Co-constructive Patient Simulation: a Learner-centered Method to Enhance Communication and Reflection Skills

Lead Author: Andres Martin, MD
Submitted by: Claudia Arancibia, Leonardo Pérez & Iván Silva, Clinical Skills Center, University of Chile

Co-construction of clinical scenarios could drive one to achieve best practices in simulation. Here, Martin et. al. presents a "co-constructive patient simulation model" highlighting the active collaboration of clinical instructors, standardized patients, and students. In summary, co-constructive patient simulation offers a novel strategy to engage learners and promote significant learning and relevant experiences that balance the cultivation of their professional competencies with the specific needs of the learners themselves enhancing communication and reflecting skills.

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The Use of Clinical Simulation to Address Disability Content Inclusion in Nursing Education: A Review of The Literature

Lead Author: Eda Ozkara San
Submitted By: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

Nursing students receive limited education to prepare them for providing quality nursing care to people with disabilities. The aim of this article is to provide the state of the science, or what is known, about nursing simulation with disability content to provide direction for nursing education and research in the future. Thirteen studies were reviewed and appraised in this integrative review. This review revealed three major student-related study outcomes for simulation activities: (a) empathy, (b) understanding and awareness, and (c) communication and disability. Only a few studies integrated a definition of a disability and specified the disability model to guide the development of the simulation activity. This review revealed limited research on the use of simulation with disability content in nursing education. The findings indicate there is a need for nurse educators and researchers to use best practices, such as a competency-based approach, when integrating simulation activities with disability content into the nursing curriculum.
Read the full study here.

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Teaching Students as a Family

Author: Erika Klein
Submitted by: Kerensa Peterson, University of California Riverside

Many of you are familiar with the joys of Simulated Patient work. But how many of you have had the fortune of working with multiple generations in your SP Program? At UCR, I’ve had the privilege of working with a young woman, her mother and her grandmother. Our Communication team at the School of Medicine heard about our three generations of SPs and wrote a short piece about them. I hope you enjoy this quick read about their love and passion for SP work!

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The Role of Standardized Patient Programs in Promoting Equity, Diversity, and Inclusion: A Narrative Review

Lead Author: Derya Uzelli Yilmaz, RN
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

Integrating equity, diversity, and inclusion (EDI) in curricula for training health professionals is a frequent institutional goal. Here the authors present a theoretical model based on a synthesis of the literature for using standardized (or simulated) patient programs (SPPs) in EDI training, along with a narrative review of the available literature between January 2000 and October 2019. Three primary themes emerged: improving cultural competence, effective communication with diverse patients, and highlighting health inequalities.

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Integrating the Electronic Health Record Into Patient Encounters: An Introductory Standardized Patient Exercise for Preclinical Medical Students

Lead Author: Joseph A. Cristiano, MD
Submitted by: Erin Walsh, Rosalind Franklin University of Medicine and Science

This article explores incorporating the electronic health record (EHR) into simulated patient encounters with standardized patients. The authors created a formative exercise where preclinical medical students practiced EHR related communication and data collection while interviewing standardized patients. Two-hundred and eighty- nine second-year students took part in the exercise and most rated the activity as extremely or quite effective. The article suggests the training session was a valuable exercise to introduce preclinical medical students to integrating the EHR in patient encounters. Details of the exercise are included in the article.

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Medical students’ experiences when empathizing with patients’ emotional issues during a medical interview – a qualitative study

Lead Author: Knut Ørnes Brodahl
Submitted by: Marsha Harman, Rush Center for Clinical Skills and Simulation

There are few in-depth studies investigating medical students’ own experiences when trying to empathize in concrete clinical encounters. This study explores medical students’ perceptions, experiences, and reflections when empathizing with patients expressing emotional issues. After conducting an interview with a Standardized Patient, participants were asked to reflect on their internal experiences during the encounters. Five themes which may influence student empathy during history-taking were identified through analysis of interview data: (1) Giving priority to medical history taking, (2) Interpreting the patient’s worry as lack of medical information, (3) Conflict between perspectives, (4) Technical communication skill rather than authentic and heart-felt and (5) The distant professional role. 

