SP-Trainer Blog

SP Potpourri

2009-11-10T09:40:00.000-08:00

A nice article in the Greensboro News-Record:

Pretend patients help train real medical students

I can't help but find it interesting that a student quoted in this Shreveport Times article seems to think that their SP Program is one of the only ones in the country!

Medical school enrollments up here, nationwide

And congratulations to the University of South Florida for having their SP program featured on the NBC Today Show on November 4th! Sorry I missed it, but maybe they've got video of the program available?

SP Video

2009-08-20T13:56:00.000-07:00

The New York Times has also posted some accompanying video to their end of life article referenced in the previous post.

This shows first-year residents working with a Standardized Patient in a breaking-bad-news scenario, and also some of the feedback.

Delivering Bad News

SPs in Blogs and Press

2009-08-20T09:56:00.000-07:00

As students start up their first year in medical school over the next weeks, some of them will already be seeing SPs. This student blogs about his first experiences:

Lost in Philadelphia: first standardized patient session

This article in today's New York Times describes the field of palliative care medicine, why end-of-life counseling is not a "death panel", and some of the issues facing teaching physicians about breaking bad news. Alongside actual palliative care patients, an SP session is featured.

At the End, Offering Not a Cure but Comfort

SP Publications

2009-08-04T11:19:00.000-07:00

Dr. Win May of USC wrote to me to let me know about two SP-related publications that came out recently:

1. May W, Park J, Lee JP. (2009) A ten-year review of the literature on the use of standardized patients in teaching and learning: 1996-2005. Medical Teacher, 31:6,487 - 492.

2. May W (2008). Training Standardized Patients for a High-stakes Clinical Performance Examination in the California Consortium for the Assessment of Clinical Competence.
Kaohsiung J Med Sci., 24(12): 640-5.

Great work advancing our field!

SPs in the Press

2009-07-08T12:33:00.000-07:00

The recent "Piece of My Mind" essay in JAMA features a reflection from a medical student who contrasts her experiences using her "doctor kit" with an SP and then with a real patient, and the gulf that divides the two experiences for her:

Physician by Number by Rachel A. Winer

SPs in the Press

2009-04-13T11:10:00.001-07:00

Great article about how the SP Program at Dartmouth is using SPs to teach. and create interest in, geriatrics:

These Elderly "Actors" May be Retired, but They're Not Retiring

SPs in the Press

2009-04-10T08:56:00.000-07:00

Jennifer Ware's program in Memphis had an in-depth article written by a reporter who also spent time as one of the SPs:

Standardized Patients Act Sick for Medical Students' Training

Great press, Jen!

Virtual Medical School

2009-04-02T11:26:00.000-07:00

Kris Slawinski brought the following article to my attention this week, and it raises interesting questions about what kind of virtual experiences we can create for our students, whether in Second Life or in other environments, and how useful they might be:

Can Second Life Help Teach Doctors to Treat Patients?

Is your school or institution using any kind of virtual patient system, either for individual or for group "patient" interactions? Tell us about it in the comments!

Blogging About SPs

2009-03-12T14:39:00.000-07:00

Not every student takes the time to write out a positive SP experience in his/her blog, but I like to think that this student speaks for many colleagues in this post:

My First (Standardized) Patient

Film about Development of GTA Program

2009-02-20T09:20:00.000-08:00

"At Your Cervix" is a film about the rather checkered history of teaching medical students about the pelvic exam, and features the NYC Gynecological Teaching Associate organization. The film has been reviewed by the Indypendent, and is expected to be released later this year.

I hadn't heard about this until this review, but am very much looking forward to hearing more about the film and when/where it will be released. I'd love to see it screened at the ASPE conference, wouldn't you?

Find a short clip and more information about the movie: At Your Cervix

SP Potpourri

2009-02-20T09:13:00.000-08:00

A new center opens, and an English GP writes a lovely reflection on using SPs to teach communication skills:

OU medical school opens simulation training facility

Teaching Communication Skills

"The Burning"

2009-01-30T11:50:00.000-08:00

Not sure how long it will stay up on YouTube, but the Seinfeld episode where Kramer works at Mt. Sinai SP program has been edited to the relevant portions, and posted:

Hidden Curriculum of Medical School

2009-01-30T08:35:00.000-08:00

Anna Lank of C3NY sent along the following article on the "Hidden Curriculum of Medical School" from the New York Times. In Dr. Chen's ongoing column, she explores a number of issues surrounding medical education, and while she doesn't directly mention Standardized Patients as one of the ways that 'bedside manner' is taught, this column touches directly on our main goals with this methodology.

I found the comments (I've read only the first 20 or so posted) interesting -- it seems that some readers interpreted "hidden" to mean that bedside manner isn't directly taught during medical school. Makes me wonder if we shouldn't ask Dr. Chen for a follow-up column detailing some of the many ways we do!

SP Potpourri

2009-01-27T10:04:00.000-08:00

A little of everything over the weekend, after a bit of an SP/Simulation news dry-spell:

A terrific and detailed press release about the new simulation center opening at Tulane -- congrats over there, folks!

Nice little photo gallery of SPs in Clinton, MS -- doesn't seem to be attached to an article, at least not one easily located.

And finally, one student's description of a day spent with SPs and GTAs and how he (barely) survived to laugh about it. And had his bike stolen.

Blogging About SPs

2008-12-08T09:39:00.000-08:00

Here's a lovely written piece about one student's gratitude for her Standardized Patient:

Slicing, Sawing & Feeling

SPs in the Press - Video

2008-12-04T09:52:00.000-08:00

Another article about SPs and simulation, this time from Loma Linda. In addition to the written article, there's a nice video about an OSCE featuring SP Educator Nancy Heine and some of the Loma Linda SPs and students.

Local actors assist doctors in training at Loma Linda medical school

SPs in the Press

2008-12-01T10:21:00.000-08:00

SP programs continue to thrive and receive press:

Brody Students Practice Patient Assessment Skills

And not exactly simulation-specific, but interesting and worth considering how it might work its way into simulation education:

UW Uses Artwork to Help Sharpen Visual Skills of Future Doctors

SPs in the Press

2008-11-25T09:40:00.000-08:00

Indulge me while I share a news article featuring the University of Washington's most famous former SP, Joel McHale. He's "gone and done good", and we still miss him around here -- he made every session he worked fun. Congrats Joel!

