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How Medical Improv Training Sparks Better Communication, Teamwork

By: Timothy M. Smith

Submitted by: Michael Maury, UC-San Diego

Some of the most adverse patient outcomes are caused by poor communication, so medical schools are adopting improv—improvisational theater training—to help students live more in the moment and better empathize with patients. A study published prior to the pandemic found that students used the skills they learned from it, but the gravity of COVID-19 now supplies the ultimate proving ground.

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In Our Own Time: Medical Students’ Informal Social Studying and Learning

Lead author: Daniela Keren

Submitted by: Kathy Herzberger, Loma Linda School of Medicine

Social studying and learning (SSL), according to the authors is any independent, elective, self-directed and self-organized approach to learning. The article explores what kind of SSL second year medical students developed, their viewpoints regarding the pros and cons, and their perceptions on how it affected their overall learning. How Covid has influenced SSL at this school would make for an interesting follow-up study.

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SP Stories: Corona Thoughts

By: David Weiss

Submitted by: Kerensa Peterson, NBOME

David Weiss is a Standardized Patient at Northwestern University and Rush University in Chicago, IL. David created a beautiful (and brief) sound story – listen to Corona Thoughts.

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Crisis Communication and Grief in the Emergency Department: A Podcast with Naomi George and Kai Romero

By: Eric Widera and Alex Smith

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

The Emergency Department (ED) is a hard place to have serious illness discussions, whether it be goals of care or code status discussions, or whether or not to consider intubation for a seriously ill patient. Emergency physicians often don't have the time for in-depth discussions, nor have been trained on how to do so. There often is limited information about the patient, their functional status, or their prognosis. These are some of the most challenging and some of the most important conversations in medicine, as 75% of older adults visit the ED during the last 6 months of life (data thanks to this Alex Smith publication in Health Affairs!) So how do we have these urgent conversations in a time of crisis to ensure that patients receive care that aligns with their goals? We have Naomi George, researcher and ED physician extraordinaire from the University of New Mexico, and Kai Romero from UCSF and Hospice by the Bay join our podcast to discuss.

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WVU Medicine Improving Care for Transgender Patients

Source: Cumberland Times-News

Submitted by: Todd Lash, The Ohio State University

Across the nation, many individuals who identify as transgender or gender diverse avoid accessing health care, even basic primary care, because of fear of discrimination or mistreatment — but WVU Medicine is implementing a number of strategies to improve care for that patient population.

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Addressing Race and Racism in Medical Education

Published by: Academic Medicine

Submitted by: Kerensa Peterson, NBOME

Academic Medicine has released a collection of articles that address race and racism in Medical Education.  The collection is geared toward a variety audiences within the Medical Education Community from medical students to simulation educators to faculty physicians to program directors.

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ASPE Webinar Review

The Social Construction of Race and its Impact on Medicine and Biomedical Research by John Chenault, PhD

By Dan Brown, Emory University

As mentioned in my recap of the opening plenary from the 2020 ASPE virtual conference, Dr. Chenault had to rush through the end of his plenary speech “Medicine and the Black Body,” and attendees were hungry for more, so as we’d hoped, he was invited to do a webinar. The webinar took place on Oct. 30, 2020, and the full webinar is available at the ASPE site. The discussion centered on three questions: What is race? What does medicine and biomedical research tell us about race? How useful are racial categories in biomedical research and practice?

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In The Spotlight: The Ohio State University

Submitted By: Todd Lash

Full Center Name: Clinical Skills Education and Assessment Center

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What does improv comedy have to do with medicine?

By: Jamie Bartosch

Submitted by: Michael Maury, UC-San Diego

While describing a simple exercise known as One-Word-Story, Jamie Bartosch writes “It’s a fun activity, but it serves an important purpose for these future doctors. It forces them to listen. This exercise, like the many others they engage in, makes them realize they don’t know where the story is going to go, so they must pay attention to verbal and non-verbal cues.” Skills like these are vital to successful patient care in medicine. While improv can provide some extra laughs, it ultimately “has nothing to with comedy” as University of Chicago Medicine pediatrician Nikki Orlov, MD states. “It’s all about improving advanced communication skills.”

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A Study on Evaluator Factors Affecting Physician-Patient Interaction Scores in Clinical Performance Examinations: A Single Medical School Experience

Lead author: Young Soon Park

Submitted by: Kathy Herzberger, Loma Linda University

Establishing major competencies and training for clinical performance in medical education has been prevalent in Korea for only the last 15 years. This is due to the clinical skills test that was added to the paper-based Korean Medical Licensing Examination (KMLE) in 2009. This crucial change in the KMLE has strengthened clinical performance in Korean medical schools. This interesting study emphasizes how evaluator factors as well as the type of scale utilized can influence physician-patient interaction scores.

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Empathy or Compassion: Which is Better for Patients and Providers?

By: Brian James

Submitted by: Todd Lash, The Ohio State University

Imagine a medical student sitting in the room across from a 50-year-old female standardized patient who presents with fatigue and vague abdominal pain. It’s their second year of medical school, and they know generally how to conduct a patient interview. They eventually reach the family history, concerned that any incidence of pancreatic cancer in the family may mean the standardized patient is in for a long, scary and painful journey of diagnosis and treatment. The question finally arises: any family history of a cancer diagnosis? The standardized patient, without skipping a beat, coldly tells you that her father passed away from pancreatic cancer over 10 years ago at age 59. The student knows what to do; they have been trained extensively in the ways of empathy. They pause, say “I’m sorry to hear that,” then pause again for dramatic effect.