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Developing standardized patient-based cases for communication training: lessons learned from training residents to communicate diagnostic uncertainty

Lead Author: Dimitrios Papanagnou
Submitted by: Marsha Harman, Rush Center for Clinical Skills and Simulation

Effective case design is essential to ensure an SP encounter successfully meets learning objectives that are focused on communication skills. Creative, well-designed case scenarios offer learners the opportunity to engage in complex patient encounters, while challenging them to address the personal and emotional contexts in which their patients are situated. Therefore, prior to considering the practical execution of the patient encounter, educators will first need a clear and structured strategy for writing, organizing, and developing cases. 

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Simulated Patient-Based Communication Skills Training for Undergraduate Medical Students at a University in Ethiopia

Simulated Patient-Based Communication Skills Training for Undergraduate Medical Students at a University in Ethiopia
Lead Author: Tesfamichael Alaro Agago
Submitted by: Mekail Ebbert, NYIT-COM @ Arkansas State University

“The verbal and non-verbal messages we utilize to interact with others could result in common understanding and are the cornerstone in the training of communication skills (CSs).” A study implemented at an Ethiopian University searches for answers to which interactive methods of teaching communication skills proves to be the most successful when working with medical students. Which do you think offered better results for students learning communications skills-simulated patients or case-based role-play?

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Feasibility of Using Simulated Patients for Onsite Structured Practice Feedback in Jordanian Community Pharmacy Settings

Lead Author: Eman A. Hammad
Submitted by: Kerensa Peterson, University of California Riverside

Simulated patient (SP) visits followed with structured feedback is useful to outline training needs as well

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Submitted By: Mekail Ebbert
Full Center Name: Institute for Clinical Competence

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In The Spotlight: Northeast Georgia Health System (NGHS)

Submitted By: Nicole Beringson
Full Center Name: NGHS Center for Simulations and Innovation
Center Location: Gainesville, GA USA
Year Opened: 2006

Center Mission Statement: Our mission is to promote high quality and safe patient care, enhance education, and develop research through excellence in multimodal simulation-based training and experiential learning.

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IMSH 2022 Keynote Presentation - Yassmin Abdel-Magied, “Transformative Leadership”

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

I had the pleasure of attending the IMSH 2022 Keynote Presentation from Yassmin Abdel-Magied, speaking about “Transformative Leadership.” Yassmin is a Sudanese-Australian writer, broadcaster, and award-winning social advocate with a background in mechanical engineering. Yassmin is a globally sought-after advisor on issues of social justice, focused on the intersections of race, gender and faith. What struck me most about her was her sense of humor, her completely approachable style and her clever use of “costume changes” as a way to challenge assumptions based on appearance. She characterized confirmation bias and group think as “sneaky little buggers,” sharing her experience of being the only woman working on an oil rig. She outlined methods of marginalization; when difference is amplified, we impose stereotypical expectations, and the individual is tuned out. She advocates for the use of standardized decision-making tools to overcome unconscious bias and a focus on patient-centered communication to see people as individuals and not a member of a group. She encourages us to lean into our discomfort to make real, structural change.

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Quality in standardized patient training and delivery: retrospective documentary analysis of trainer and instructor feedback

Lead author: Derya Uzelli Yılmaz, R.N., Ph.D.
Submitted by: Erin Walsh, Rosalind Franklin University of Medicine and Science

This study analyzed trainer and instructor feedback given to SPs on performance and issues related to quality assurance and improvement. Six years (2014-2020) of feedback forms were reviewed and analyzed for this study. A logic-based model aiming at developing quality management culture in SP programs is proposed. The study suggests an important part of feedback is that it is analyzed and incorporated into portrayal as soon as possible. The changes that are being made should be communicated to stakeholders to ensure consistency.

