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USML/ Mundelein Cor Luxta Meum Project: Introduction to Simulation Pedagogy


USML/ Mundelein Cor Luxta Meum Project: Introduction to Simulation Pedagogy
By: Mundelein Seminary
Submitted by: Darrell Brock, University of Pittsburgh

Faculty and students tell an interesting story of how SP methodology is making an impact in theology training at a seminary.

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Implementing Standardized Patient Caregivers to Practice Difficult Conversations in a Pediatric Dentistry Course

Implementing Standardized Patient Caregivers to Practice Difficult Conversations in a Pediatric Dentistry Course
By: Beau D. Meyer, DDS, MPH
Submitted by: Marsha Harman, Rush Center for Clinical Skills and Simulation

The objective of this educational activity was to describe the implementation of three SPs in a pediatric dentistry course for second-year dental students. The authors developed three SP encounters covering interactions with caregivers of an infant with severe early childhood caries, an adolescent on the path to gender affirmation, and a child with autism and dental caries whose caregiver was resistant to fluoride- and silver-containing dental materials. The article describes the case design process, rubric construction and calibration, student debriefing, and pandemic modifications. The effectiveness of the implementation was evaluated by thematic analysis of student reflections following each encounter using a qualitative descriptive framework. Qualitative analysis showed that students preferred a more realistic encounter by having a child or other distraction present. Students relied on different elements of motivational interviewing depending on the objective of each encounter and the age of the patient. Overall, the SP encounters were well received by students and faculty as an alternative or supplement to traditional student evaluation methods. A number of lessons learned about implementing SP methodology in pediatric dental education were noted. With these experiences now in place, future evaluations should measure student performance in the SP encounters against student performance during clinical care.

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Saudi Health Simulation Conference Celebrates 5th Year with Entire Week of Events

Saudi Health Simulation Conference Celebrates 5th Year with Entire Week of Events
By: Lance Baily
Submitted by: Darrell Brock, University of Pittsburgh

Riyadh hosts its 5th annual Health Simulation Conference where it focused on the optimization of healthcare simulation, the safety of patients, facility management, development and innovation, and finally the future of healthcare. Check it out.

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Comparison of Resident Self-Evaluation to Standardized Patient Evaluators in a Multi-Institutional

Comparison of Resident Self-Evaluation to Standardized Patient Evaluators in a Multi-Institutional Objective Structured Clinical Examination
Lead Author: Benjamin John Diaczok, MD
Submitted by: Nicholas Gonzalez, Gordon Center for Simulation and Innovation in Medical Education, University of Miami Miller School of Medicine

The Objective Structured Clinical Examination, or OSCE, has stood the test of time and cemented its use in medical simulation and education. With each institution that applies the use of OSCEs, there comes evaluations, and those who evaluate. This article seeks to shine a light on self-evaluation among residents and if Standardized Patients (SPs) evaluate said residents at a similar level of accuracy. This interrater reliability allows one to view how capable residents are of self-evaluating after taking part in a series of challenging OSCEs, and if they rate their performances higher, lower, or equal to that of SPs’ evaluations.

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Interprofessional Communication in Medical Simulation: Findings from a Scoping Review and Implications for Academic Medicine


Interprofessional Communication in Medical Simulation: Findings from a Scoping Review and Implications for Academic Medicine
Lead Author: Sadie Trammell Velásquez
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

Interprofessional communication is an integral part of healthcare. It can be taught in medical school and other health professional schools through interprofessional education (IPE) activities. In this scoping review conducted on simulation-based IPE, the authors describe the characteristics of published simulation IPE activities involving undergraduate medical students in a simulation center. To strengthen IPE simulation, the authors recommend that medical educators deliberately incorporate (1) hybrid instructional methods to bypass logistic hurdles, (2) longitudinal approaches to achieve higher-level learning outcomes, and (3) assessment tools with established validity evidence (IPEC) to measure those outcomes.

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Inclusion Targets: What’s Legal?


Inclusion Targets: What’s Legal?
By: ACLU Southern California
Submitted by: Dan Brown, Emory University

Navigating the law when it comes to hiring SPs is challenging. Many sources recommend against asking about demographics to prevent discrimination lawsuits. But how do we improve diversity in our hiring efforts without asking these questions?

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Actors Help Medical Students Learn the Less Technical Side of Medicine: How Actors Are Teaching Medical Students Compassion and Understanding for their Patients


Actors Help Medical Students Learn the Less Technical Side of Medicine: How Actors Are Teaching Medical Students Compassion and Understanding for their Patients
By: Paul Jablow
Submitted by: Amy Lorion, NBOME

The Philadelphia Inquirer recently published an article describing the use of standardized patients by local medical schools. This isn’t overly unusual in itself—newspapers occasionally run such articles—but what struck me was the article’s emphasis on the ability of SPs to make a genuine difference in the lives and professional work of medical students, particularly in sensitive areas such as race and gender. The author, Paul Jablow, centers SPs in the article, showing them as educators in themselves, not just a tool used by medical schools. As Jablow writes, “While veteran doctors teach them how to repair broken bones and suture wounds, standardized patients teach medical students how to care for people with compassion and understanding.” Although the article is behind a paywall, those with access may find the article a refreshing read with its highlights of SPs making a real difference, often in their own words. And this starts from the beginning of the article, with an anecdote about an SP whose ER doctor recognized him from when she was a medical student 10 years prior: “She thanked me for teaching her to become more sensitive.” 

