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Three Zones of Cultural Competency: Surface Competency, Bias Twilight, and the Confronting Midnight Zone

By: Tanisha Jowsey
Submitted by: Todd Lash, The Ohio State University

Regulatory authorities in healthcare are authorized to develop and assess the cultural competence of their professionals. There remains significant diversity on approaches to cultural competency training and assessment. Little evidence exists about whether existing cultural competency training leads to improved patient health outcomes and reductions in health disparity.

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In The Spotlight: University of Portland

Submitted By: Jodi Blankenship

Full Center Name: University of Portland Simulated Health Center

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ASPE Standards of Best Practice Translated into Japanese

Lead Author: Keiko Abe, Aichi Medical University Collage of Nursing and Cathy Smith, Baycrest Health Sciences
Submitted by: Holly Gerzina,
Northeast Ohio Medical University 

The Association of Standardized Patient Educators (ASPE) Standards of Best Practice (SOBP), published in Advances in Simulation in 2017, represents an important milestone in the development of SP methodology and the professionalization of the practices of those who work with SPs. Designed to be used in conjunction with other simulation standards, such as those developed by INACSL, the ASPE SOBP focus on providing principles and practices that help ensure safety and effectiveness related to the work of all human role players involved in simulation. Currently, the SOBP have only been published in English. Although the SOBP are being implemented in many English speaking countries, there is a barrier related to putting the ASPE SOBP into practice in countries where English is not the first language. As ASPE’s mission is global the ASPE International Committee has initiated the translation of these standards into other languages. The Japanese version is available now on ASPE’s website. This initiative represents the first of many translations of ASPE SOBP into other languages to ensure that simulation practitioners around the world can benefit from using these standards.

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How to Identify, Address and Report Students’ Unprofessional Behaviour in Medical School

Lead Author: Marianne Mak-van der Vossen
Submitted by: Kathy Herzberger, Loma Linda School of Medicine

This AMEE guide provides a research overview of the identification of, and responding to unprofessional behaviour in medical students. It is directed towards medical educators in preclinical and clinical undergraduate medical education. It aims to describe, clarify and categorize different types of unprofessional behaviours, highlighting students’ unprofessional behaviour profiles and what they mean for further guidance. This facilitates identification, addressing, reporting and remediation of different types of unprofessional behaviour.

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Evaluating Cultural Competence in Undergraduate Nursing Students Using Standardized Patients

Author: Deborah Byrne, PhD, RN, CNE
Submitted by: Marsha Harman, Rush University

The need for culturally competent health-care providers is essential in reducing health disparities and ensuring positive patient outcomes. The use of simulation with standardized patients (SPs) is an effective strategy that could be integrated throughout undergraduate nursing curricula to evaluate a student’s cultural competence.

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Patients with Empathetic Doctors are at Reduced Risk of Early Death

Author: Kelly Earley
Submitted by: Catherine Hagele, Perelman School of Medicine at the University of Pennsylvania

Patients reporting better experiences of empathy in the first 12 months after diagnosis have a significantly lower risk of death over the subsequent 10 years, compared to those who experienced low practitioner empathy.

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Development of an Empathy and Clarity Rating Scale to Measure the Effect of Medical Improv on End-of-First-Year OCSE Performance: A Pilot Study

Lead Author: Carol A. Terreginoa,
Submitted by: Michael Maury, UC-San Diego

Patients want empathetic physicians who listen and understand. How do you teach and measure empathy? The objective of this study was “To develop a framework and instrument, the Empathy and Clarity Rating Scale (ECRS), for measuring communication elements used by actors and physicians, and pilot ECRS to test effectiveness of medical improv on first-year students’ communication skills.” Four medical schools collaborated. USMLE Step 2 Communication and Interpersonal Skills (CIS) domains were used as framework for discussion among three focus groups, each with clinicians, actors, communication experts, and community members with patient experience. Audiotaped discussions were transcribed; open coding procedures located emerging themes. Final ECRS was used to study student performance across three levels of experience with medical improv. What was developed from this pilot study was “a communication scale enlightened by experiences of actors, clinicians, scholars and patients.”

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Your Professional Decline is Coming Sooner Than You Think

Author: Arthur C. Brooks
Submitted by: Dan Brown, Emory University

This article is relevant to any creative professionals; to anyone who finds their value in the quality of their work.

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How to Define Core Entrustable Professional Activities for Entry into Residency?

Lead Author: Ylva Holzhausen
Submitted by: Mary Launder, Rosalind Franklin University of Medicine and Science

The definition of core Entrustable Professional Activities (EPAs) for entry into postgraduate training has become an active field of development. Many institutions are currently considering the use of EPAs as outcomes for their undergraduate medical programs. These institutions can build in part on EPAs which have been reported at a national level and at a local level, but will be required to undertake their own content validation process to adapt these EPAs to their specific context. However, available reports do not include a fully detailed description of the EPA development process which could guide other institutions. In this article, we report in detail on a systematic, literature-based approach we employed to define core EPAs for entry into residency as outcomes for the undergraduate medical curriculum at Charité - Universitaetsmedizin Berlin, Germany.

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Saving the Family Physician One Doctor at a Time through ‘Lifestyle Medicine’

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

Physician burnout, especially among family doctors who often labor long hours with little support, is a major problem in the United Sates, contributing to a growing nationwide shortage of practitioners. Bethlehem, Pennsylvania-based St. Luke’s University Health Network has launched an innovative residency program to stop burn-out before it happens. The new program promotes “lifestyle medicine” not only for patients, but also for doctors themselves.

