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Research Article: Impact of standardized patients on the training of medical students to manage emergencies

Lead author: Frank Herbstreit
Submitted by: Todd Lash, Publications Committee Chair

The investigators compared standardized patient’s ability to transmit knowledge and skills compared with a more traditional teaching approach for emergency management skills. Medical students were randomized to receive either training on standardized patients simulating 3 emergency settings (“acute chest pain,” “stroke,” and “acute dyspnea/asthma”) or traditional small group seminars. The students were evaluated on their knowledge base before and after their respective training pathway. Teaching using standardized patients resulted in a small, but statistically significant improvement in objective structured clinical examination scores. There was no difference in the written examination scores. Read the full article in Medicinehere.

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Research Article: Step Up-Not On-The Step 2 Clinical Skills Exam - Directors of Clinical Skills Courses (DOCS) Oppose Ending Step 2 CS

Lead author: David J. Ecker
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

Recently, a student-initiated movement to end the United States Medical Licensing Examination Step 2 Clinical Skills and the Comprehensive Osteopathic Medical Licensing Examination Level 2-Performance Evaluation has gained momentum. These are the only national licensing examinations designed to assess clinical skills competence in the stepwise process through which physicians gain licensure and certification. Therefore, the movement to end these examinations and the ensuing debate merit careful consideration. The authors, elected representatives of the Directors of Clinical Skills Courses, an organization comprising clinical skills educators in the United States and beyond, believe abolishing the national clinical skills examinations would have a major negative impact on the clinical skills training of medical students, and that forfeiting a national clinical skills competency standard has the potential to diminish the quality of care provided to patients. In this Perspective, the authors offer important additional background information, outline key concerns regarding the consequences of ending these national clinical skills examinations, and provide recommendations for moving forward: reducing the costs for students, exploring alternatives, increasing the value and transparency of the current examinations, recognizing and enhancing the strengths of the current examinations, and engaging in a national dialogue about the issue. Read the full article in the Journal of the Association of American Medical Colleges here.

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General Interest: Mindfulness Apps Aim To Help People Disconnect From Stress

By: Allison Aubrey
Submitted by: Michael Maury, UCSD School of Medicine

As we fearlessly roller skate through our busy everyday lives, it is good to remember that there are great practices that can help us manage any stress that may invade our body and mind. Meditation has long been an important relaxing practice that helps individuals remain present and calm in the moment. As of late, Mindfulness Meditation has been a hot topic for many to help cope with the raucous rumblings that our world is witnessing. In this NPR news segment, Allison Aubrey makes note of some helpful downloadable Apps that may help us connect to our calming breath bringing us closer to a state of simple being. It is pointed out in this piece that there are “documented benefits of mindfulness meditation” which “can include better management of chronic pain, an increase in self-awareness, improved digestion and higher immune function.” It is understood that we all are busy with our jobs and personal lives. It is a good reminder, as the Zen proverb states, “You should sit in meditation for twenty minutes every day – unless you’re too busy. Then you should sit for hour.” Read on here for some potentially influential and uplifting guidance.

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Research Article: Communication Skills of Medical Students during the OSCE - Gender-specific Differences in a Longitudinal Trend Study

Lead author: Joachim Graf
Submitted by: Todd Lash, Publications Committee Chair

The aim of this study was to analyze gender differences in communication skills of medical students in the context of an OSCE exam. A longitudinal trend study based on seven semester-cohorts, was analyzed to determine gender differences in medical students’ communication skills. The students (self-perception) and standardized patients (SP) (external perception) rated the communication skills using uniform questionnaires. Statistical analysis was performed by using frequency analyses and t-tests. Across all ratings in the self- and the external perception, there was a significant gender difference that favored female students performing better in the dimensions of empathy, structure, verbal expression and non-verbal expression. The results of male students deteriorated across all dimensions in the external perception over time. Recommendations were made regarding gender-specific teaching that considered the reported differences between female and male students. Read the full article in BioMed Central Medical Educationhere.

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Research Article: Standardized Patients' Perspectives on Workplace Satisfaction and Work-Related Relationships - A Multicenter Study

Research Article: Standardized Patients' Perspectives on Workplace Satisfaction and Work-Related Relationships - A Multicenter Study
Lead author: Claudia Schlegel, MME, RN
Submitted by: Valerie Fulmer, ASPE President Elect

From the article: The use of standardized patients (SPs) in health care education has grown in the last 50 years. In addition, the requirements for SPs have increased steadily, and thus, the work of SPs has become more difficult and demanding. It has been claimed that SP programs are highly contextualized, having emerged from local, institutional, professional, and national conditions, but their effects on SPs have not been investigated. We have studied the effects of this job development on SPs and their programs. Read the full article in Simulation in Healthcarehere.

