Research Article: What can we learn from simulation-based training to improve skills for end-of-life care? Insights from a national project in Israel
Lead author: Mayer Brezis
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

This research article describes the design of interprofessional simulation-based workshops with standardized patients and family members to improve end of life (EOL) care. These simulations provided an opportunity to explore barriers and challenges for hospital staff in providing optimal care at the EOL. The workshops so were successful in highlighting the need for more training that they eventually led to an expansion of palliative care services and demand for EOL care education in nursing homes and other professional areas. Read the full article in the Israel Journal of Health Policy Research here.

Media Article: VTC School of Medicine Student Motivated to Serve Patients and Overcome Health Disparities
Submitted by: Michael Maury, UCSD School of Medicine

This article is a wonderful display of hope in the future of medicine. Learn about Jay Patel and his path to medicine which the article points out “begins with the heart.” Patel gives praise for what we do as SP Educators. As the author writes, “His favorite part of the school so far has been the clinical skills curriculum. We are exposed to patients from day one and have interactions with standardized patients [or trained patient actors] every week.  It prepares us to interact with patients and be a physician who actually listens to your patients, knows how to talk to them and interview them, and tie that into the clinical reasoning aspect of medicine." Read the full article at WVNSTC.com here.

SIGs: Introducing the Social Justice Special Interest Group
By: Kevin Hobbs

The Social Justice Special Interest Group (SIG) has assembled a description of the SIG. The SIG was established in 2017 and currently has 6 active members and 12 associate members.

General Interest: Top 5 Lists for Kansas City
Submitted by: Julie Mack, KU School of Medicine

Julie Mack has shared some “Top 5” lists of destinations and restaurants in Kansas City.

Editorial: Certification, accreditation and professional standards: striving to define competency, a response to ASPiH Standards for Simulation-Based Education: Process of Consultation, Design and Implementation
By: Carrie Bohnert and Karen Lewis
Submitted by: Valerie Fulmer, ASPE President

The Standards of Best Practice Committee members Barrie Bohnert and Karen Lewis discuss the Simulation- Based Education in Healthcare Standards Framework and Guidance published by the Association for Simulated Practice in Healthcare (ASPiH) in 2017. Read the editorial in the BMJ Simulation and Technology Enhanced Learning here.

General Interest: My Stepfather Started Raping Me When I Was 7. It Changed The Course Of My Life Forever.
By: Michael Broussard
Submitted by: Denise LaMarra, Perelman School of Medicine at the University of Pennsylvania

Michael Broussard is one of the SPs at the Perelman School of Medicine at the University of Pennsylvania. When he is not working as an SP, he does a one-man show, “Ask a Sex Abuse Survivor.” It is a very powerful performance, which he does in theaters throughout the region, and now nationally. He has also performed at the medical school at the University of Pennsylvania for the past two years. Both the play and the article are strong testimonials on theater art as a healing mechanism. Read the full article at HuffingtonPost.com here.

General Interest: 3 Methods for Teaching Communication to Radiology Residents
By: Subrata Thakar
Submitted by: Michael Maury, UCSD School of Medicine

In this short article, Subrata Thakar mentions 3 methods for teaching communication; (1) Microteaching (2) Simulation-based Training and (3) Mnemonics, Scripts and General Aids. For more details and perhaps new insight into these various communication methods read the full article at Radiology Business here.

Media Article: Oregon medical students face tough test - Talking about dying
By: Jonel Aleccia
Submitted by: Kerensa Peterson, Northwestern University Feinberg School of Medicine

The distraught wife paced the exam room, anxious for someone to come and tell her about her husband. She’d brought him to the emergency department that afternoon when he complained about chest discomfort. Sophia Hayes, 27, a fourth-year medical student at the Oregon Health & Science University, entered with a quiet knock, took a seat and asked the wife to sit, too. Softly and slowly, Hayes explained the unthinkable: The woman’s husband had had a heart attack. His heart stopped. The intensive care team spent 45 minutes trying to save him. Then Hayes delivered the news dreaded by doctors and family members alike. “I’m so, so sorry,” she said. “But he died.” Read the full article at Salon.com here.