It all started in the Seattle area for E!'s king of snark Joel McHale

SPs in the Press

2008-11-19T10:20:00.001-08:00

Another nice, newsy feature, and a column based on an older journal post by an SP:

As standardized patients act out symptoms, medical students rehearse for careers

Playing patient less fun than playing doctor

SP Video

2008-11-17T10:11:00.000-08:00

Check out a nice news piece about a study done using Unannounced SPs at the University of Rochester. Bonus: You'll see SP Educator Alison Venuti doubling as an SP.

Undercover Patients Help Doctors

Nice work!

SPs in the Press

2008-11-10T08:18:00.000-08:00

Yo San University of Chinese Medicine in Los Angeles, CA is starting what they say is the first school of Traditional Chinese Medicine to teach using a Standardized Patient Program. See the press release.

Apparently the BBC loves to feature medical simulators every few months, as demonstrated by this most recent article (with short video) and by the line up of related articles in the right sidebar.

I guess many SP Educators might be hoping one of these shows up as a holiday present!

SP Potpourri - Medical Student Edition

2008-11-04T10:03:00.000-08:00

Today's post focuses on the medical student experience, both with SPs and with school in general.

A very popular article in the New York Times addresses Medical Student Burnout.

Sometimes an SP encounter leaves you feeling unsure of yourself:

From Class Time to Patient Time

Other times it buoys your self-confidence:

Super Fantastic Day!

And sometimes you are just glad to get the chance to work with a patient at all:

Cardiovascular Exam

SP Potpourri

2008-11-03T09:50:00.000-08:00

Today we've got a Knol, a Schol, and a LOL:

Knols are Google's entry into the knowledge aggregation realm, competing somewhat with Wikipedia. The difference being, people sign and manage their entries and other people cannot edit them, although they can comment on and rate them. There is a Google Knol on Simulation. What do you think, is the topic covered adequately? Is enough weight given to Standardized Patients in there -- I'll admit it seems skimpy to me:

Simulation in Medicine

The "Schol" is for scholarly work, in this case an interesting use for Standardized Patients -- people keep finding wonderful new ways to use this methodology, which is why I think it rates more than a paragraph in an overview of medical simulation!

Using a standardized patient walk-through to improve implementation of clinical trials

Finally, LOL is internet-speak for "laugh out loud", and is a good tag for our final link today, a collection of limericks from a medical student, including one about SPs:

Limericks (no, not from Ireland...less dirty)

SP Potpourri

2008-10-24T11:57:00.000-07:00

Lots of blogging going on! We hear from students and even a program coordinator today, and present Successful SP Program Navigation in a three-part series:

Step one: Don't kill your Standardized Patient:

So I Moved to New York

Step two: Don't let your Standardized Patients (or the stress of seeing them) kill you:

Somehow I'm Still Afloat

Step three: If you'd like to improve your SP program and cases, consider joining SP-Trainer. I can almost guarantee you'll get better advice:

Questions about SP Experiences

SPs Potpourri

2008-10-15T12:00:00.000-07:00

A neat use of a simulation center, medical student SPs and high school students to get youth interested in careers in health care:

Playing Roles of Doctors

Physical therapists find a role for SPs/Patient Instructors in teaching the assessment of the pelvic floor:

The Use of Standardized Patient Models for Teaching the Pelvic Floor Muscle Examination

Blogging About SPs

2008-10-10T11:08:00.000-07:00

Standardized Patient encounters can be an incredible way to achieve what educators often refer to as "Transformative Learning", which is in many ways their greatest strength as a teaching modality.

Still, no one said all that change couldn't be a little painful:

A Standardized Test?

A Lesson in Humility

These reflections make me pretty sure, though, that in both cases, these authors will come through just fine.

Blogging About SPs

2008-10-08T09:00:00.000-07:00

With northern hemisphere medical schools fully back into the swing of things this Fall, SPs are starting to show back up on assorted blogs:

This student seems a bit confused as to what is "standardized" in a Standardized Patient:

Standardized patient interview -- come to me if you want to talk. If you care about your health, maybe not...

With so many of us facing class expansion impacts on our SP programs, perhaps it makes sense to start 'em young!

Mommy Made This

Finally: Next step in communication training - removing extraneous quotes!

Sept 30, 2008

SPs in the Press

2008-10-03T09:07:00.000-07:00

Well, it never fails, right? Just after I complain we aren't hearing much about SPs recently, we get two terrific mentions.

One is an in-depth look at the use of Standardized Patients and clinical simulation, published in the Yale Daily News:

Practice Makes Perfect

The other is an article in the New York Times that discusses SPs in the context of looking at how doctors break bad news:

The Dance Before Diagnosis

Both are excellent additions to the collection of popular press pieces about these methodologies.

SPs in the Press

2008-09-29T09:02:00.001-07:00

So -- it may just be the summer season, but I've noticed a real drop off in the number of press articles about Standardized Patients and clinical simulation lately. Perhaps it's because fewer new centers are opening? Or, it might be that there's so much other news, what with the US Presidential Election and general economic meltdown, there's less column space for "features" on things like education? And, very likely this is the fallout of the loss of so many reporters at so many local and national newspapers -- fewer people dedicated to finding these sorts of stories.

The "super-local" papers are still at it, however! Here's a great feature on the new center at Vanderbilt University's Medical Center, with a quote from SP-Trainer member Lisa Rawn:

Medical Center adds new technology for teaching

In the meantime folks, maybe we need to put some thought into continuing to get our work out there into the public sphere, either through conventional press channels, or through some of the newer ones, like blogs, wikipedia, podcasting and video-streaming. We can't afford not to be part of the international conversation about patient care and medical education.