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Structural Inequities in the Treatment of Standardized Patients and What That Means for Patient Care

By: Temple D. West, MMHPE
Submitted by: Marsha Harman, Rush Center for Clinical Skills and Simulation

Standardized patients (SPs) play a pivotal role in medical education. They are proxies for real patients, preparing students to meet the challenges of excellent patient care. Human simulation, with SPs, is used for teaching and assessing communication and clinical skills in medical education around the world. Standardized patients work individually with other faculty, students, or in conjunction with medical faculty to facilitate learning with feedback. In most simulation centers, SPs receive extensive training in communication and clinical skills, yet they inhabit territory often unrecognized as professional in medical education. The manner in which SPs are seen and treated by faculty and students may be a reflection of how real patients are seen and treated—not always heard, not always respected—and this tension detracts from both simulated and real patient encounters. Exploring how SPs, as proxies for real patients, are treated in medical education is a key to what we might learn and how we might close gaps in cultural respect and, ultimately, in patient care.

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An Interview with Five Conference Attendees

At the Communications and Connections Committee’s invited presentation, How Do I Communicate and Connect with ASPE? The CommConn Committee Tells You How, committee member Dan Brown sat down with five volunteers to interview them about their conference experience. Here are their answers!

When was your first ASPE conference?

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Gender-Affirming Care with Transgender and Genderqueer Patients: A Standardized Patient Case


Lead author: Laura Weingartner, PhD, MS
Submitted by: Renee Wadsworth, SP-ed

Transgender and gender-diverse (TGD) people experience extreme health disparities and prejudice in health care settings. The lack of provider training around gender-affirming care for TGD patients has historically contributed to this inadequate care. Patient simulation is a crucial component of teaching medical students about gender-affirming care because it allows students to practice and become more comfortable with these skills in a low-stakes setting.

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It Is Not Just the Script that Matters: Overlooked Elements in Standardized Patient Methodology


By: Sandra Jaramillo-Rincón, MD, MHPE, Juan Manuel Potes, MD
Submitted by: Nicholas Gonzalez, The Gordon Center at University of Miami Miller School of Medicine

Standardized patients (SPs) range from individuals looking for additional work to full blown actors and actresses, to somewhere in the middle. This article entails what advantages SPs have and what skills they bring to the table regarding the teaching/learning process. The authors go into detail discussing the training and further development of acting, thematic, pedagogic, and planning and leadership skills among their SPs.

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Aportes de la Simulación al Desarrollo del Razonamiento Clínico en Estudiantes de Pregrado de Medicina


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

La simulación clínica en Latinoamérica ha ganado relevancia como herramienta formativa en las últimas décadas. En la formación de pregrado en Medicina, el cómo enseñar razonamiento clínico de la mejor manera aún requiere de consenso. Armijo-Rivera y equipo comparte en la revista de la Federación Latinoamericana de Simulación Clínica (FLASIC) una revisión del uso de simulación clínica con pacientes simulados como una excelente alternativa para “promover el desarrollo de aptitudes procesales, la comunicación con los pacientes, la entrega de los pacientes, el razonamiento ético y el trabajo en equipo” además de integrar información y ayudar a la toma de decisiones. También advierte que se requiere de estudios longitudinales que consoliden esta base de conocimiento, dado que el razonamiento clínico en medicina es un constructo complejo de enseñar y de evaluar. Así, queda abierta la invitación a investigar y socializar nuestras experiencias en simulación clínica con pacientes simulados en el mundo hispano hablante.

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Use of Standardized Patient Encounters as Predictors of Fieldwork Performance: A Pilot Study

Lead Author: Linda Frasier
Submitted by Karen Lewis, The George Washington University SMHS

Although standardized patient encounters (SPEs) are being used in occupational therapy (OT) education, limited literature exists on the value these experiences have on OT student learning outcomes and preparation for fieldwork. This study sought to examine if SPEs had the potential to predict Level II A fieldwork performance

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Pursuing a Medical Career While Black: What it Takes and Why it Matters

Authors: Saul Weiner and Stefan Kertesz
Submitted by: Kerensa Peterson, University of California Riverside

“Making it into and through medical school is tough even for those who have all the advantages: excellent schools starting at a young age, well-educated parents who may be doctors themselves, lots of role models and…white skin. In this episode we hear from two pre-meds and one newly minted physician, all Black, about their journeys with few of these advantages. Despite their remarkable optimism, their burdens are evident, and many do seem tied to race, as it is understood in the US. The extreme underrepresentation of Blacks in medicine should be a source of deep concern for the profession and for society, as a matter of social justice as well as patient care. The passion of these young men and woman is inspiring, and the mentorship opportunities provided by pipeline programs like the I Am Abel Foundation, which has been central to their lives, offers hope.”  

