By: Leanne Picketts, Marika Dawn Warren, Carrie Bohnert
Submitted by: Marsha Harman, Rush Center for Clinical Skills and Simulation

Healthcare learners can gain necessary experience working with diverse and priority communities through human simulation. In this context, simulated participants (SPs) may be recruited for specific roles because of their appearance, lived experience or identity. Although one of the benefits of simulation is providing learners with practice where the risk of causing harm to patients is reduced, simulation shifts the potential harm from real patients to SPs. Negative effects may be amplified when SPs are recruited for personal characteristics or lived experience. Educators have an ethical obligation to promote diversity and inclusion; however, we are also obliged to mitigate harm to SPs.

Lead Author: Shane A. Pritchard, BPhysio, et al
Submitted by: Kerensa Peterson, NBOME

Using an interpretivist research paradigm and qualitative design, these researchers from Australia considered simulated patients’ self-identified role within healthcare education. The researchers engaged 18 SPs in frank discussion about the SPs’ role in order to explore their experiences, perspectives and practices within their SP programs. The researchers have a rich discussion of themes that emerged from those SP conversations. They offer SP Educators ways to further benefit SPs and engage in quality educational experiences for learners with input from the professionals performing the simulation – the Simulated Patients themselves.

Submitted By: S. Barry Issenberg, M.D.

Full Center Name: Michael S. Gordon Center for Simulation and Innovation in Medical Education

Submitted By: Dan Brown

Full Center Name: Clinical Skills Center
Center Location: Atlanta, GA, USA
Year Opened: 2001
Center Mission Statement: Not our mission statement, but our "Why": We enhance human interaction.

Interviewed by: Kerensa Peterson
Edited and Submitted by Marsha Harman, Rush Center for Clinical Skills and Simulation

Please tell our readers who you are and what schools you’ve worked for as an SP? My name is Armando Reyes. I’ve been with Northwestern from the beginning when I first started SP work. I do work at Rush University, as well. Those are the two main schools that I work at.SP work has been very limited. I’ve done two events so far since this whole thing started. I’ve been fortunate because I have other jobs that I juggle, as well. I was doing a lot of remote work beforehand, which has helped - well, I shouldn’t say helped. I don’t know. It’s a strange new world now that we’re living in.

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

In anecdotal reports from residency retreats, female residents described a high frequency and negative impact of interruptive behavior by male colleagues. The authors sought to characterize interruptions during residency teaching conferences by gender. The results are eye-opening.

Lead Author: Daniel Suarez
Submitted by Kathy Herzberger, Loma Linda School of Medicine

This study looks at the association between sexual orientation and the mental health of medical students. One of the more heartbreaking findings was the higher rate of family dysfunction among non-heterosexual students that leads to decreased social and financial support. Once again, our vigilance is essential to help our students find the help that they need to improve their well-being.

Lead Author: Joshua A. Roshal
Submitted by: Marsha Harman, Rush Center for Clinical Skills and Simulation

This study identified self and simulated patient (SP)-reported ratings of US first-year medical students’ interpersonal and communication skills (ICS) and the influence of age and gender on performance appraisal during the Objective-Structured Clinical Examination (OSCE). While the majority of students and SPs evaluated the students’ ICS as very good, there was a disparity in the rating of the medical students’ ability to encourage patient question-asking and answer questions; more SPs gave an “inadequate” rating in that category than students. Neither age nor gender influenced the medical students’ self-assessment of ICS. Female SPs assigned lower scores to students in regard to respecting patients and encouraging patient question-asking and answering. Older SPs were more likely to assign lower scores on all survey questions.

Lead Author: Martina Ann Kelly
Submitted by Kathy Herzberger, Loma Linda School of Medicine

We have all realized how much touch is essential to our lives during this past year. Touch, according to the authors, expresses healing, caring, and connection. They discuss how virtual life has transformed interactions with their patients and colleagues. If telemedicine continues beyond our current pandemic, then physicians will need to find a way, other than touch, to connect with their patients to develop therapeutic relationships. 

By: Kara Gavin
Submitted by: Marsha Harman, Rush Center for Clinical Skills and Simulation

People who take opioid medications for chronic pain may have a hard time finding a new primary care clinic that will take them on as a patient, according to a new “secret shopper” study of hundreds of clinics in nine states across the country. Simulated patients who said their doctor or other primary care provider had retired were more likely to be told they could be accepted as new patients, compared with those who said their provider had stopped prescribing opioids to them for an unknown reason. Stigma against long-term users of prescription opioids, likely related to the prospect of taking on a patient who might have an opioid use disorder or addiction, appears to play a role.

