM have been tested in a periviable setting.

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A Good Physician — On Complacency and Communication

Author: Michelle M. Kittleson, M.D., Ph.D.
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

“I recently cared for a 45-year-old man for over a month and never spoke to him.” This moving reflection from Dr. Kittleson details her realization about the lack of communication with her patient awaiting a heart transplant who is also deaf. “I fell into a complacency born of pragmatism and confidence in my abilities: I knew I was providing the best medical care, so I ignored the importance of direct communication.” This personal story highlights the need for direct doctor-patient communication no matter what perceived barriers exist – a concept for which SP educators continue to advocate.

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An Overview of How to Encourage the Standardized Patient (SP) Teaching Methodology – From the Perspective of a SP and SP Trainer

By: Wu Jiansheng
Submitted by: Todd Lash, Publications Committee Chair

As one of the first generation of Standardised Patients in China, perhaps Asia as well, I have been working in the clinical skills training center in West China Medical School of Sichuan University for 25 years. I would like to share with you how I joined this little-known and somewhat mysterious field, participated in this form of teaching, and progressed from a normal SP to a SP trainer. It is noted that the Standardised Patient (SP) was first introduced by Howard Barrows in 1963. In 1993, West China School of Clinical Medicine, Sichuan University was the first to do the training courses and trained the first group of SPs. In 2003, China Medical Board (CMB) America organized a “Student Evaluation Plan Program”; 8 Chinese medical schools joined and imported the training program to China.

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Why We Forget What the Doctor Told Us (and What to Do About It)

Author: Cleveland Clinic Health Essentials
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

Has your mind ever gone blank after leaving your doctor’s office? You may be trying to remember the specific instructions or the answers to your “what if questions” - “What if I don’t feel better after a couple of days?” “What if I miss a dose of my medication?” “What if I feel worse in the middle of the night?”

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Perceptions of a longitudinal standardized patient experience by standardized patients, medical students, and faculty

Lead author: Lauren Block
Submitted by: Mary Launder, Rosalind Franklin University of Medicine and Science

Background: Longitudinal standardized patient (LSP) experiences mimic clinical practice by allowing students to interact with standardized patients (SPs) over time. LSP cases facilitate practice, assessment, and feedback in clinical skills and foster an appreciation for the continuum of care.

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New Fort Worth Med School Turns to Coaches to Preserve Student Empathy

By: Christopher Connelly
Submitted by: Michael Maury, UC-San Diego

“Medical school is draining. It’s a mix of sleepless nights spent studying, a lot of student debt, massive pressure to succeed, and learning to treat difficult patients over long hours at the hospital. This recipe for mastering medicine been used to train generations of physicians, but it bakes in a problem: Over the course of their studies, medical students tend to become less empathetic. The issue is that empathy is increasingly valued as an essential tool for physicians, says Dr. Danika Franks, assistant dean of students for the Texas Christian University-University of North Texas Health Science Center School of Medicine in Fort Worth.” Author Christopher Connelly reports how Dr. Franks and her school are looking to foster more empathy within their students as they progress through their studies.

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How Does Health Care Simulation Affect Patient Care?

Lead author:  Joseph O. Lopreiato, MD, MPH
Submitted by:  Dyan Colpo, Cleveland Clinic, Simulation and Advanced Skills Center

Health care simulation programs have spread to many parts of the United States health care system, including hospitals, medical and nursing schools, community college programs, and clinics. Many educational and training units use simulation to help teach new skills, refresh old skills, and promote teamwork in the delivery of health care.

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Standardized Patients Teach Skills and Empathy

Lead author: Dinah Wisenberg Brin
Submitted by: Mary Launder, Rosalind Franklin University of Medicine and Science

This is a great article to pass along to anyone interested in what the world of simulation is about as well as its positive outcomes.

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A Pilot Project Exploring Medical Students’ Barriers to Screening for Intimate Partner Violence and Reproductive Coercion

Lead Author: Sarah E. Stumbar, MD, MPH
Submitted by: Catherine Hagele, Perelman School of Medicine at the University of Pennsylvania

Why is it that most health care practitioners do not routinely screen patients for intimate partner violence (IPV)? This third-year family medicine clerkship included a pregnancy options counseling OSCE aiming to explore students’ internal barriers to screening patients for IPV. Even though the educational module included scripted screening questions, students reported a major barrier to screening was difficulty finding the words with which to ask the questions, thereby suggesting that these kinds of practice encounters may be more effective, offering a performance model that can support skills acquisition.

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ASPE SOBP Receive Special Contribution Award

Submitted by: Todd Lash, Publications Committee Chair

The ASPE Standards of Best Practice (SOBP) received a special contribution award for advancing SP methodologies in China. The award came from the China SP Practice Teaching Guidance Committee (CSPC) and the China International Association for Promotion of Science and Technology (CIAPST).

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Where Improv Meets Dementia: Play Along With Your Partner's Strange Conversation

By: Gary Rotstein
Submitted by: Michael Maury, UC-San Diego

Author Gary Rotstein states in this article, “Performers in improvisational sketch comedy learn basic guidelines: Speak in positives, think of your partner, listen well, give helpful prompts” and “don’t be long-winded.” He goes on to say, “Caregivers for those with dementia rarely hear that same advice, but they should — it might ease a lot of stress on both sides.” Many of us in Medical Education have seen the benefits and value of utilizing humanitarian practices such as improvisational theatre to better communication between patients and caregivers. Could the art-form of improv be utilized to better communication with patients living with dementia? Please read on to see how improvisational theatre skills have worked for Rachael Wonderlin and Christopher Wright of the “Agreeing to Remember” workshops at Steel City Improv Theatre in Pittsburgh, PA. Read the full article in the Pittsburgh Post-Gazette here.

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Communication Skills and the Problem with Fake Patients

By: George Gillett, Fourth Year Medical Student
Submitted by Kathy Herzberger, Loma Linda School of Medicine

George Gillett, who was a fourth year medical student when he wrote this article, expressed an interesting perspective regarding empathy and standardized “fake” patients. Included in this discussion is a suggestion from Anu Atluru, MD that “improv’s fundamental principles of honesty and spontaneity” might be helpful in teaching students how to acknowledge feelings without the rote “I’m sorry to hear that…” The opinions expressed are certainly issues to ponder as we develop future communication curriculum and assessment.

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Maximizing the Acquisition of Core Communication Skills at the Start of Medical Training

Lead Author: Hasan Mohiaddin
Submitted by: Marsha Harman, Rush University

How does contact with actual patients affect how medical students develop communication skills, and how does it impact their performance in an SP encounter? First year medical students at Imperial College London learn communication skills through lectures, small group teaching, and SP encounters. This study compared two groups of first-year students; the study group experienced repeated contact with real patients as part of a volunteer organization aiming to reduce isolation in elderly inpatients, while the control group received only the formal curriculum on communication.

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The Link Between Health Literacy & Cancer Communication

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

In an era of increasingly complex advances in oncology, how can health professionals help cancer patients with low health literacy better understand their diagnoses and treatment options? In an effort to improve cancer communication strategies with patients, the National Cancer Policy Forum (NCPF) convened a meeting of invited speakers in Washington, D.C. At the meeting, the point was repeatedly made that skills in cancer communication can be taught and learned, and it is the responsibility of health professionals to make sure all their patients (including those with low health literacy) truly comprehend the information they are being given. We as SP Educators know that SP methodology is an excellent tool for practicing these communication skills.

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