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ASPE Plenary: Celebrating Our Past, Imagining Our Future: 3 Presidents Reflect


By Daniel C. Brown, Emory University

Monday morning in New Orleans, the first full day of ASPE’s 2022 conference included a plenary address from three prior ASPE Presidents: Tamara Owens, Grace Gephardt, and Rob MacAulay. The trio regaled the audience with stories from ASPE’s history, reminded the crowd of recent and current accomplishments, shared a vision for the future, and issued calls to action for ASPE members.

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Annual Literature Review from the ASPE 2022 Conference

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

It was a pleasure to be back in-person for our 2022 annual conference! One of the highlights every year is the review of published literature in SP methodology, usually run by Dr. Karen Szauter. This year, the job was handed into the capable hands of the Grants and Research Committee. Before they got into the literature, they gave a heartfelt thank you to Dr. Szauter, which culminated in a standing ovation for our esteemed colleague. The committee hailed this literature review as a “celebration of our work”. For 2021, there were 200 papers reviewed, narrowed down to 12 they presented in this session. 6 themes emerged from the work: SP Voices in Social Justice, Addressing the Gap Between Education and Clinical Practice, SP Professional Identity, Advancing SP Educators as Authors, SPs as Assessors, and Interprofessional Education/Program Improvement. A full list will be posted on the ASPE website and added to the existing bibliography here.

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Quality in Standardized Patient Training and Delivery: Retrospective Documentary Analysis of Trainer and Instructor Feedback

Lead Author: Derya Uzelli Yilmaz, RN
Submitted by: Mekail Ebbert, NYIT-COM at Arkansas State University

Creating and maintaining a consistent and meaningful SP quality assurance program has always been a priority of mine, and one that I’ve learned requires a continuous approach of evaluation and monitoring. This article documents a study using the collection of 6 years worth of feedback to “determine programmatic and systematic issues in the scope of quality assurance and improvement...” With this large collection of data they were able to review the outcomes of both trainer and instructor feedback on SP performances, resulting in the emergence of four key themes.

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Barriers, Challenges, and Supports to the Implementation of Standardized Patients and Simulated Environments by Occupational Therapy Education Programs

Lead Author: Amanda Mack, OT, OTD, MS, OTR, CLC
Submitted by: Marsha Harman, Rush Center for Clinical Skills and Simulation

A national survey examined the implementation rates, barriers, challenges, and supports to implementation of two types of simulation (standardized patients and simulated environments) by entry-level occupational therapy education programs in the United States. An online survey inquiring about academic program characteristics and use of simulation was sent to all occupational therapy and occupational therapy assistant programs in the United States in 2017 prior to the implementation of the 2018 Accreditation Council for Occupational Therapy Education Standards and the onset of the COVID-19 Pandemic. Data were analyzed using both statistical and content analysis. Thirty-eight percent of responses used standardized patients and 70% used simulated environments in their didactic coursework.
Funding was the most cited support, challenge, and barrier to the use of standardized patients. Physical space was the most cited support and challenge for the use of simulated environments, with funding as the most cited barrier. This study highlights the need for additional research in the use of simulation in OT education, specifically into feasibility and outcomes of lower-cost methods of simulation. Also, the outcomes of the study indicate that OT education programs would benefit from widely available, easy to access, and low-cost or free resources to help with the development and implementation of simulation within their own curricula. Access to these resources may allow academic programs to overcome some of the institutional barriers to implementation of simulation. For simulation to become more widely implemented and to truly reduce the burden of fieldwork education on fieldwork sites and partners, academic institutions may need to provide resources to help occupational therapy education programs overcome the common barriers and challenges and strengthen existing supports.

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Enhancing the Structural Competency of Nurses Through Standardized Patient Simulation

Lead Author: Zvika Orr, PhD
Submitted by: Marsha Harman, Rush Center for Clinical Skills and Simulation

Structural competency is a new conceptual and educational framework for training health professionals to discern and respond to the impact of social, political, and economic structures on health. This article discusses a new online standardized patient simulation method that enhances the structural competency of nurses and nursing students. This method has been used to train nurse practitioner students. The article suggests that simulation-based learning can help nurses translate the theoretical comprehension of macro-level forces into clinical practices. This method expands the nurses' perspective, develops their social-political awareness, and encourages them to lead interventions. This simulation can contribute to dismantle structural racism and reduce health inequities.
The article includes a description of one of the scenarios used and a selection of the nursing students’ responses to experience.

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Experiences of Simulated Patients in Providing Feedback in Communication Skills Teaching for Undergraduate Medical Students

Lead Author: Riya Elizabeth George
Submitted By: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

The experiences of SPs and their perspective on providing feedback is an under-studied area. This study aims to explore SP experiences and views on feedback, factors influencing their feedback and implications for training. The authors conducted six focus groups with 30 SPs. Five over-arching themes were identified: feedback processes, challenges in providing feedback, cumulative experiences, web of interpersonal relationships and dynamics, and portraying the character and patient representations.
Read the full study here.

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