SPs in the Press

2008-08-07T08:59:00.000-07:00

Great article about training ethics consultants about working directly with patients and ethical issues , and the use of Standardized Patients in some of the sessions:

Ethics consultants get doses of realism through simulations

SP Potpourri - part two

2008-08-01T09:22:00.000-07:00

And here are another batch of blogs and articles:

Thumbs Down:
Standardized Patients

Thumbs Up:
Reflecting on a Crazy Day: One of Many To Come

Referencing SP-based research:
Patient doctor relationship: Self Disclosure

Editorial in support of simulation centers
Centers key in medical education

SP Potpourri

2008-07-29T10:13:00.000-07:00

Hi All - I've been either running OSCEs or on vacation, so there's been a bit of a lag in this blog, sorry about that. Postings on SPs tend to drop off a bit in the summer as well, but today I've got a whole raft of blog posts and related articles. Hope you've all had a chance at a little summer vacation (if you are in the northern hemisphere, that is!) and if you are at your computer, here are some of the more interesting July links:

Hurried Doctor Visits May Leave Patients Feeling Forgetful

USMLE Step 2 Clinical Skills

Doctor and Patient, Now at Odds

It's a Long Way to the Top

ASPE 2008: Millennials Presentation -- Slawinski/Struijk

2008-06-27T09:52:00.001-07:00

Kris Slawinski and I will lead a presentation and discussion session on Wednesday, July 2nd, 2008 at the ASPE conference, entitled:

Why Won't They Just Read the Syllabus? Understanding the Impact of the Millennial Generation on Medical Education.

We'd love to have you join us in what promises to be a lively, interactive session. Additionally, we are posting our materials here so that attendees can access them once they return to their home institutions. If you have trouble accessing any of the material here, or have questions, please email janim@u.washington.edu for assistance.

Presentation:
ASPE 2008 Millennial Generation Presentation (ppt)
(Note: you don't need to sign in to view, just click "view this presentation in new window" to start presentation)

Books:
Millenials Rising: The Next Great Generation; Neil Howe and William Strauss, 2000

Crossing the Generational Divide - From Boomers to Zoomers; Wendover, Robert; 2007

Video:
A Vision of Students Today

Pritzker Students’ “Scrubin’” Video

Articles:
Generations at Work: Managing Millennials

Law Practice Today: Generation X and the Millennials: What You Need to Know About Mentoring the New Generations

The Disconnect between Library Culture and Millennial Generation Values

Teaching the Millennial Generation

Blogs:
Millennial Generation Blog

Life Before Noon: A Millennial’s Manual

Generations Blog

Editorials:
Millennial Generation: Large and in Charge

We Invented the World You Live In, Kid

SP Potpourri

2008-06-25T08:37:00.000-07:00

The article that went out on the newswire a couple of weeks ago about the Vermont SP Program stimulated some thought in the "blogosphere":

How Do Doctors Train?

Standardized Patients in Medical Training

Unsurprisingly, students still have a lot to say about the CS Step 2:

Notes on the $1000 Exam

But it warmed my heart to see Standardized Patients listed on the blog "Stuff Medical Students Like":

Standardized Patients

Well, folks -- it's almost time for the ASPE conference in San Antonio. Hope to see you down there soon, and if you have ideas for the SP-Trainer blog or listserv, let me have 'em!

AMA says "no" to undercover patients

2008-06-20T17:26:00.000-07:00

Like most NY Times Health Blog articles, the comments are both more interesting and more terrifying than the original article:

Should Undercover Patients Check Up on Doctors?

And, is there really an SP Code?

Maybe it takes a life like Bukowski's to not end up sounding like a *****?

SPs in the Press and Blogs

2008-06-09T08:25:00.001-07:00

A nice story out of Vermont featuring comments from Tamara Owens and Cate Nicholas:

Medical Students Practice on Fake Patients

And in the blog arena, medical student Eric muses on hospital patients, simulated patients, medical student skill and muppets. Yes, muppets.

Below the Belt

SP Education Resources - TB

2008-06-03T09:27:00.000-07:00

Hi All - sorry about the long delay between postings. I was out of town for much of May, and the pickings around the web about SPs and simulation have been pretty slim. So I was excited to find a blog post today with a press release describing the National Tuberculosis Curriculum Consortium and the resources they are offering on their website:

The mission of the National Tuberculosis Curriculum Consortium (NTCC) is to instill knowledge, skills, and appropriate attitudes in the management and control of active and latent TB among undergraduate and graduate students (medical, nursing, pharmacy, public health, respiratory therapy, medical technology, physician assistant) in their formative years, as well as establish a foundation by which complex issues relating to TB can be continually revisited throughout the span of their careers.

The NTCC has developed an extensive offering of curricular materials that are available to educators, students, and healthcare professionals worldwide. These teaching and learning materials cover a wide range of important TB topics and offer a variety of training resources. The NTCC educational products including interactive computer-based clinical cases, resource banks, and other educational assets covering Tuberculosis.

In addition, the website has been reviewed by the University of California San Diego Library, which mentions that the UCSD School of Medicine developed the website with input from 24 other schools of medicine and public health.

I really look forward to checking it out -- there are SP cases, images and lab materials, and teaching resources and handouts. Great work San Diego!

Blogging About SPs

2008-04-24T10:17:00.001-07:00

The terrific student reflections continue. See this one on working with SPs to learn about talking to patients about death and dying:

Breaking Bad News

Blogging About SPs

2008-04-18T08:10:00.000-07:00

This student wrote a really nice reflection on his experience as he's coming to the end of his 2nd year of medical school, and offers some ideas for change. Many of these reference the use of SPs and other forms of simulation.

Reflections on Preclinical Curricula

SP Video

2008-04-10T11:17:00.000-07:00

KOLO Reno Channel 8 had a nice little feature on the local Standardized Patient program this week, and has streamed the video online:

Bedside Manner Class

SPs in the Press

2008-04-07T09:53:00.001-07:00

Spring has sprung and apparently that means it's time for features on medicine in general, and SPs and simulation in specific. Here are a couple of good ones, and note: the first article contains links to the YouTube videos of the Seinfeld episode, "The Burning", set at Mt Sinai's SP program.

Acting sick for cash not as easy as 'Seinfeld' makes it seem

Using drama to train for high trauma

'Faux' patients help med students hone bedside manner

SPs in the Press

2008-04-02T09:17:00.000-07:00

Another great article featuring the UAMS Pulse Center, Mary Cantrell and Grace Gephardt:

LR hospital marks year of pediatric-crisis drills

And a Standardized Patient writes about it as "a survival job" for others in the acting profession:

The Actors Voice - POV -- Standardized Patient

Blogging About SPs

2008-03-31T09:15:00.000-07:00

A couple of really nice blogs about SP experiences:

I made my patient cry today

"Is it...gonorrhea?"

