By: Sarah Waller
Submitted by: Todd Lash, Publications Committee Chair

In the hallway of Samford University’s Experiential Learning and Simulation Center, a “standardized” patient stumbled to the ground to simulate a patient experiencing cardiac arrest. The Doctor of Physical Therapy student who was with him jumped into action and called a code. Within seconds, an interprofessional team of students gathered. Undergraduate nursing students took over CPR, Doctor of Pharmacy students prepared the needed medications and Master of Social Work students attended to the patient’s family. This is just one scenario that students were able to experience together during the College of Health Sciences’ annual Acute Care Simulation.

By: Helen Wilbers
Submitted By: Michael Maury, UC-San Diego

Gina Shannon, associate director at the Emory University School of Medicine’s Clinical Skills Center and ASPE member, spoke at Westminster College’s Hancock Symposium on Tuesday, September 11^th, 2018, about the purpose of simulated patients in Medical Education. As Wilbers lays out in this article, Shannon points out the importance of using SPs “to teach doctors to empathize and communicate with patients.” Wilbers writes that Shannon contemplated, "If a health care provider is with a patient and they aren't in agreement, where can that relationship go?" Wilber discusses how Shannon relies on her 7 years of theatre teaching and applying the rules of improv to the clinical setting. With an emphasis on the important improv tenet of ‘yes-and’ Shannon successfully guides doctors toward an acceptance and mutual agreement of what is being laid out by a patient. Shannon says, "If we're in a scene together the only way we can elevate the scene and keep it going is by agreeing."

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

Several studies have found that exams consisting of multiple-choice questions—particularly the United States Medical Licensing Examination—are not the best or only evaluation method for postgraduate residency selection. To that end, Dr. Senthil Rajasekaran and the team at Eastern Virginia Medical School is developing video vignettes of standardized patient encounters. He believes they are a practical, effective option for assessing a student’s clinical acumen.

Lead Author: Timothy C. Clapper, MA
Submitted by: Amber Snyder, University of Pittsburgh

Understanding adult learning theory is essential for all educators who are working with adult learners. Those working in simulation often access Malcolm Knowles theory of andragogy to ensure that curriculum addresses the needs of adult learners.

By: Jan Hoffman
Submitted By: Michael Maury, UC-San Diego

According to the Centers for Disease Control and Prevention, addiction — whether to tobacco, alcohol or other drugs — is a disease that contributes to 632,000 deaths in the United States annually. But comprehensive addiction training is rare in American medical education. A report by the National Center on Addiction and Substance Abuse at Columbia University called out “the failure of the medical profession at every level — in medical school, residency training, continuing education and in practice” to adequately address addiction.

By: Joshua Niforatos
Submitted by: Mary Launder, Rosalind Franklin University of Medicine and Science

After introducing myself as a first-year medical student working with the attending physician, I went through the medical history with the patient to ascertain his chief complaint and the history of present illness. Since this was only a six-month follow-up appointment in an internal medicine outpatient clinic, there was not much to cover besides checking whether his medications were up-to-date and how he had been managing his chronic conditions. As this was my last patient of the day, I asked if I could practice various aspects of the physical exam that were not necessary for his appointment. Typical of my experience in longitudinal clinic, the patient obliged and thought it was great that he would get some “additional care.” “Are you a fellow or something?” he asked during the exam. “No, no. I’m a first-year medical student,” I reminded him.  It seems that “fellow” and “medical student” were synonymous to this individual. Part of the curriculum of my medical school includes various readings in both the social sciences and the humanities. We recently reflected upon the titles we are known by, such as medical student, student physician or student doctor. More specifically, what is meant by the names and titles we are known by? After contemplating how to introduce myself to patients, I offer the following reflection.

Submitted by: Todd Lash, Publications Committee Chair

Oakland University William Beaumont School of Medicine (OUWB) and University of Detroit Mercy School of Dentistry (Detroit Mercy) will launch a new interprofessional course to educate medical and dental students on how health care professionals collaborate for the benefit of their patients.

Lead Author: Shelley Zhang
Submitted by: Kerensa Peterson, Northwestern University

As other clinical professions enter the world of simulation, their questions and development are catalogued in research. The pharmacy profession is an example of a clinical profession that is evolving to include a larger emphasis on communication skills and collaborative care. New simulation practitioners are asking how to assure quality in their newly developed standardized patient (SP) programs. This article focuses on the authors’ recommendations and applications for quality assurance in SP programs through a thematic analysis of the current scholarly literature.

Lead author: Cynthia L. Foronda
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

There has been increased focus on the need to combat inequities in healthcare by teaching cultural humility. As SPEs, we know SPs are a fantastic tool to teach this skill. However, this review of literature shows there is a lack of studies published involving the use of simulation to teach cultural humility. The authors point out that “current international simulation standards lack an emphasis on diversity and cultural humility; thus, simulation curricula may be missing this essential component.” The study identified the need for more robust research on the subject. Let’s get cracking.

Lead Author: Mary Ann Forgey
Submitted by: Amber Snyder, University of Pittsburgh

Assessment in intimate partner violence (IPV) is an essential component to determine the course of interventions and support provided. This study used Standardized Clients (SC) to train eight Army civilian social workers to implement an evidence-based assessment protocol of IPV.