General Interest: Type A and Type B Personalities - Useful Measure of Personality or Conspiracy Funded by Tobacco Companies?
By: Adam Sinicki
Submitted by: Dan Brown, Emory School of Medicine

Continuing our exploration of medical and/or psychological terms that are frequently misused or misapplied, this article discusses the history of Type A and Type B personality theory. People often refer to themselves or others as “Type A” personalities, but “Type B” is much rarer in conversation. Sinicki, a writer who holds a bachelor’s psychology degree, breaks down the theory and explores its roots as an attempt to identify people who live at a higher stress level, and who are therefore more likely to suffer cardiac disease. The founders of the theory, Drs. Meyer Friedman and Ray Rosenman, were cardiologists not psychologists, and their study has been criticized for decades, partially due to its connection to the tobacco industry.

Research Article: A Walk in My Shoes - Using Art to Explore the Lived Experience of Psychiatric–Mental Health Standardized Patients
Lead author: Debra Webster
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

Use of SPs to teach mental health nursing skills is increasing. Although the literature regarding the effectiveness of this teaching strategy supports its use, information regarding the effect of portraying mental illness on SPs is lacking. Using a qualitative approach incorporating art as expression, this effect was examined. Five SPs created an artistic expression to describe their work portraying an individual with mental illness while working with senior nursing students enrolled in a psychiatric–mental health clinical nursing course. Themes identified include: (a) Walking the Walk, (b) Listen to Me, (c) See Me as a Person, and (d) Letting it Get to Me. The current article offers best practice approaches to address psychological implications for SPs portraying mental illness. Read the full article in the Journal of Psychosocial Nursing and Mental Health Services here.

Media Article: Simulation Room Preps Ohio State Students for Active Shooter Response
By: Nick Bechtel
Submitted by: Todd Lash, Publications Committee Chair

Medical students at the Ohio State University are using a simulation room at the Wexner Medical Center to practice their response to a mass shooting situation. A part of the hospital has been transformed to look like a movie theater, where students and staff simulated mass casualty event on Tuesday. Fake gunshots rang out, and students posing as wounded victims covered in fake blood screamed out for help. "It was definitely startling, the extent of some of the injuries, and having the blood shoot out onto us," said Jess Pinto, a fourth-year medical student. "At one point a patient is talking to us and the next minute they're not, startling and scary."  See the full coverage at NBC4 here, or view the video coverage here.

President’s Message
Val Fulmer, ASPE President

Dear ASPE Members,

Submitted by: Dan Brown, Emory School of Medicine

Last summer, I attended the ASPE conference for the first time. I had been an SP Educator for six months, and knew I would be learning a lot, but really had no idea what to expect. Nine months later, and having just booked my attendance at the 2018 conference, these are my lasting impressions, along with advice that did (or would have done) me some good:

General Interest: Mimicking rashes - Use of moulage technique in undergraduate assessment at the aga khan university, Karachi
Lead author: Saniya Raghib Sabzwari
Submitted by: Todd Lash, Publications Committee Chair

To assess the validity and feasibility of moulage technique–where a cosmetically constructed rash is used on simulated patients–two dermatologic rashes were developed using moulage simulation on standardized patients (SPs). Dermatologists created checklists for cases that focused on history taking of a skin rash. These included a description and identification of lesions, differential diagnosis, and basic management. Sixty-four students were assessed on a Herpes Zoster case and 32 students on a Herpes Simplex case. Face validity for all groups was established through input of content experts. The investigators determined that the use of moulage technique to develop dermatologic lesions on SPs may be utilized for student assessment. Read the full article in Education in Health here.