SPs in the Press

2008-03-18T08:48:00.000-07:00

Not a lot going on after quite a big pickup on the "undercover knee replacement SPs" story, but here's a very in-depth profile on an SP in Iowa:

Practice suits 'patient' who polishes his fake symptoms

SP Scholar

2008-03-12T10:23:00.000-07:00

Big news out of Canada! A great study using undercover SPs exposed a major gender bias in the recommendation of patients for total knee replacement. This is the kind of data that is most accurately determined with undercover SP studies, which are not easy to do. But when they pan out, boy are they worth it.

Find the original article here:
The effect of patients' sex on physicians' recommendations for total knee arthroplasty.

Read a well-written news article about the study here:
Undercover Patients Expose Huge Gender Bias in Care

A nice bit from the original article describes the training:

Standardized patients received training by the StandardizedPatient Program at the University of Toronto, Toronto, Ontario,using established training protocols. Training totalled 21hours and involved a group session lasting 3 hours, 4 grouppractice and feedback sessions lasting 4 hours each, and a reliabilityand readiness assessment session lasting 2 hours.

Great job, UToronto!

Blogging about SPs

2008-03-10T12:43:00.000-07:00

Excellent! After a few weeks of grumpy postings about SPs and related methodologies, we have a trio of positive responses:

Taking a sexual history for the first time is never easy, but it's a natural for an SP experience, and this illustrates why:
Why Do You Want the Blue Pill?

Yes, the feedback from SPs does reach the students:
If I Can't Be a Doctor at Least I Can Try to Act Like One

And a very quick mention, but heartening to see that SPs were listed as one of the:
Reasons Going to School is Still Fun

Great work, everyone!

SP Potpourri

2008-03-07T08:21:00.000-08:00

Some interesting press articles and blog ruminations this week:

Actors Simulate Illness at Stony Brook Medical Center

India hopes to obtain some high-level simulation equipment for their first medical simulation center

"Sim Man", a Supplementary Tool for Clinical Learning

Is lying to patients less stressful than telling the truth? A study uses SPs to look at the issue:

Original Study in the Journal of Clinical Oncology

Pallimed Blog Review of Study

Finally, not directly SP/Simulation related, but it speaks to the work many of us try to do:

Is There a Hardening of the Heart During Medical School?

SPs in the Press

2008-02-28T09:51:00.000-08:00

So, if you were still under the impression that Standardized Patients was a cutting-edge, developing educational methodology, think again:

Before 'Sim Man', Med Schools Taught with Old-School Techniques

Ouch?

Blogging About SPs

2008-02-25T08:58:00.001-08:00

What can I say, the world of simulation doesn't always run smoothly. I met a young, new-in-town, first-job-out-from-residency doc at a party this weekend, and when she found out what I do, I got the litany of "terrible Standardized Patients I've known" along with the "Why simulation is useless" lecture. Other than that, she and her husband were charming party companions, but it's a little disheartening to hear one's chosen profession so casually dismissed.

A similar level of distress seems to be present in the recent SP-related blogs. But I remind myself, it's the painful experiences we generally need to process -- otherwise, how to square the surfeit of negative blogs to the overwhelmingly positive feedback most SP programs get from students, in addition to the typical requests for "more SP experiences"?

Well, he may struggle with "fake patients" but he's got a passing grade in sarcasm:
Dr Ayche

I'm not a doctor (yet), but I played a patient at the Med School!
When You Don't Know Enough

Here, I'm going to sympathize with the poster -- this was a hard day:
On Video

Another shot across the bow of the Step 2 CS:
Fixing the Boards Exams

But then finally, let's end on a positive note. A set of two posts from the same blog to remind us why we do what we do with SPs and medical simulation in general:
The Grim Reaper Comes to Town
Not the End of the World

SPs in the Press

2008-02-19T11:27:00.000-08:00

Southern Illinois University has taken their request for a new Simulation Center to the people!

This nice article details the need for the new center, the way simulation is used in clinical teaching, and the historic role SIU has played in SP education, all to encourage public support for their part of a bill in front of the state legislature. Check this article out for some great quotes from leading SP educators, Linda Morrison and Mary Aiello -- nice job!

SIU School of Medicine Diagnoses Need for New Center

Resources - SimSingularity Blog

2008-02-11T12:42:00.000-08:00

Jeff Taekman's SimSingularity blog is a terrific way to stay up on developments in simulation in healthcare. He has a great focus on gaming and robotics and finds a lot of really interesting stuff to post about. You'll want to check in here often if you've got an interest in the tech of simulation. Jeff Taekman is currently heading the Serious Games and Virtual Environments Special Interest Group in the Society for Simulation in Healthcare, in which I also participate. If you are a member of SSH (or looking to become one) and you'd like to participate in the SIG, feel free to contact either of us.

SimSingularity

Resources - Medicine 2.0

2008-02-08T11:02:00.000-08:00

It's hard to do a reasonable job of describing the resources available here, but if you are interested in medical education, virtual patients and environments, and how to use technology to further our educational mission in various ways, I suggest you put some time aside for exploring the Medicine 2.0 blogsite. Compiled and maintained by a Hungarian medical student, it's a friendly and link-filled introduction to such topics as: Second Life as an virtual medical school, how to use wikis and blogs to improve your teaching, and podcasting/videocasting, among other topics. Definitely check it out.

Medicine 2.0

Simulation in the Press

2008-02-01T11:17:00.000-08:00

This is a really terrific article about a new Sim Center at Drexel, and about the utility of hybrid simulations. And calling the SP the "star of the show"? Just the icing on the cake. Well done! Is anyone else using SPs in radiology-related simulations?

Meet the SimFamily

SP Potpourri

2008-01-29T10:53:00.000-08:00

A quick round up of articles, letters to the editor and blogs mentioning medical simulation and Standardized Patients.

About to Take the MCAT?

Medical Simulation Centre Planned in Dubai

Students Learning a Lot from Dummies

How Does it Feel?

A Lesson in Ethics

Blogging About SPs

2008-01-22T10:22:00.000-08:00

As the school year continues, the blogs keep coming:

Come to mention it, SPs are kind of an eclectic bunch:
My Head Shot?

Students are starting to notice the SPs around them:
From Patient to Proctor

It's nice that sometimes SP day is also a good day:
Good Day

SPing may be a fun job, but I'm not sure it pays as well as being a physician:
On Standardized Patients

True, but what kind of feedback would those patients give?
Standardized Patients

SP Potpourri

2008-01-07T10:53:00.000-08:00

Happy New Year, everyone! I'm really looking forward to next week's IMSH conference, in particular learning about some of the new advances in the development and use of computerized virtual patients. And a few days in San Diego doesn't sound too bad either.