Authors: Richelle K Marracino, MD and Robert D Orr, MD
Submitted by: Mary Launder, Rosalind Franklin University of Medicine and Science

Oscar Thompson, a third-year medical student on a shift in the emergency department, is eager to participate in as many procedures as possible. According to the triage nurse's history, the next patient to be seen is a 58-year-old man who has had fever, headache, and neck stiffness. Anticipating his first lumbar puncture, Oscar approaches the room with enthusiasm. The nurse whispers that the patient is irritated and can't wait to see the doctor. The student pauses, draws back the curtain, and says, “Hello, I'm Dr. Thompson, how can I help you today?”

Lead author: Christine Bradway, PhD, GNP-BC
Submitted By: Michael Maury, UC-San Diego

This pilot study aimed to compare a group of interprofessional health professions students' self-reported level of confidence in communication, explore behavior change and professional identity, and identify areas for future interprofessional education. Students participated in a simulated team meeting with a standardized family member of an older adult patient hospitalized with an acute aspiration pneumonia and a chronic, progressive illness.

Conference: ASPE Town Hall Report
By: Valerie Fulmer, President, ASPE

The June ASPE conference in Kansas City was a rewarding time to connect with many ASPE members in person; however, I realize that it probably feels like a distant memory at this point. Many members were not able to attend, which may leave some feeling “out of the loop.” Let us start with some conversations the membership had with the executive committee (EC) during a “Town Hall” meeting at the conference. 

General Interest: International perspective on word describing symptoms - Use of Onomatopoeia to Enhance Emotional Expression during Medical Encounters in Asian Countries
By: International Committee work
Submitted by: Keiko Abe, International Committee Chair, Aichi Medical University

Onomatopoeia is a term that comprehensively refers to "mimetic word." Examples of onomatopoeia in English include “cuckoo,” “sizzle,” “hiccup,” or “buzz,” in that the words imitate the sounds they describe.

Research Article: Nursing and Social Work Trauma Simulation: Exploring an Interprofessional Approach
Lead Author: Sara Manning, M.S.
Submitted by: Amber Snyder, University of Pittsburgh

Individual competencies in the fields of Nursing and Social Work are essential to be successful in the profession. Equally as important is the competence to work successfully interprofessionally. This article describes an interprofesional training strategy which combined nursing and social work programs to create one simulation.

General Interest: Medical School – Learning More Than Just Facts
By: Adam Nessim
Submitted by: Anna Lank, C3NY – Clinical Competence Center of New York

Here is a link to a terrific blog post by an Albert Einstein College of Medicine students about his work with the C3NY Standardized Patients at the end of his second year.

General Interest: Right Coat Ceremony
By: Shadi Ahmadmehrabi
Submitted by: Dyan Colpo, Cleveland Clinic Simulation and Advanced Skills Center

It was my first day of orientation at medical school. In a hallway stood a coat rack overflowing with white garments. I set down my accumulated papers, reached for a hanger and, for the first time ever, shrugged first one arm and then the other into a white coat. It was too large, but I had no other options. The unisex coats ran from XXS to XXL, but the smallest had all been claimed.

General Interest: Avoiding Jargon, Building Empathy Will Be Focus at New Fort Worth Medical School
By: Bill Zeeble
Submitted By: Michael Maury, UC-San Diego

A new medical school will be opening next year in Fort Worth, Texas as a joint effort by Texas Christian University and the University of North Texas Health Science Center. This new school is taking a different approach to medical education as it “will feature a four-year curriculum in communication, a program believed to be the first of its kind in the country.” The school’s assistant dean for Narrative Reflection and Patient Communication, Dr. Evonne Kaplan-Liss believe that “by injecting regular lessons in communication as early as the first semester, graduates and their patients should emerge healthier.” She goes on to say that the difference in this new school is that the communications education is “embedded throughout their four years of curriculum. It’s not labeled as ‘communications.’ It’s part and parcel of everything that they’re doing.”

Research Article: “I need to know what makes somebody tick …”: Challenges and Strategies of Implementing Shared Decision‐Making in Individualized Oncology
Lead author: Joschka Haltaufderheide
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

Shared decision‐making (SDM) has been advocated as an ethical framework for decision‐making in cancer care. When using SDM, patients make decisions in light of their values and based on the available evidence. However, SDM is difficult to implement in cancer care. This empirical‐ethical study explores current difficulties in translating the concept of SDM into clinical practice. SP methodology is an excellent tool to help prepare practitioners to explore patients’ values and preferences before making decisions.

Research Article: Assessing Mental Health First Aid Skills Using Simulated Patients
Lead Author: Sarira El-Den
Submitted by: Kerensa Peterson, Northwestern University

Many of us who work in simulation recognize the temptation of learners to say, “I already know how to do this.” When learners must self-assess their skills and then perform those skills, there is sometimes inaccuracy in that reflection. A group of researchers at the University of Sydney tackled the question of self-assessment in regards to mental health first aid skills. By utilizing a self-evaluation followed by two simulated patient roleplays with each participant, the researchers were able to find some startling results in the confidence levels versus the observed performance of those learners’ skills.