As the year draws to a close, the team here at VSPN wishes all our members, the SP methodology and simulation learning community the best during this festive season. We look forward to bringing more news as well as the latest updates in the field of SP methodology and simulation learning in 2016.
Attaining realism when working with SPs – The strategies used at San Francisco State University, School of Nursing
The SP program at San Francisco State University, School of Nursing utilises a number of strategies to achieve realism in their simulation training. In the article ‘Nursing program mixes medicine, make-believe‘ published on the 10th December 2015, some of these tactics were discussed.
Traditional theatre language and techniques form the key basis of the program. For example, SPs are given fully developed lives and background. The scenarios used are also not only constrained to the clinical setting, adding further depth to the situation that students have to deal with. These scenarios are carried out in rooms that are set up to reflect the scenes in the script including one that is designed to look like the home of a patient. Props, costumes and make-ups are also part of the equation to achieve realism in their simulation program.
For more details on the SF State University, School of Nursing simulation program, read the full article here.
In their paper, Hurst et al. (2015) described an intervention involving SP methodology focusing on communication skills and the ethics of truth-telling. Two cohorts of preclinical third year students (120 in 2004 and 105 in 2005) worked with a SP on a scenario that features uncertainty about the future. This scenario provided students with ethical challenges relating to truth-telling. The intervention was implemented in a problem-based medical curriculum, together with the doctor–patient communication and ethics programs.
The researchers then designed a longitudinal study by following the same medical students to their clinical rotations (fifth year) to investigate the impact of the intervention. Data were collected via a survey that included both closed and open-ended questions. The same instrument was used 3 times in the study to obtain comparative data:
i) 1 week before the intervention (survey 1)
ii) 1 month after the intervention (survey 2)
iii) 2 years later during clinical rotations (survey 3)
The authors concluded that such intervention is useful in helping students to better understand the concept of truth-telling. The experience also made these students more reflective. Over time, those that participated in the intervention also reported a shift of focus from concerns about personal (what they have to do) to relational (what the patient is doing or experiencing) during the process of breaking bad news.
This study is published in Med Educational Online 2015, 20: 28133.
The full paper is available here.
In the article ‘Acting sick: Fake patients help teach medical students’ (published in The Orlando Sentinel), the work of SPs are highlighted and explored. The piece featured the SP program at the University of Central Florida’s College of Medicine’s Clinical Skills and Simulation Center.
The article suggest that working with SP gives medical students the opportunity to gain experience, helping them learn the following skills: – bedside manners, medical-history documentation and critical-thinking. The involvement of SP in formal assessment is also briefly discussed in this short piece. Given the role that SP play in learning, the process involved to be an SP is thorough beginning from recruitment to audition, and it includes training as well as practice.
The SPs interviewed in the piece indicated that though it is a little difficult to explain to others what they do professionally, they found their work to be rewarding.
The full article can be accessed here.
Registration to obtain the best rate is available until the 29th December 2015.
A published paper by Koo et al. (2014) entitled Qualitative evaluation of a standardized patient clinical simulation for nurse practitioner and pharmacy students investigated the use of SP methodology in an interprofessional learning setting.
The project involved a collaboration between the School of Nursing and School of Pharmacy at the University of Maryland. The researchers developed two scenarios focusing on interdisciplinary collaboration and management issues. Forty-six students (32 were nurse practitioner students and 14 were pharmacy students) participated in the learning experience. The students took turns to either participate in the scenario or observe the interactions during the scenario and reflection was part of the learning process. Out of these 46 students, 3o participated in the study via focus groups.
The researchers found two overall arching categories in the themes identified within the data:
i) clinical issues
ii) educational experience.
The students reported the following after the experience:
a) improved understanding of roles
b) increased confidence
c) better sense of support.
Students’ feedback also revealed areas that are important to support educational experience:
This paper was published in Nurse Education in Practice, 14 (2014), pp. 740-746.
A recent article by Corrine May Botz in the ASPE eNews discusses the work in her upcoming exhibition “Bedside Manner”. This exhibition will feature a video and photographs of SPs in action.
The exhibition will held from December 17, 2015 until February 6, 2016 at Benrubi Gallery in NYC. Benrubi Gallery is located at 521 West 26th Street, 2nd Floor.
To read more about her work “Bedside Manner:” Photographing SPs and Medical Simulations, please click here.
For more of Botz’s work, visit her website.
The article Paid actors help CMU’s future docs fine-tune skills in The Morning Sun (02/11/15) featured the CMU SP program. The program was developed to enable medical students to practice their communication and physical examination skills, history taking techniques as well as their body language when dealing with potential patients.
Prior to the SP program, student roleplay was used. However, a more authentic experience is achieved when working with SPs. The program gives students the opportunity for hands-on experience in a safe environment.
The SPs are mid-Michigan area residents and they receive training to portray SPs. Benefits for both medical students as well as SPs are suggested and discussed in the article.
To read the full article, click here.
One of the key ways working with SPs facilitate the training of health professionals is in the area of breaking bad news. The article Physicians work with actors to get better at breaking bad news by Becky Rynor covers a training program at Ottawa Hospital on the art of breaking bad news. The program allows surgical residents to work with SPs and the scenarios used are developed from stories of patient advocacy groups and files from the Ottawa Hospital.
Read the full story here.
Research – The Benefits and Risks of Being a Standardized Patient: A Narrative Review of the Literature
Plaksin et al. (2015) investigated the impact of the experiences of SPs via a systematic literature review, involving 67 published papers. The authors found both immediate and long term benefits as well as risks. Benefits include valuing experience and contribution to educating healthcare providers, increased medical knowledge and knowledge of the healthcare system. Among all the risks identified are pain/discomfort due to repeated physical examinations or postures held during encounters, and frustrations with performance or feedback given. It was concluded that the benefits of being an SP outweighs the risk.
Research – The learning experiences of senior student nurses who take on the role of standardised patient: A focus group study
Mackey et al. (2014) explored the experiences of nursing students who took on roles of standardised patients. The authors were specifically interested if the experience had any impact on learning outcomes. Qualitative methodology was used and data were collected via focus groups involving 15 senior undergraduate nursing students. Thematic analysis was used to make sense of the data.
Four main themes were discovered:
i) Seeing the nurse through the eyes of the patient
ii) Using observation skills
iii) Using reflection
The authors concluded that the experience enhanced the learning opportunity for these students as it provided a mean for the students to observe and reflect, identifying areas that could be improved within their own nursing practice.
The CREST program is running a short course on the 13 November 2015, at The University of Melbourne, Parkville. Students in the program work with Indigenous and CALD simulated patients to gain understanding on communication skills across culture. To read more about the CREST program, see here.
This workshop will be held at 9:15am – 1:30pm (followed by lunch).
The cost of the course are the following:
Full $385 (incl GST)
Special Concession# $330 (incl GST)
Students* $165 (incl GST)
Applications close on 3 November 2015.
For more details about the course and application, see the brochure here.