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General Interest: NASA Program Aims to Prepare Astronauts to Become Space Doctors

General Interest: NASA Program Aims to Prepare Astronauts to Become Space Doctors
Submitted by: Scott Winfield, The Ohio State University

NASA and Brigham and Women’s Hospital have teamed up to create a first-of-its-kind simulator to teach astronauts how to deal with medical emergencies. Watch the NBC Nightly News feature on YouTube here.

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Editorial: Creating a quality improvement culture in standardized/simulated patient methodology - the role of professional societies

Editorial: Creating a quality improvement culture in standardized/simulated patient methodology - the role of professional societies
Lead author: Debra Nestle
Submitted by: Karen Lewis, George Washington University, ASPE Standards of Practice Committee Chair

An editorial about the ASPE Standards of Best Practice has been written and published in Advances in Simulation. Read the editorial here.

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Research Article: Tracing the Prescription Journey - a Qualitative Evaluation of an Interprofessional Simulation-based Learning Activity

Research Article: Tracing the Prescription Journey - a Qualitative Evaluation of an Interprofessional Simulation-based Learning Activity
Lead Author: Caoimhe Cooke
Submitted by: Michael Maury, UCSD School of Medicine

“At Queen’s University Belfast (QUB), an innovative Interprofessional education (IPE) activity was developed for medical and pharmacy undergraduate students that aimed to develop a greater understanding of their roles and duties in community prescribing and dispensing. This study set out to evaluate the impact of such a simulation-based education (SBE) activity on students’ attitudes towards collaborative practice in prescribing and dispensing medication in the community.”

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Interview with a Transgender Adolescent for Case Development

Interview with a Transgender Adolescent for Case Development
By: Dan Brown, Emory School of Medicine

Along with Stephanie Holt, M.D., I recently developed a case featuring a transgender adolescent. To ensure a fair, accurate, honest portrayal, we wanted to base the character on a specific person. I interviewed Lane Brown, my brother, and his answers were so helpful and eye-opening that I thought they would be beneficial to share with the ASPE community, for anyone else who has interest in developing a transgender case. These are some excerpts from that interview.

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Research Article: Training Social Work Students to Recognize Later-life Depression - Is Standardized Patient Simulation Effective?

Research Article: Training Social Work Students to Recognize Later-life Depression - Is Standardized Patient Simulation Effective?
Lead author: Zvi D. Gellis
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

It gives me great pleasure to share this scholarly article with our ASPE membership, as the Penn Med SP Program was involved in the study. This has been a successful program for about 5 years. It involves 2nd year Master of Social Work students having discussions with geriatric SPs regarding late-life depression and chronic disease. Please see the abstract and link below for more information on this study.

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Preparing For LGBTQ Health Issues as an SP Educator

Preparing For LGBTQ Health Issues as an SP Educator
By: Kris Slawinski, The University of Chicago Pritzker School of Medicine

Carrie Bonhert blazes our path to providing LGBTQ healthcare simulations with her ongoing work and presentations at ASPE and other medical education conferences.

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Research Article: An Easy-to-build, Low-budget Point-of-care Ultrasound Simulator - From Linux to a Web-based Solution

Research Article: An Easy-to-build, Low-budget Point-of-care Ultrasound Simulator - From Linux to a Web-based Solution
Lead Author: Domagoj Damjanovic
Submitted by: Kerensa Peterson, Northwestern University Feinberg School of Medicine

Finding a hands-on ultrasound simulator that is inexpensive and easy to access in any setting is a challenge for many medical schools.  There are computer-based programs that have been developed that are either affordable or accessible but combining these two principles has remained challenging – until now.  The authors of this study analyzed the usability of an HTML-based solution to this problem that they created based on the developers of the original EDUS2, Paul Kulyk and Paul Olszynski.  Take a look at this incredible innovation in the Critical Ultrasound Journal here.

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Research Article: Communicating to Promote Informed Decisions in the Context of Early Pregnancy Loss

Research Article: Communicating to Promote Informed Decisions in the Context of Early Pregnancy Loss
Lead Author: Maria Brann
Submitted by: Michael Maury, UCSD School of Medicine

In this research article, authors Maria Brann and Jennifer J. Bute of the Department of Communication Studies at Indiana University and Purdue University facilitated a simulation in which interns engaged with Standardized Patients portraying woman who had just experienced a miscarriage, in “minimum informed decision making (IDM).” They note that “As many as 25% of known pregnancies end in a miscarriage” and “evidence suggests that informed decision making does not occur in many cases of early pregnancy loss.” The purpose of their study was “to evaluate an OSCE program in which OB/GYN residents are trained using standardized patients to engage women in decision making during a pregnancy loss scenario.”