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Healing a Broken Clerkship Grading System

By: Justin Bullock, MD, MPH and Karen E. Hauer, MD, PhD
Submitted by: Dan Brown, Emory University

This article by a first-year resident and associate dean at University of California San Francisco highlights the problems in how many medical schools assess clerkship students. It’s a valuable read for any SP Educators who manage simulations for clerkships, arguing for pass/fail grading, more evaluation training for assessors, quality feedback, and an honest examination of bias in grading.

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What is the Students’ Opinion about Using Scenarios with Manikins and Simulated Patients in Undergraduate Medical Education?

Lead Author: Kamil Torres
Submitted by: Mekail Ebbert, NYIT-COM @ Arkansas State University

“Medical simulation has turned out to be a well-developed educational technique at a postgraduate level, including residency programs and continuing vocational training. However, its applicability has still not been clearly defined when providing education to undergraduate medical students.” See how one study sought the opinion of undergraduate medical students about the “effectiveness of manikin-based and SP-based high fidelity scenarios for clinical objectives.”

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A Framework for Developing Antiracist Medical Educators and Practitioner–Scholars

Lead Author: Sylk Sotto-Santiago
Submitted by: Kerensa Peterson

“With an increasing awareness of the disparate impact of COVID-19 on historically marginalized populations and acts of violence on Black communities in 2020, academic health centers across the United States have been prioritizing antiracism strategies. Often, medical students and residents have been educated in the concepts of equity and antiracism and are ready to tackle these issues in practice. However, faculty are not prepared to respond to or integrate antiracism topics into the curriculum. Leaders in faculty affairs, education, diversity, and other departments are seeking tools, frameworks, expertise, and programs that are best suited to meet this imminent faculty development need.”

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In The Spotlight: Duqesne University School of Nursing

Submitted By: Rosanna Henry

Full Center Name: The Learning and Simulation Center 

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Teaching Sexual Orientation and Gender Identity in Pediatric Clinical Settings: A Training Workshop for Faculty and Residents

Lead Author: Caroline R. Paul, MD
Submitted by: Kerensa Peterson, University of California, Riverside

“Health disparities for the lesbian, gay, bisexual, transgender, queer, intersex, asexual, all other genders, sexes, and sexualities (LGBTQIA+) population are striking. Yet, deliberate efforts to integrate sexual orientation and gender identity in pediatric education settings remain lacking. The type of formal training that pediatric educators currently have for the teaching of sexual orientation and gender identity is unclear and limited, which led to the development and implementation of this curriculum.”

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A Curriculum Innovation on Writing Simulated Patient Cases for Communication Skills Education

Lead Author: April R. Christensen, MD, MS
Submitted by: Mekail Ebbert, NYIT-COM @ Arkansas State University

With patient communication being a crucial skill for medical professionals, ongoing focus on the design and implementation of meaningful and well-written SP communication cases is imperative to healthcare education. Surveyed educators in this study reported a struggle to write communication cases with a lack of clear guidelines, yet a reported 90% interested in learning more. See how the creation and piloting of a “...workbook that guides SP case development, paired with an in-person case-writing session to teach medical educators a skill vital to conducting effective communication skills education... significantly increased the quality of SP cases, with high reported educator confidence and satisfaction.”

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Standardized Vaccine-Hesitant Patients in the Assessment of the Effectiveness of Vaccine Communication Training

Authors: Shanna Barton, Aaron Calhoun, Carrie Bohnert, et al.
Submitted by: Janice Radway, The Perelman School of Medicine at the University of Pennsylvania

Despite the well-known individual and societal benefits of childhood immunization programs and the demonstrated safety of vaccines, many parents are hesitant to have their children vaccinated. Vaccine hesitancy is more than a simple delay or refusal of vaccination. Rather, it can be characterized as a state of mind regarding immunization marked by uncertainty, indecision, conflict, or opposition, and it is best understood as a complex phenomenon with deep sociocultural and psychological roots. The authors developed a laboratory in which communication could be studied in a codified and controlled environment, using standardized patients portraying vaccine-hesitant parents, video-recording, assessment by blinded raters, and a pseudorandomized assignment of pediatric residents to AIMS or standard of care training.

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