Things were fairly quiet over the holidays, so let's jump back in with a potpourri of blogs and news articles.

The New York Times has an interesting article about the lessening prestige of the professions, with the medical profession cited as a prime example. Is this reducing the interest of some of the most qualified applicants to medical school just at the time we are increasing class sizes to fend off a physician shortage? Very possibly:

The Falling-Down Professions

A lovely online memorial of an SP who obviously brought a lot of heart to her work with students:

In Memoriam Betsy Laitinen

A student describes the Step 2 CS:

USMLE Step 2 BS

This Northwestern SP is now in L.A. and hoping to break back into the SP world:

Standardized Patient Work

Blogging About SPs - Real and Virtual

2007-12-26T10:41:00.000-08:00

It's quiet during the Winter holidays, but a couple of interesting blogs:

I really don't know how I missed this at the time (August), but here's a neato blog post with screenshots about a medical simulation done in Second Life. Now, they jumped right to the labs, it seems like -- I'd have liked to see a real "avatar" in there playing the patient. But still, very cool and I think, something we'll be seeing more of in the future. Especially if our class sizes keep expanding but our facilities don't!

Live Blogging Today: First Medical Simulation in Second Life

But as you can tell from the reflections of this SP in the UK, oftentimes it's those real-world communication skills that students need a chance to practice:

At the University of Upnorth

Have a wonderful New Year, everyone! I hope to expand this blog in 2008, so watch this space. And as always, if you'd like to contribute to the SP-Trainer blog, either by sending interesting links and news articles or by writing your own content, let me know.

SP Scholar

2007-12-20T11:43:00.001-08:00

A couple of really neat studies involving SPs.

First, one that really piqued my interest, which looked at the differing behavior of residents when seeing announced SPs vs. unannounced SPs -- does it change what they do if they know it's "being rated"?

Residents' Asthma Communication Skills in Announced Versus Unannounced Standardized Patient Exercises

And another study looking at two different ways of rating student communication skills -- can you link SP ratings to a validated communication rating system?

Assessing validity of standardized patient ratings of medical students’ communication behavior using the Roter interaction analysis system

Blogging (& Commenting) About SPs

2007-12-11T08:54:00.000-08:00

Ok Folks, I have to admit sometimes I read these blogs and I just want to put my head on my desk and take a nice, deep cleansing breath:

Yo, Ms. Med Student -- I have 14 SPs down the hall who might disagree with your conclusions on how "easy" their gig is. That said, the wealth of comments are awesome:

Medschool Type Stuff

And Ms. Med Student no. 2 -- sorry you find SPs "worthless", but if you said even one of the funny examples you listed below, you need more of them, not fewer:

Freudian Drips

And this student is just pissed off but I think I see the roots of his/her communication issue with the SPs...

Studying the Medical-Student-Simulated-Patient Relationship

But you know, I get it. It's been a long quarter/semester and it's time for a break, well deserved by the SPs, SP Educators and yes, even the Med Students...

And to leave on a positive note, some thoughts about why we teach, even when sometimes it makes us want to put our heads down on our desks:

To Rear the Tender Thought...

What brings you back to the Blackboard Jungle? Post a comment below.

SP Scholar

2007-12-07T09:02:00.001-08:00

Interesting new study that made use of unannounced SPs at UC Davis:

New UC Davis study finds physician style and HMO affiliation impact lengths of patient visit

I look forward to reading the full journal article.

SPs in the Press and Blogs

2007-12-05T08:44:00.000-08:00

Stony Brook's new Clinical Skills Center got a nice writeup in their local paper Monday:

Clinical Skills Center Helps Med Students Become Real Doctors

And, because this blog entry from a medical student about an SP experience and her reflections following is too insightful to wait for the next post:

Today Was One of the Harder Days

SP Potpourri

2007-12-03T09:46:00.000-08:00

Nothing too controversial lately, but the small blog mentions have been piling up. In the interest of completeness, it's time for SP Potpourri:

Physician and Patient

When I'm 64

SP Gig at McMaster

Oh, Doctor Doctor, Is This Love I'm Feeling?

Standardized Patient Work (Note to LA folks -- this experienced SP is looking for work!)

SPs in the Press

2007-11-29T08:19:00.000-08:00

A nice article about the SP Program at Vanderbilt, and a picture of one of my favorite ladies, Lisa Rawn:

Paid to Play Sick

Issues in End-of-Life - Video

2007-11-28T11:22:00.001-08:00

This isn't a simulation, but is a great use of the internet for an important area of medical education. The video linked below could be used in group classes as described on the video website, or could be used to train SPs involved in end-of-life simulations. Or, could be watched as part of the personal journey we all make.

Thank you to Dr. Joseph Civetta for making this resource available and letting us know about it:

203 Days

Thank you also to the filmmaker, Bailey Barash, who has given permission for the University of Connecticut Health Center to stream this short (27 minutes) film for educational use.

Medical Simulation Video

2007-11-15T10:54:00.000-08:00

Ok, still pretty crude, but maybe these technical games will have some applications as the technology continues to improve!

Below is a quick demonstration of the forthcoming Nintendo Wii Trauma Center: New Blood

Whaddya think? Should I put this on my wishlist?

International Meeting on Simulation in Healthcare

2007-11-08T09:02:00.001-08:00

Ok, I realized I only had a week left and hurried up to get my registration in at SSIH. This will be my first time at the IMSH meeting, but as SPs, task-trainers and virtual reality all become more enmeshed, it's time to get into the fray. It's not all quarter-million dollar surgical simulation, after all.

Some of the most exciting things for me, as an SP-educator, are the developing ways to tie technology into live-action simulations. For instance, the virtual stethoscope which reads wireless signals given by the SP to deliver the proper heart/lung sounds. Or virtual SPs available online or in the lab at all hours of the day and night, developed from the movements and voices of the human SPs who first played the case.

These are a couple of the areas that interest me most. Are you headed to IMSH? What are you looking forward to this coming January?

SPs in the Press

2007-10-31T08:30:00.000-07:00

Every so often we get a cute article either about SPs or referring to SPs. This one manages to name-check ER, tell a great first-aid story, and describe SPs in Sydney, Australia. What more could you want?

How A Doctor Like Luka Saved This Boy

Thomas Jefferson University has a new building and a new sim center!

