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Development of an Empathy and Clarity Rating Scale to Measure the Effect of Medical Improv on End-of-First-Year OCSE Performance: A Pilot Study

Lead Author: Carol A. Terreginoa,
Submitted by: Michael Maury, UC-San Diego

Patients want empathetic physicians who listen and understand. How do you teach and measure empathy? The objective of this study was “To develop a framework and instrument, the Empathy and Clarity Rating Scale (ECRS), for measuring communication elements used by actors and physicians, and pilot ECRS to test effectiveness of medical improv on first-year students’ communication skills.” Four medical schools collaborated. USMLE Step 2 Communication and Interpersonal Skills (CIS) domains were used as framework for discussion among three focus groups, each with clinicians, actors, communication experts, and community members with patient experience. Audiotaped discussions were transcribed; open coding procedures located emerging themes. Final ECRS was used to study student performance across three levels of experience with medical improv. What was developed from this pilot study was “a communication scale enlightened by experiences of actors, clinicians, scholars and patients.”

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Your Professional Decline is Coming Sooner Than You Think

Author: Arthur C. Brooks
Submitted by: Dan Brown, Emory University

This article is relevant to any creative professionals; to anyone who finds their value in the quality of their work.

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How to Define Core Entrustable Professional Activities for Entry into Residency?

Lead Author: Ylva Holzhausen
Submitted by: Mary Launder, Rosalind Franklin University of Medicine and Science

The definition of core Entrustable Professional Activities (EPAs) for entry into postgraduate training has become an active field of development. Many institutions are currently considering the use of EPAs as outcomes for their undergraduate medical programs. These institutions can build in part on EPAs which have been reported at a national level and at a local level, but will be required to undertake their own content validation process to adapt these EPAs to their specific context. However, available reports do not include a fully detailed description of the EPA development process which could guide other institutions. In this article, we report in detail on a systematic, literature-based approach we employed to define core EPAs for entry into residency as outcomes for the undergraduate medical curriculum at Charité - Universitaetsmedizin Berlin, Germany.

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Saving the Family Physician One Doctor at a Time through ‘Lifestyle Medicine’

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

Physician burnout, especially among family doctors who often labor long hours with little support, is a major problem in the United Sates, contributing to a growing nationwide shortage of practitioners. Bethlehem, Pennsylvania-based St. Luke’s University Health Network has launched an innovative residency program to stop burn-out before it happens. The new program promotes “lifestyle medicine” not only for patients, but also for doctors themselves.

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Medical Education Trends for Future Physicians in the Era of Advanced Technology and Artificial Intelligence: An Integrative Review

Lead Author: Eui-Ryoung Han
Submitted by: Kathy Herzberger, Loma Linda School of Medicine

Medical education must adapt to different health care contexts, including digitalized health care systems and a digital generation of students in a hyper-connected world. The aims of this study are to identify and synthesize the values that medical educators need to implement in the curricula and to introduce representative educational programs.

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Effect of a Single-Session Communication Skills Training on Empathy in Medical Students

Lead Author: Cheryl D’souza
Submitted by: Catherine Hagele, Perelman School of Medicine at the University of Pennsylvania

Empathy scores have been found to decline over the years spent in medical school. These authors aimed to evaluate the change in empathy levels in medical students following a single-session communications skills training. While levels initially went up, they then went down after a few weeks. A regular communications skills training program may enhance empathy and prevent its decline over the years.

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Parent-Provider Paediatric Literacy Communication: A Curriculum for Future Primary Care Providers

Lead Author: Tiffany Kindratt
Submitted by: Kerensa Peterson, NBOME Chicago

Scholarly literature has expanded on the benefits of literacy programs designed to get parents and children between the ages of 6 months to 5 years reading together. Many of those studies have shown that training in residency on programs like Reach Out and Read may improve knowledge, skills, and attitudes toward pediatric literacy. Previous studies, however, lacked simulation experiences in which learners can practice the communication skills necessary to engage with patients and caregivers.

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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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