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Research Article: Twelve Tips for Conducting Successful Multiple Patient Encounter Simulations (Simultaneous Simulations)

Research Article: Twelve Tips for Conducting Successful Multiple Patient Encounter Simulations (Simultaneous Simulations)
Lead author: Craig Brown
Submitted by: Todd Lash, Publications Committee Chair

The authors described twelve tips for conducting successful multiple patient encounter simulations (MPES), divided into pre-, intra- and post-simulation considerations. They conclude that with these twelve tips, educators can plan successful, fiscally responsible, well-organized, structured sessions for all learners (active and observing) that will achieve the learning outcomes desired using this advanced method of simulation. MPES offer a host of opportunities for learners and educators alike in ways that single patient encounter simulations cannot. Whilst this method of learning adds in increasing complexity for simulation designers, facilitators and learners by its inherent nature this should be embraced as a strength of this educational approach. Read the full article in Medical Teacherhere.

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Research Article: Use of Simulation to Integrate Cultural Humility Into Advanced Health Assessment for Nurse Practitioner Students

Research Article: Use of Simulation to Integrate Cultural Humility Into Advanced Health Assessment for Nurse Practitioner Students
Lead author: Abraham N. Ndiwane
Submitted by: Todd Lash, Publications Committee Chair

To access cultural issues and level of student satisfaction, the authors created an Objective Structured Clinical Examination (OSCE) offered to nurse practitioner students practice in simulation. This learning activity included pre- and post-assessments of knowledge on cultural content. Course content included an exemplar video and a simulation interview with an African American standardized patient. Standardized patient scenarios scored highest for satisfaction, followed by critical thinking, and with self-confidence scoring lowest. The favorable knowledge outcomes from this teaching intervention support future applications of OSCE methodology for teaching sensitive cross-cultural content. Read the full article in the Journal of Nursing Educationhere.

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Media Article: Learning Is a Behavior - Supporting How Learners Learn

Media Article: Learning Is a Behavior - Supporting How Learners Learn
By: Brian S. McGowan, Ph.D., FACEhp
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

While almost every training professional can point to one or two examples of an intervention that achieved nearly everything it was designed to, it’s not exactly the norm. Engaging learners is challenging. Their attention ebbs and flows, and even in the best of scenarios, you may be content if a small percentage of participants learns a small percentage of the content. Read the full article at Trainingindustry.com here.

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Media Article: MU Health Care Holds Outdoor Emergency Training

Media Article: MU Health Care Holds Outdoor Emergency Training
By: Maia McDonald
Submitted by: Dena Higbee, Missouri University Shelden Clinical Simulation Center

Rock Bride Memorial State Park looked anything but normal with hikers oozing fake blood, groaning out like they were in pain while strewn out across the rock-filled stream.  Others peeked around trees, anxious and worried as Boone County firefighters worked frantically to treat the "injured." Read the full article on the KOMU website here.

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General Interest: Kathryn

General Interest: Kathryn
By: David Muller, MD
Submitted by: Dan Brown, Emory School of Medicine

Dr. Muller begins with a story of a fourth-year medical student that took her own life, and ends with a call to action at his own school, encouraging the same of others. He describes the relentless pressure faced by prospective and current students, and calls for a culture change. For us, as educators administering the tests that cause the learners some of the greatest stress of their academic careers, this can serve as a reminder of the fragile mental state they may be in.Read the full article in the New England Journal of Medicinehere.

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Research Article: Effectiveness of Mental Health Simulation in Replacing Traditional Clinical Hours in Baccalaureate Nursing Education

Research Article: Effectiveness of Mental Health Simulation in Replacing Traditional Clinical Hours in Baccalaureate Nursing Education
By: Denise A. Soccio, DNP, RN
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

The purpose of the current study was to (a) determine whether baccalaureate nursing students receiving mental health simulation as a replacement for 25% of traditional clinical hours have equivalent or greater mental health knowledge and self-confidence compared to those who did not receive this simulation; and (b) explore students' perceptions of their mental health simulation compared to traditional clinical hours. An evidence-based practice pilot study was conducted using a mixed-methods design. Quantitative data demonstrated that students who received mental health simulation as a replacement for 25% of traditional clinical hours have equivalent mental health knowledge and self-confidence as those who did not receive the simulation. Qualitative data indicated students found the simulation helpful in learning how to manage patient behaviors. The current study provides substantial evidence that simulation can be used as a replacement for 25% of traditional clinical hours in mental health nursing.Read the full article in the Journal of Psychosocial Nursing and Mental Health Services here.

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Research Article: A simulated “Night-onCall” to assess and address the readiness-for-internship of transitioning medical students

Research Article: A simulated “Night-onCall” to assess and address the readiness-for-internship of transitioning medical students
Lead Author: Adina Kalet
Submitted by: Michael Maury, UCSD School of Medicine

“Medical students transitioning from undergraduate medical education (UME) to graduate medical education, experience uncertainty and distress about their readiness-for-internship. This lack of readiness may be partially responsible for the “July effect”—a reported increase of 10% in fatal medical errors in teaching hospitals in North America when these new graduates enter the workforce each July.”This article lays out the details of a simulated “Night-on-Call” (NOC) for incoming interns and residents providing them with “an authentic educational experience” to help ease any anxiety about their new appointments.Read the full article in Advances in Simulation here.

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