Jeff debuts $60 Million Classroom Building

The Armed Services continue to lead the way in the use of simulation:

Simulated Help for Iraq

SP Video

2007-10-29T10:37:00.000-07:00

Nice little article and video about students at the University of Hawaii School of Medicine:

Medical Students Getting Lots Of Experience Without Ever Touching A Human

SP Scholar

2007-10-29T10:06:00.000-07:00

Today there's a nice article in the UCSF student newspaper that mentions a great study done by faculty about suicide screening in primary care using unannounced SPs:

Screening for Suicide: Mentioning the Unmentionable

Find the original journal article here:

Let's Not Talk About It: Suicide Inquiry in Primary Care

along with comments from readers. Great work in the field!!

Blogging About SPs

2007-10-23T11:26:00.000-07:00

Our first "blog" is actually what I'd consider the blog's predecessor -- the newsy-about-town column in the local paper. There's a really nice mention of Dawn Drake and her program in North Dakota:

Docs of the Future Learn Bedside Manner

Complaints? Yeah, it's that time of year!

Complaints about SPs in the Pre-Clinical Years

Complaints about SPs in the Clerkship Years

Any suggestions for these students? Leave a comment on this post below!

Virtual SPs - Cultural Training

2007-10-15T09:32:00.001-07:00

This post is an in-depth writeup of a virtual "simulated patient" programmed to respond to cultural communication cues. I was especially intrigued that the logic had been developed in such a way that once offended, a patient is easier to re-offend - just like in real life!

Virtual Standardized Patients

SP Miscellany

2007-10-12T08:12:00.000-07:00

I couldn't quite figure out which category to use for this post, but I sure couldn't let it go by unremarked. Welcome to the new occasional "SP Miscellany" category:

The Future, or Something Remarkably Like It

Have a terrific weekend, all!

Clinical Simulation Video and Simulation in the News

2007-10-10T09:32:00.000-07:00

This article and news video clip show Georgia Southern nursing students working on a patient simulator while another student acts as the concerned daughter SP at the bedside. They go on to make a point about the problem of nursing shortages, and its genesis in the lack of educational programs and teaching faculty:

What's Ailing Georgia's Nurse Workforce

Similar story about nursing students in San Diego:

Code Blue Simulation

This video gives a terrific overview of the Institute for Surgical and Interventional Simulation at the University of Washington, a multi-disciplinary simulaton center.

Finally, no video, but those of us who put together simulation exercises live in fear of this headline ever applying to us:

Two Remain in Hospital after Mock Disaster

SP Resources Online - Social History Compendium

2007-10-08T14:18:00.000-07:00

One of my most favorite SP-related sites is the University of Pittsburgh's Social History Compendium. Developed with an Association of Standardized Patient Educators Project Award, this site offers detailed information on a variety of vocations, all based on in-depth interviews:

"These occupational interviews are designed to aid the creation of standardized patient cases. Writing cases is a time-consuming process. While the medical details can be composed based on a real patient case, it is often key details about a patient's life, including vocational history, that are difficult and time consuming to create. Often, the vocation is related in some way to a piece of the social history (an attorney who drinks too much) that may not be based on reality. However, these details are also what make the case come alive, and make the experience as true-to-life as possible. The goal of this project is to provide true-to-life social histories which can be used as the backbone for the development of a new case."

Not only is it a wonderful resource for adding veracity to SP cases, it's just a fun read generally -- a bit "Studs Terkel", if you will. If you haven't visited it, or haven't been there lately, check it out soon.

Blogging About SPs

2007-10-01T09:24:00.001-07:00

Today I'd like to feature a blog posting only slightly related to SPs, but which I feel really illustrates much of what we hope our students take to the wards after their initial work with SPs and other clinical simulation:

Getting used to palliative patients might take some time

This student details some of the work with SPs and End-of-Life that many of us do at our own institutions:

Cutting Out Cancer

Another student finds that working with a GTA has become less stressful and more rewarding as he advances through his training:

Over My Med Body

One student's view of clerkship OSCEs:

Another rotation come and gone

Virtual Patient - DIANA

2007-09-26T10:08:00.000-07:00

The University of Florida's life-size "DIANA" virtual Standardized Patient was first announced in 2005 (long before the start of the SP-Trainer blog!), but there were some great followup articles and blog posts (with pictures) with more information about the way these types of programs are working:

Serious Games and the Art of Medical Interview

Virtual Reality and the Art of Medical Interview

Anyone using DIANA or something similar at their site? How is it working?

And yet, advanced as Virtual Patients get, there will never be any substitute for:

The Human Touch (UCLA)

(great pictures here too!)

Blogging About SP TRAINERS

2007-09-18T11:56:00.000-07:00

Aside from short, panicked blog posts from first-year medical students encountering their first SPs, the big news continues to be the JAMA article about MCC test communication scores and later patient complaint levels in clinical practice -- it's all over the wire services.

In the midst of that I found a nice interview with Stan Rogal of the Toronto Program. We may know him best as an SP trainer, but not surprisingly, he's up to a lot more:

12 or 20 questions: with Stan Rogal

Blogging About SPs

2007-09-10T08:22:00.000-07:00

So, last week I met my first-year student small group and we spent part of our session talking about their hopes and fears relating to their training and to the practice of medicine in general. I honestly cannot think of anything more invigorating and motivating than working with first-year medical students, and part of my personal mission as a medical educator is to help them protect and nurture that energetic and optimistic human flame through what can be a rough next decade or so.

Today I found a wonderful blog post that really illustrates this. And what good fortune for this student that he's at EVMS, where I can say with certainty that he'll see some of the very best SPs in the world. Also -- good for him for taking advantage of this optional activity.

Time with an SP

Better Bedside Manners

2007-09-07T09:58:00.000-07:00

Neat article in Time Magazine that points out the importance of effective clinician - patient communcation as measured longitudinally -- looking at the Standardized Patient evaluations during the Medical Council of Canada exam and a later correlation to the number of complaints each physician received in his/her first year of practice.

Better Bedside Manners

It's terrific to see this type of article making it out into the mainstream media. Find the original Sept 5, 2007 Journal of the American Medical Association article here:

Physician Scores on a National Clinical Skills Examination as Predictors of Complaints to Medical Regulatory Authorities

SP Scholar

2007-08-29T13:11:00.000-07:00

The following article was recently shared by a subscriber on the SP-Trainer listserv. I found it to be one of the more effective concise overviews of SP use, and particularly value the Nursing focus as I place larger numbers of SPs into these courses each year.

