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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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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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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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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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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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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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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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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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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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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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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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An Overview of How to Encourage the Standardized Patient (SP) Teaching Methodology – From the Perspective of a SP and SP Trainer

By: Wu Jiansheng
Submitted by: Todd Lash, Publications Committee Chair

As one of the first generation of Standardised Patients in China, perhaps Asia as well, I have been working in the clinical skills training center in West China Medical School of Sichuan University for 25 years. I would like to share with you how I joined this little-known and somewhat mysterious field, participated in this form of teaching, and progressed from a normal SP to a SP trainer. It is noted that the Standardised Patient (SP) was first introduced by Howard Barrows in 1963. In 1993, West China School of Clinical Medicine, Sichuan University was the first to do the training courses and trained the first group of SPs. In 2003, China Medical Board (CMB) America organized a “Student Evaluation Plan Program”; 8 Chinese medical schools joined and imported the training program to China.

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A Good Physician — On Complacency and Communication

Author: Michelle M. Kittleson, M.D., Ph.D.
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

“I recently cared for a 45-year-old man for over a month and never spoke to him.” This moving reflection from Dr. Kittleson details her realization about the lack of communication with her patient awaiting a heart transplant who is also deaf. “I fell into a complacency born of pragmatism and confidence in my abilities: I knew I was providing the best medical care, so I ignored the importance of direct communication.” This personal story highlights the need for direct doctor-patient communication no matter what perceived barriers exist – a concept for which SP educators continue to advocate.

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Perceptions of a longitudinal standardized patient experience by standardized patients, medical students, and faculty

Lead author: Lauren Block
Submitted by: Mary Launder, Rosalind Franklin University of Medicine and Science

Background: Longitudinal standardized patient (LSP) experiences mimic clinical practice by allowing students to interact with standardized patients (SPs) over time. LSP cases facilitate practice, assessment, and feedback in clinical skills and foster an appreciation for the continuum of care.

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A Pilot Project Exploring Medical Students’ Barriers to Screening for Intimate Partner Violence and Reproductive Coercion

Lead Author: Sarah E. Stumbar, MD, MPH
Submitted by: Catherine Hagele, Perelman School of Medicine at the University of Pennsylvania

Why is it that most health care practitioners do not routinely screen patients for intimate partner violence (IPV)? This third-year family medicine clerkship included a pregnancy options counseling OSCE aiming to explore students’ internal barriers to screening patients for IPV. Even though the educational module included scripted screening questions, students reported a major barrier to screening was difficulty finding the words with which to ask the questions, thereby suggesting that these kinds of practice encounters may be more effective, offering a performance model that can support skills acquisition.

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Communication Skills and the Problem with Fake Patients

By: George Gillett, Fourth Year Medical Student
Submitted by Kathy Herzberger, Loma Linda School of Medicine

George Gillett, who was a fourth year medical student when he wrote this article, expressed an interesting perspective regarding empathy and standardized “fake” patients. Included in this discussion is a suggestion from Anu Atluru, MD that “improv’s fundamental principles of honesty and spontaneity” might be helpful in teaching students how to acknowledge feelings without the rote “I’m sorry to hear that…” The opinions expressed are certainly issues to ponder as we develop future communication curriculum and assessment.

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Maximizing the Acquisition of Core Communication Skills at the Start of Medical Training

Lead Author: Hasan Mohiaddin
Submitted by: Marsha Harman, Rush University

How does contact with actual patients affect how medical students develop communication skills, and how does it impact their performance in an SP encounter? First year medical students at Imperial College London learn communication skills through lectures, small group teaching, and SP encounters. This study compared two groups of first-year students; the study group experienced repeated contact with real patients as part of a volunteer organization aiming to reduce isolation in elderly inpatients, while the control group received only the formal curriculum on communication.

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The Link Between Health Literacy & Cancer Communication

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

In an era of increasingly complex advances in oncology, how can health professionals help cancer patients with low health literacy better understand their diagnoses and treatment options? In an effort to improve cancer communication strategies with patients, the National Cancer Policy Forum (NCPF) convened a meeting of invited speakers in Washington, D.C. At the meeting, the point was repeatedly made that skills in cancer communication can be taught and learned, and it is the responsibility of health professionals to make sure all their patients (including those with low health literacy) truly comprehend the information they are being given. We as SP Educators know that SP methodology is an excellent tool for practicing these communication skills.

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Assessment of Clinical Empathy Among Medical Students Using the Jefferson Scale of Empathy-Student Version

By: Shahid H. Mirani, Noor A. Shaikh, and Amber Tahir
Submitted by: Dan Brown, Emory University

This study was conducted among medical students of Ghulam Muhammad Mahar Medical College, using a self-administered and self-perceived inventory called the Jefferson Scale of Empathy-Student Version. It compared the empathy scores by gender, by year of medical school, and by career preference. Its findings were comparable to similar studies, in that empathy scores decline over the course of medical school. The study concludes that it is “very important that we pay attention to nurture our medical students to have empathy rather than lose it under the stress of academic performance.”

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Integrating Opioid Use Disorder Training in Physician Assistant Education

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

At the American Academy of Physician Assistants (AAPA) annual meeting, held May 18 to 22, 2019 in Denver, Colorado, research was presented about physician assistant (PA) students and training on opioid-use disorder (OUD). Students in the didactic Behavioral Medicine course at Mercer College of Health Professions in Atlanta, Georgia, participated in a lecture series on OUD that included standardized patients to simulate a realistic presentation of patients with clinical pain complaints and provided screening, diagnosis, and counseling techniques. Students in the clinical course received the same instruction following completion of their core clinical rotation. Faculty observers provided students with feedback on patient interaction, empathy, use of professional medical terminology, opioid risk and benefit assessment, universal monitoring strategies, and including patients in the treatment decision-making process. These students reported improved confidence following the OUD instruction.

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