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Humility Revisited

By: Zeke Hernandez

Submitted by: Michael Maury, UC-San Diego

“Stagnation happens when we adopt one of two extreme mentalities. On one extreme is overconfidence, which arises from underestimating the complexity of the situation and overestimating our own ability. On the other extreme is fear, which arises from overestimating the complexity of the situation and underestimating our own ability. In between the two extremes is humility. ”In these times of such extremes and great uncertainty, it is helpful to be reminded of humility. Can we approach each new moment and experience with curiosity and a beginner’s mindset? Perhaps even the act of tying our shoes could be performed differently as to yield better results.

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Love is Everything

By: Hamilton Sage, SP at Emory University

Interviewed by: Mary Launder, Rosalind Franklin University of Medicine and Science, and edited by Kerensa Peterson, NBOME

How has your experience as an SP changed since  the pandemic? Well, it’s definitely changed quite a  bit as far as just shifting over from in person  to Zoom, and actually, I think it was a very tall task considering the size of some of these events. There’s like 60 plus learners sometimes and [the staff’s] ability to set up different rooms and get it all logistically running smoothly, it’s been pretty cool. It’s been a blessing for me because I’ve been able to continue to have some income from home without having to put myself or my family at risk by going out and interacting with people. I’ve been really grateful for that.

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My SP Experience During the Pandemic

By: Susan Ganger, SP at The Ohio State University and Crossing Guard

Submitted by: Kerensa Peterson, NBOME

I will try my best to give my input into what it has been like to be a SP during this pandemic. I am at a bit of disadvantage as I had just started as a SP in February and only had one live interaction  before the shutdown occurred. So, I don't have a lot of experience with the pre-pandemic routine.

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My SP Experience During the Pandemic

By: Bill Goldsmith, SP and Theatre Artist

Submitted by: Todd Lash, The Ohio State University and Kerensa Peterson, NBOME

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In The Spotlight: Rosalind Franklin University of Medicine and Science

Submitted By: Cory Krebsbach

Full Center Name: Center for Advanced Simulation in Healthcare

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ASPE Annual Conference Poster Winners

ASPE Annual Conference Poster Winners
Submitted by: Todd Lash, The Ohio State University

The ASPE 2020 Annual Conference featured 10 innovation and 6 research poster submissions. Kevin Hobbs announced the winners during the Awards Ceremony on Friday, August 14, 2020. Poster judges included Kerry Knickle, Nancy McNaughton, Karen Szauter, Jane Miller, Cate Nicholas, Temple West, Emma Vic and Jackie Klevan.

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5 Ways the Health-Care System Can Stop Amplifying Racism

5 Ways the Health-Care System Can Stop Amplifying Racism
Lead Author: Ezekiel J. Emanuel
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

The coronavirus pandemic didn’t create the health disparities among Americans, but it has exposed once again how stark the problem is. Black and Latino patients are two to three times as likely as white patients to be diagnosed with COVID-19, and more than four times as likely to be hospitalized for it. Black patients are more than twice as likely to die from the virus. They also die from it at younger ages. COVID-19 has exacerbated long-standing trends: Black and Latino Americans have lower rates of insurance coverage, a higher prevalence of chronic diseases, worse health outcomes, and a lower life expectancy. People in the health-care world sometimes speak of these patterns as if they are inevitable facts of life—something the industry is powerless to change. More doctors and hospitals need to acknowledge and address how the U.S. health-care system is rife with structural racism. For decades, American medicine has discriminated against people of color.

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ASPE Virtual Conference Opening Plenary: John Chenault – “Medicine and the Black Body”

By Dan Brown, Emory University

Social Justice was a common theme throughout ASPE’s virtual conference, and Prof. John Chenault set the tone in his opening plenary, with a moving introduction by University of Louisville colleague Carrie Bohnert. In his presentation, Medicine and the Black Body, Chenault began by clarifying the definition of race as an artificial societal construct, and presented the pseudoscience that perpetuated racism, as well as the legal precedents introduced that created a divide and a definition for what level of mixed ancestry legally qualified a person as a “Negro.” He then walked the attendees through the grim history of medicine and its treatment of African slaves and their descendants: many medical advances came at the expense of Black bodies, including unethical cadaver sourcing, experimental surgeries and studies, drug trials, and more. He then connected this painful history to present day health disparities.

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Manifesto for Healthcare Simulation Practice

Lead Authors: Christine S. Park, Lou Clark, Grace Gephardt, Jamie M Robertson, Jane Miller, etc.
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

A pandemic has sent the world into chaos. It has not only upended our lives; hundreds of thousands of lives have already been tragically lost. The global crisis has been disruptive, even a threat, to healthcare simulation, affecting all aspects of operations from education to employment. While simulationists around the world have responded to this crisis, it has also provided a stimulus for the continued evolution of simulation. We have crafted a manifesto for action, incorporating a more comprehensive understanding of healthcare simulation, beyond tool, technique or experience, to understanding it now as a professional practice. Healthcare simulation as a practice forms the foundation for the three tenets comprising the manifesto: safety, advocacy and leadership. Using these three tenets, we can powerfully shape the resilience of healthcare simulation practice for now and for the future. Our call to action for all simulationists is to adopt a commitment to comprehensive safety, to advocate collaboratively and to lead ethically.

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