Working With Standardized Patients: A Primer

What do you think?

Blogging About SPs

2007-08-23T09:38:00.000-07:00

School has started in a lot of places, and the rest of us aren't far behind. Suddenly there's a surge of giddy first-year student postings about their first SP experiences. It's gratifying to hear that they appreciate the encounter and the feedback.

Happiness is a journey, not a destination......

So much

Standardized patients

And a neat little CNN article about the stress of OSCEs, medical school, and why anyone still chooses to follow the path to an MD

Medical Student Struggles to Preserve Her Idealism

Welcome back, everyone!

Blogging About SPs

2007-08-13T10:53:00.000-07:00

Again, August is a quiet month, but let's check in with the blogs:

Training Spirit-Friendly Doctors Nice discussion (and informal survey) of the inclusion of spiritual issues in medical encounters, and efforts in this direction using SPs.

I Love My Job! It's definitely the people that make medical education so much fun.

Doctors With Heart Problems This columnist says she can "count on two hands the number of hours she had learning how to talk and listen to patients" in medical school. My only question is, where the heck did she go, and when? At the UW, even our first year students would beat that in a month.

Thoughts? Hope everyone is enjoying the last days before everyone descends back into the hallways.

SP Resources Online - Toronto Ethics OSCE

2007-08-01T10:36:00.000-07:00

Ahh -- it's August and the web is quite quiet about the doings of medical students and SPs. Of course, here in Seattle we are about to start a week of Year IV OSCE so it's not feeling as laid back in our halls.

Today we start a new feature looking at the many resources and excellent SP-related websites available online. Let's start with one that's helped a great many of us in the years (since about 1994!) that it's been available on the web.

The Ethics OSCE

Toronto and Buffalo's ethics programs have led the way with sharing these cases, both in spurring development of ethics-related OSCE stations and with inspiring the development of similar casebanks and compendiums at many other institutions, including the original SP Casebank at the University of Washington (now found at the Association of Standardized Patient Educators). I found myself going back to these cases for ideas and feedback items just a couple of weeks ago as I developed some informal role-plays for a program. I also have seen medical student blogs reference using these cases to create their own practice sessions prior to national or school SP-based exams.

Bravo to Peter Singer and Anja Robb for their early work in this area, and to sharing it with us all!

Blogging About SPs

2007-07-24T12:30:00.001-07:00

Time to check back in -- as always, students have a varied experience and view of SPs:

Standardized Patients (Gripes)

Transitioning

身體不舒服 (the post is in English)

Wake Forest got a nice writeup as well:

Medical Students Respond Positively to Simulated Patient Experience

SP Scholar

2007-07-16T09:20:00.000-07:00

One of the more exciting, if logistically difficult, ways to use Standardized Patients is in research with "Unannounced SPs". These stealth-SP visits are probably the gold-standard in assessing current clinical practice. Now, what I'd like to see is more about how more recent projects have set these programs up -- how they dealt with issues of insurance, payments, patient identity, and clinic access -- as these obstacles often sink great research before it can even get started. I know they are daunting to me, even as a veteran of two such projects.

JJ Rethans, et al agree, and take it further to look at the entire methodology -- how can studies show us that the USPs are reliable? Check out their new article reviewing these studies in Medical Education. The group at Maastricht has long been refining their own work with USPs, so I'm glad to see them leading the charge:

Unannounced Standardised Patients in Real Practice: A Systematic Literature Review

A terrific example of the type of work that can be done with USPs can be found in the recent article from the Annals of Family Medicine:

Exploring and Validating Patient Concerns: Relation to Prescribing for Depression

R Epstein, an author on the previous paper, has also published an article on clinical assessment that details many of the advantages of unannounced SPs

Assessment in Medical Education

Have you worked with USPs at your institution, or for your own research? Why or why not?

ASPE Conference Plenaries

2007-07-12T10:53:00.000-07:00

The two terrific plenaries from the 2007 ASPE Conference in Toronto have been posted. ASPE members can log in and check them out. Not yet a member? Now is a great time to join!

2007 ASPE Plenaries

Blogging About SPs

2007-07-11T09:41:00.000-07:00

The discussion stimulated by the Human Guinea Pig article continues:

Med Student's Perspective

GTAs blog too!

Funny Gynecological Anecdote

The no-show charge makes a lot of sense, and having the students bring their own tongue depressors? I love it!

Scrubs, Rucks and Anything but the Library

SPs in the Press - Slate Magazine Discussion

2007-07-06T09:51:00.000-07:00

Emily Yoffe, Slate Magazine's Human Guinea Pig, wrote about her work as a Standardized Patient earlier this week (see July 4th post) and on July 5th, she held a live chat with readers, which was posted to Slate later in the day.

Firstly, I have to say I'm bemused by anyone who can't "Google" Seattle Standardized Patient Program and find me -- if anyone is on the web, it's us!

Oh No, She Didn't! Live Chat Transcript

Cool that she name-checked the Association of Standardized Patient Educators in the first response, though, isn't it? Thanks Emily!

Also, when reading the original article, be sure to follow the links at the end into "The Fray" to see reader comments.

SP Scholar

2007-07-05T11:12:00.001-07:00

Time to toot our horn at the University of Washington a bit: check out this innovative research using SPs to assess and improve Motivational Interviewing skills among drug and alcohol counselors:

What is Seen Through the Looking Glass

I know that the SPs who worked on this study were involved in creating much of the script together with the researchers, and were also extensively trained in MI techniques themselves for evaluation and feedback purposes. All of them expressed a strong sense of satisfaction about their involvement in this project.

SPs in the Press

2007-07-04T12:40:00.000-07:00

So, it was inevitable, I suppose, that Slate Magazine's "Human Guinea Pig" would eventually get around to working as an SP. Check out Emily Yoffe's adventures at Georgetown. Whaddya think?

Oh, no! I'm the first patient these 23 med students have ever examined!

In the meantime, check out another article written from the standpoint of a reporter who worked as an SP for the story. This one is a year old, but I thought it was very well done -- from Stanford:

Acting Sick

What are your thoughts on these articles? Would you let a reporter SP in your program?