Lead Author: Scott Haperin
Submitted by Kathy Herzberger, Loma Linda School of Medicine

Medical students suffer from increased anxiety and depression. Add Covid isolation to an already difficult situation and these problems are exacerbated. This study assessed the mental health situation of 1,428 students from 40 U.S. medical schools. The results suggest that we should be especially vigilant in recognizing and offering help to students that require extra emotional support.

By Dan Brown, Emory University

At the 2020 ASPE virtual conference, Towanda Underdue, an SP Educator at Johns Hopkins Medicine and an ASPE member since 2016, presented a Snapshot titled Setting Boundaries: What SP’s Should Not Say at Work or Post on Social Media. I reached out to her via email for an interview.

By: Kaitlin Descutner
Submitted by Kerensa Peterson, NBOME

This is part of the SP Voices series we have been running since June 2020: The pandemic has certainly set us all back extremely. However, the outcome has been positive for me in a way. I decided to move back home to Pennsylvania in June 2020 with no jobs lined up. Because Ohio State University pursued holding events virtually, I was able to keep my job as an SP. I am the first SP at Ohio State to work from another state remotely. I’ve always been gracious to be in the SP world – expanding medical training and communication. I continue to be gracious to be an SP in a new, virtual world so that we can all learn how to communicate through telehealth.

In The Spotlight: University of Central Florida – College of Medicine
Submitted By: Rebecca Beiler

Full Center Name: Clinical Skills and Simulation Center

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

I can summarize what it means to be a SP during this time in one word. GRATEFUL! It is important for me to make a difference. I feel so grateful to have a position where I can help future medical personnel learn how to interact with people.

Lead Author: Greg M. Reger, PhD, et al
Submitted by: Marsha Harman, Rush Center for Clinical Skills and Simulation

What is the efficacy of training with a virtual standardized patient (VSP) compared with traditional academic study for learning motivational interviewing (MI) skills? Findings In this randomized trial of 120 health care professionals, training with a virtual standardized patient resulted in significantly greater improvements in 3 of 4 motivational interviewing composite skill scores, including the technical global score, the relational global score, and the reflection-to-question ratio, compared with academic study.

Lead author: Andrew M. Luks
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

The authors make a compelling argument as to why clinicians should avoid using jargon: “Despite our best efforts to ensure appropriate care for patients, we often find ourselves distracted on rounds by the sometimes bewildering array of jargon during bedside presentations. Why does our team want to “sprinkle” or “hit” the patient with diuretics? Do our patients have the capacity to “fly” off the ventilator or “throw” PVCs (premature ventricular contractions)? …Perhaps the biggest challenges arise when we consider how our words sound to patients and their families. Many of our word choices run the risk of confusing them rather than clarifying the patient’s condition, diagnosis, or treatment. They may nod, but do they clearly understand what we have said? Even worse, are they offended by what they hear?”

Lead author: Doreen M. Olvet
Submitted by: Kathy Herzberger, Loma Linda University

This is an interesting article discussing near peer 4^th year tutors to give feedback to 1^st and 2^nd year students on note writing skills. The authors found that near peers can be an asset to medical education. I too, have found near peer tutoring effective. I have used 4^th year students that are remediating to help grade our 2^nd year OSCE. This exercise enhances the 4^th year’s skills and the 2^nd years appreciate the feedback from their upper classmen.

By: Mario Veen & Anna T. Cianciolo
Submitted by: Kerensa Peterson, NBOME

Philosophy is not just “the talk on a cereal box” that Edie Brickell first sang about in 1986. But it is the topic of this first in a series of thought-provoking pieces by Veen and Ciancolo. The authors write, “ Slowing down to consider context and reflect on practice are now seen as essential to medical education as we are called upon to examine carefully what we are doing to care for learners and improve their performance, professionalism, and well-being.” During this time of COVID-19, their piece seems especially relevant as we take on questions that don’t have clear answers. We are asked to approach problems in medical education with “wonder and intense, childlike curiosity, human qualities we all share.”

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

I always wanted to be a doctor when I grew up. That dream died a quick death during junior high, when it became clear that any math beyond the bare basics completely eluded even the slightest grasp by my arts-loving brain. (The PEMDAS train left the station without me.) Fast-forward to college and a journalism major where – among all of us junior wordsmiths – the standard joke was that we were there because algebra wasn’t required. Cue a 40-year career as a writer, editor and PR/marketing coordinator. Yet, even as I wrote, edited and promoted, my interest in the healthcare field never dwindled. To get my “fix,” I volunteered in hospitals as well as at an inpatient hospice facility, working directly with people who were dying and their families. (The latter was an intensely meaningful privilege.) I even entertained the notion of becoming a registered nurse as a second career and took all of the prerequisite college courses – including remedial math! But my mother became ill and needed me, and I never pursued it further.