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Medical Education Trends for Future Physicians in the Era of Advanced Technology and Artificial Intelligence: An Integrative Review

Lead Author: Eui-Ryoung Han
Submitted by: Kathy Herzberger, Loma Linda School of Medicine

Medical education must adapt to different health care contexts, including digitalized health care systems and a digital generation of students in a hyper-connected world. The aims of this study are to identify and synthesize the values that medical educators need to implement in the curricula and to introduce representative educational programs.

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Effect of a Single-Session Communication Skills Training on Empathy in Medical Students

Lead Author: Cheryl D’souza
Submitted by: Catherine Hagele, Perelman School of Medicine at the University of Pennsylvania

Empathy scores have been found to decline over the years spent in medical school. These authors aimed to evaluate the change in empathy levels in medical students following a single-session communications skills training. While levels initially went up, they then went down after a few weeks. A regular communications skills training program may enhance empathy and prevent its decline over the years.

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Parent-Provider Paediatric Literacy Communication: A Curriculum for Future Primary Care Providers

Lead Author: Tiffany Kindratt
Submitted by: Kerensa Peterson, NBOME Chicago

Scholarly literature has expanded on the benefits of literacy programs designed to get parents and children between the ages of 6 months to 5 years reading together. Many of those studies have shown that training in residency on programs like Reach Out and Read may improve knowledge, skills, and attitudes toward pediatric literacy. Previous studies, however, lacked simulation experiences in which learners can practice the communication skills necessary to engage with patients and caregivers.

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In The Spotlight: Emory University School of Medicine

Submitted By: Dan Brown

Full Center Name: Clinical Skills Center

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Introducing the ASPE Center Spotlight

By: Todd Lash, The Ohio State University

The Publications Committee is pleased to announce an exciting new feature on the ASPE eNews Blog: The ASPE Center Spotlight. Inspired by Bob Bolyard’s member liaison project in 2018, a looping slide presentation displayed at the ASPE conference that featured photographs and statistics from multiple centers and programs, the Publications Committee sought to transform the project as a way to foster community and connection among members beyond the conference. To this point, the Publications Committee will feature one center or program per month on the ASPE eNews Blog in 2020. The mission of the ASPE Center Spotlight is to connect SP programs and simulation centers, and promote interagency and interdisciplinary collaboration in SP and simulation methodology. In addition, photographs and statistics published on the eNews Blog will be added to the slide presentation that will be displayed each year at the ASPE conference.

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Improving Lesbian, Gay, Bisexual, Transgender, and Queer/Questioning Health: Using a Standardized Patient Experience to Educate Advanced Practice Nursing Students

Lead Author: Elizabeth K. Kuzma
Submitted by: Catherine Hagele, Perelman School of Medicine at the University of Pennsylvania

Over the last few years, nursing education has begun to embrace the need for LGBTQ content in nursing curricula. When compared with their heterosexual and cisgender counterparts, individuals identifying as LGBTQ face notable health disparities including increased disease and mortality, poorer health outcomes and higher rates of certain illnesses as well as biopsychosocial disparities. This pilot project increased knowledge, comfort and skills relating to interactions with people who identify as LGBTQ.

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For Busy Medical Students, Studying Meditation for Two Hours May Be Just as Beneficial as Longer Course

Author: Neal Buccino
Submitted by: Catherine Hagele, Perelman School of Medicine at the University of Pennsylvania

For time-crunched medical students, taking a two-hour introductory class on mindfulness may be just as beneficial for reducing stress and depression as taking an eight-week meditation course, a Rutgers study finds. Researchers say many medical students would like to use meditation to avoid burnout and provide better medical care, but are daunted by the prospect of making time for a daily meditation routine. While this article focuses on medical students, there are many parallels between their stress and time-crunch that Standardized Patient Educators also experience.

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Use of Simulated Patient Encounters to Teach Residents to Respond to Patients Who Discriminate Against Health Care Workers

Lead Author: Ellen H. Eisenberg
Submitted by: Marsha Harman, Rush University

This article describes a workshop for first-year residents that used standardized patients to practice responding to patients exhibiting bias against members of the health care team. The workshop included a didactic session and four scenarios in which standardized patients portrayed patients with bias based on gender, class, or race.  Learners received feedback from a trained facilitator, peers, and the standardized patients. One hundred percent of the 19 learners who participated agreed that the simulated exercises were realistic and improved their readiness to address patient bias.

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Five Reasons It Can Be Hard to Talk to Your Doctor—And Four Ways to Do It Better

By: Gillian Rutherford, University of Alberta
Submitted by: Michael Maury, UC-San Diego

In her talk entitled “Co-Creating Care to Improve Medicine”, University of Alberta endocrinologist Rose Yeung shares that, “Miscommunication, or under communication, happens regularly between patients and their doctors, nurses, dietitians and even naturopaths.” Those of us in Medical Education understand this truth all too well. In this article, Gillian Rutherford points out why it may be difficult for most to speak with their doctor and lays out four ways in which we can overcome this challenge. Yeung mentions, “The patient and the professional are supposed to deliberate and come up with an acceptable treatment plan together.” Remembering that physicians and patients are in this health care experience together as a team, is just one piece to the solution. Please press on for more insights and ideas.

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Evaluating Shared Decision-making in Periviable Counseling Using Objective Structured Clinical Examinations

Lead Author: Brownsyne Tucker Edmonds
Submitted by: Kerensa Peterson, NBOME Chicago

Shared Decision Making (SDM) has been widely endorsed as a favorable practice for patient-centered care.  However, it is underutilized in clinical practice and has lacked tools for assessment.  There are studies which support the use of shared decision-making tools in advanced care planning, but few tools for SDM have been tested in a periviable setting.

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