Blogging About SPs

2007-06-29T08:30:00.000-07:00

And in our ongoing review of how blogs might affect exam and student confidentiality, it's not just SPs and students who may share too much. The following posts are from a clinical examination observer:

Exam Bloopers 6
Exam Bloopers 5
Exam Bloopers 2
Exam Bloopers

Not sure what happened with numbers 3 and 4... Interestingly enough, the comments section brings up the question of what, if any, confidentiality considerations apply to describing (but not naming) students in your blog.

On a much lighter note, a student got creative with the idea of the virtual simulated patient in this video on his blog:

The Interactive Simulated Patient

Medical Education in the Press

2007-06-26T10:47:00.000-07:00

The blog posts and articles have slowed down a bit for the summer, but there was a nice feature on the SP Program at Albany Medical College:

Mandatory at Med School: Bedside Manner (Albany, NY)

Moving away from SP Programs, but staying in New York (Times, that is) and well within the purview of clinical communication:

Study Says Chatty Doctors Forget Patients (New York)

Apparently, a new study (using "undercover patients") indicates that "personal disclosure" by medical providers is less effective as a rapport-building device than previously thought, especially if the provider doesn't use the disclosure as a way to create empathy while moving the focus quickly back around to the patient. Thoughts? How do you teach students about disclosure in your programs?

ASPE Conference Report

2007-06-22T11:41:00.000-07:00

Whew! I'm still processing everything I learned and heard, aren't you? I did want to get the information up about the two speakers this year, Peggy Wallace and Brian Hodges. ASPE plans to post the MP3s and PowerPoints of both presentations, but in the meantime, here are links to their latest works.

Peggy Wallace, Ph.D. spoke about her new book, Coaching SPs, and the challenges to the profession, including the myriad ways that Standardized Patients can become, well, unstandardized. She signed her book onsite and shared her website: Coaching SPs

Brian D Hodges , Ph.D., MD, FRCPC joined us again after his successful talk in Tucson, 2006. Not only did he sponsor and introduce Peggy Wallace as opening speaker, he challenged us again with his insights into the development of the SP Educator profession and the possibilities and pitfalls ahead. His newest article will be out in Medical Teacher in 2007, but isn't yet available online. However, you can check out his AMEE presentation of the same name at the Wilson Centre: Medical Education and the Maintenance of Incompetence

What was your favorite part of the 2007 ASPE conference? Leave a comment!

Virtual Patients

2007-06-14T08:27:00.000-07:00

In 10 years, will we all be...

Attending the ASPE conference on Second-Life?

Running our OSCEs on computers? (video)

Undergoing Robot Surgery?

Using Telemedicine to Teach Clinical Skills?

Where do you see us going next (or is this all pie in the sky?) Leave a comment!

Blogging About SPs

2007-06-13T09:10:00.000-07:00

Students continue to debrief their OSCE and CSE experiences online:

Continuing from last week....
OSCE Patients 2 & 3
OSCE Patient 4 & 5 Wrapup

Humor in the CSE?
A Herd of White Coats

Is it more true to call it an
Overly Stressful Clinical Examination

These exams are no less painful "Down Under"
I Flunked the OSCE!

Travel News - US Passport Restrictions Eased

2007-06-08T11:55:00.000-07:00

This news comes at exactly the right time for anyone who is still waiting for a passport to travel from the US to Canada via air for the ASPE Conference, June 17 - 20, 2007.

The US Department of State has lifted passport restrictions temporarily (through Sept 30th, 2007) -- if you can show that you have a passport application and goverment-issued photo ID, you may travel.

See the US Dept of State website for full information:

I hope this means that no one will have to miss the ASPE conference due to the recent passport insanity in the US.

SP Scholar

2007-06-08T09:51:00.001-07:00

The plane ride most of us will have to take to Toronto for the ASPE conference is a great opportunity to spend a bit of time with the latest lit in our field. In recognition of the conference theme "Learning Beyond Borders", here are some recent international and interdisciplinary publications that I find exciting:

Practical teaching How (and why) to employ simulated patients with intellectual disabilities
A sensitive and informative treatment of an absolutely fascinating program.

Simulated patient programs at German medical schools
Our German members of SP-Trainer have taken a close look at the work being done in their country, and how it can be improved. I sure hope that their conclusion that more networking is needed means we'll see them in Toronto!

Comparison of self, physician, and simulated patient ratings of pharmacist performance in a family practice simulator
Pharmacists continue to expand their use of SPs and are often on the forefront of the development of interprofessional educational experiences.

Use of simulated clients in marriage and family therapy education
An excellent description of the extension of SPs (SCs) into the mental health fields. Note active SP-Trainer member Heidi Lane and her program's participation in the work.

Have you recently published an article about your work in SP Education? Email janim@u.washington.edu to have your article featured on the SP-Trainer blog.

Blogging About SPs

2007-06-06T09:25:00.001-07:00

The opinions about OSCEs, Clinical Skills Exams and Standardized Patients in general runs the gamut:

The Good: SP Heaven

The Bad: OSCE - Patient 1

The UGLY: Drop the Clinical Skills Exam

And, to end on a sweet note, blogging used for the power of good: Web 2.0 : A Sharing Culture

ASPE In Toronto

2007-06-04T10:45:00.000-07:00

Ok, who's excited about the upcoming ASPE Conference in Toronto? I know I am! It's really gratifying to return to Canada, the site of ASPE's first conference in 2002 (Ottawa) for the 6th Annual ASPE Conference.

If you haven't yet had a chance -- check out ASPE's conference web page and download the daily program, because with up to 8 concurrent tracks of workshops and presentations, figuring out your own best schedule is up there with scheduling SPs for an OSCE, logistically (oy!)

Also important -- plan your party attire now for the Palais Royale Social -- I've heard there might be a photographer or two around....

Finally, if you've got a moment or two left before you hit absolute exhaustion -- Toronto itself is full of activity during the summer. I counted at least 7 festivals in town the weekend of the conference alone! Myself, I'm thinking I might head down Harbourside for the Barbados Festival on Saturday.

I look forward to seeing many of you there -- travel safe, and if you are flying, don't forget your passport!

Blogging About SPs

2007-05-30T10:09:00.000-07:00

OSCE Season is in full swing as the school year ends and the new year begins. Faced with an OSCE, it only makes sense to get a bit of advice, right?

I Need Your Wise Words

Blunt Trauma (Did The Advice Help?)

More evidence that using SPs rather than students improves the quality of the simulation:

About Rabbits and Unprotected Sex