International News: State of Simulation in Healthcare Education: An Initial Survey in Beijing
Lead author: Zichen Zhao
Submitted by: Todd Lash, Publications Committee Chair

The objective of this study was to assess the current state of the use of simulation-based training in Beijing and to explore the barriers to further development. This study included hospitals in Beijing accredited by the Standardized Residency Training (SRT) program. The questionnaire was designed online and distributed to the SRT management departments by e-mail or instant message. Thirty hospitals were invited to participate in this survey, and 15 responses were completed and met the inclusion criteria. The results of the survey indicated that there is a need for more development of training facilities, and for training the “trainers” and administrators. Financial funding, curricular design, and research seem to be crucial for building a long-term, sustainable, effective program. Read the full article in the Journal of the Society of Laparoendoscopic Surgeons here.

General Interest: How 'Artful Thinking' Can Improve Your Visual Intelligence
By: Teodora Zareva
Submitted by: Michael Maury, UCSD School of Medicine

In this article, author Teodora Zareva discusses “a recent study from the University of Pennsylvania” which “shows how principles from the field of visual arts can successfully be applied to medical training to increase observational and descriptive abilities.” As Zareva puts it, “observational skills are critical for medical students and yet students undergo no specific training to develop them.” According to this article, the results from this research study “were impressive”. As one 1st year medical student reflected, “After just one session, I found myself listening to a radiologist discuss the same principles we used to look at art when analyzing a CT scan. Later I found our practice of creating narratives in the art class helped guide me when interacting with standardized patients.” Read on here to learn more about the “Artful Thinking” approach and how it might benefit medical education.

Media Article: Searching for the Roots of Empathy in Rituals of Care
By: Emily Wilson
Submitted by: Valerie Fulmer, ASPE President

Kerry Tribe is interested in memory, language and awkward connections. These come together in her latest project, Standardized Patient. These SPs (as Tribe calls them) are professional actors used to train future doctors how to listen, be empathetic, and establish a rapport with patients. After observing classes at Stanford University and the University of Southern California, Tribe came up with four case scenarios, and she’s made a two-channel video installation, on display in San Francisco Museum of Modern Art’s New Work series through February 25 — her first solo exhibition at a major U.S. museum. Read the full article at Hyperallergic.com here.

General Interest: Medical Jargon May Cloud Doctor-patient Communication
By: Mary Gillis
Submitted by: Michael Maury, UCSD School of Medicine

As Standardized Patient Educators, we understand the importance of clear communication. We encourage our students to use very little jargon or at least follow up any jargon with a clear explanation as to mitigate misunderstanding and confusion. In this article, Mary Gillis discusses a recent “survey of London oral and maxillofacial surgery clinic patients” where “more than a third of participants did not know the meaning of terms like ‘benign’ or ‘lesion’ and more than half could not define ‘metastasis’ or ‘lymph node’.” According to UK researchers, Gillis states, “when patients misunderstand commonly used medical terms, communication and decision-making may suffer.” Read the full article on Reuters Health News here.

Media Article: Searching for the Roots of Empathy in Rituals of Care
By: Emily Wilson
Submitted by: Valerie Fulmer, ASPE President

Kerry Tribe is interested in memory, language and awkward connections. These come together in her latest project, Standardized Patient. These SPs (as Tribe calls them) are professional actors used to train future doctors how to listen, be empathetic, and establish a rapport with patients. After observing classes at Stanford University and the University of Southern California, Tribe came up with four case scenarios, and she’s made a two-channel video installation, on display in San Francisco Museum of Modern Art’s New Work series through February 25 — her first solo exhibition at a major U.S. museum. Read the full article at Hyperallergic.com here.

International News: China’s First International SP forum held in Hangzhou
Submitted by: Robert MacAulay, Director, Standardized Patient Program UCSD School of Medicine

In December 2017 China held its first international simulated patient forum in the city of Hangzhou hosted by the China SP Practice Teaching Guidance Committee (CSPC) and sponsored by Zhejiang University. ASPE was graciously invited to attend the forum as a guest of the CSPC and introduced its Standards of Best Practice to a receptive group of attendees representing eight countries. Twenty speakers presented over the two day forum including ASPE members David Li, Robert MacAulay, Debra Nestel, Carol Pfeiffer, Claudia Schlegel and Peggy Wallace. The theme of the forum was: communication, cooperation, innovation, development and pragmatism.