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Bringing OSCEs into the 21st Century: Why Internet Access is a Requirement for Assessment Validity

By: George Shand
Submitted by Kathy Herzberger, Loma Linda School of Medicine

This article presents an interesting discussion regarding the development of Open Resource Clinical Assessments (ORCAs). These assessments allow students to utilize internet resources during SP encounters just as physicians do in real practice. Assessing a student’s judgment regarding their choice of resources, interpretation of the information, and their application of this knowledge to the patient’s concern and treatment plan could be valuable in assessing their skill in information management.  

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The Emotional and Behavioral Impact of Delivering Bad News to Virtual Versus Real Standardized Patients: A Pilot Study

Lead Author: S. O’Rourke
Submitted by Kathy Herzberger, Loma Linda School of Medicine

I am personally not a big fan of virtual patients, but the findings in this study have given me pause to rethink my attitude toward virtual vs real patients. Their findings add credence for the use of virtual SPs even when dealing with difficult scenarios such as delivering bad news.

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Association of Simulated Patient Race/Ethnicity with Scheduling of Primary Care Appointments

Lead Author: Janna M. Wisniewski, PhD; Brigham Walker, MS
Submitted by: Dan Brown, Emory University School of Medicine

This study used seven Simulated Patients belonging to three ethnic groups (self-reported as white, black, Hispanic) to call 804 randomized physician offices to attempt to schedule an appointment. All patients, if asked, would report being uninsured and paying out of pocket. The black and Hispanic patients were asked about their insurance significantly more frequently than the white patients. They also had a longer average wait time until their appointment.

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Belonging, Respectful Inclusion, and Diversity in Medical Education

By: Roberts, Laura
Submitted by Kathy Herzberger, Loma Linda School of Medicine

Laura Roberts, in a well-written piece, reminds us that many of our students, tragically, still face bias, discrimination, microaggressions, and exclusionary practices in medical school. She includes results from the 2019 Medical School Graduate Questionnaire that should make all of us take notice and work hard to help each student we interact with feel respected and valued.

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Using Simulation-based Learning to Provide Interprofessional Education in Diabetes to Nutrition and Dietetics and Exercise Physiology Students Through Telehealth

Lead Author: Marie-Claire O’Shea
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

This study describes a telehealth interprofessional simulation-based learning experience with nutrition and dietetics and exercise physiology students. The common practice area of interacting with patients who have type 2 diabetes was targeted, and the simulation was delivered in partnership with simulated patients via a telehealth platform to allow interprofessional teams to work collaboratively in remote locations.

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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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Reliability of Scores Obtained from Standardized Patient and Instructor Assessments

Lead Author: Gulsen Tasdelen Teker
Submitted by: Kathy Herzberger, Loma Linda School of Medicine

We all know how hard it is to recruit instructors to participate in OSCE assessment. One alternative is to use standardized patients as raters. However, are they as reliable as instructors are? Although not a large study, I found the results very interesting.

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Three-Dimensional Needs of Standardized Patients in Nursing Simulations and Collaboration Strategies: A Qualitative Analysis

Lead Author: Hye-Rim Jin
Submitted by: Kerensa Peterson, NBOME Chicago

The authors of this study in Korea have asked what drives Standardized Patients to do great simulation work.  Their results give further explanation to studies that have been conducted since the 1990s, offering examples of how SPs find meaning in their work, are shown empathy for their work, and participate in the education process.

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Are Rating Scales Really Better than Checklists for Measuring Increasing Levels of Expertise

Lead Author: Timothy Wood
Submitted by: Kathy Herzberger, Loma Linda School of Medicine

This is a very interesting article reexamining the relationship between increased training and scoring instruments on OSCE stations. This study explores whether checklists or global rating scales are better at evaluating increasing levels of expertise.

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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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