The M Simulation team traveled to Duluth and Rochester over 10 times in 2022 to train medical and occupational therapy (OT) students, provide guidance on simulation best practices, and to learn about the Duluth medical and pharmacy school programs onsite with faculty and staff. This has been a strategic undertaking on the part of M Simulation leadership. Through a mix of in-person and online activities, the team is building and maintaining ongoing collaborations to serve health sciences students across the University system.
The M Simulation sensitive exam patient educators traveled to Duluth—supported by M Simulation staff members—to teach chest, pelvic, urogenital, and rectal exams using their own bodies. The M Simulation faculty and staff taught personal protective equipment (PPE) training to OT students, implemented simulation educational activities in Duluth and Rochester, educated incoming Duluth medical students at orientation on simulation best practices and resources, and assisted their Duluth colleagues by conducting maintenance and repairs on high fidelity mannequins. In addition to their onsite trips north and south of the Twin Cities, the M Simulation Team worked with the hybrid doctoral program in OT in Rochester and the College of Pharmacy, Duluth to develop online simulation activities.
“M Simulation is here to serve and support all University of Minnesota campuses, which includes those outside of the Twin Cities,” said Lou Clark, PhD, MFA, executive director for M Simulation. “Our goal is continued collaboration and expansion with system campus colleagues to support our students through a strategic use of in-person and online simulation. It is critical to provide high quality simulation education for all U of M health sciences students, including and especially those who are training to serve patients in rural communities.”
Sensitive Exam Training with Patient Educators
Patient educators are a subset of the Standardized Patient (SP) Program, diverse individuals who are highly-trained and who simulate real-life clinical experiences by portraying individuals with specific medical conditions, concerns, and histories. Patient educators teach using their bodies for chest, pelvic, urogenital, and rectal exams—they are advocates for their own health and help facilitate dialogue in a safe space. Learners practice procedural skills and build confidence whereby they get direct feedback from patient educators.
Since April 2021, M Simulation worked to catch students up on delayed training due to the COVID-19 pandemic, in advance of working with patients in their clerkship year. The M Simulation team collaborated with Medical School faculty in Duluth and partnered with St. Scholastica to use their facilities, equipment, and exam room settings. Learners were introduced to medical content as well as trauma informed consent. The small group setting allows learners to observe one another, gain different perspectives, and foster richer conversation. This training was completed in June 2022 and continues with new medical school classes.
“During the workshop, learners are coached every step of the way, they get instant feedback and advice from patient educators, opportunities to try again and ask questions like, ‘how was that for you,’ ‘what is a better way to ask for permission,’ and ‘where is it OK to touch.’ Patient educators decide what to disclose and help facilitate sensitive conversations,” said Joe Miller, BS, CHSE, Human Simulation Program manager. “Teaching with your body is a vulnerable experience. Patient educators are advocates and educate about patient health using the body as a tool. These are brave spaces for both learners and patient educators to build trust.”
Anne Woll, MS, education director for M Simulation, added, “Patient educators have been offering this training since before 2000. It takes a commitment to meet this important training need. They have a tremendous amount of experience in teaching and value the opportunity to share from a patient perspective and inform trainees of a patient-centered approach.”
M Simulation staff are working to expand the collaboration with Duluth and are looking to recruit and train community members, staff and faculty to help locally for that population. They are exploring multiple strategies for simulation-based training and implementing a hybrid model to best meet learning needs.
“Patient educators and standardized patients are instrumental in learners’ experiences. These scenarios can feel intimidating, but they are powerful experiences where students can practice communication and technical skills in order to be successful in their medical training,” said Woll.
Clark added, “Students often feel understandably nervous going into these encounters, and then often express gratitude afterwards saying that working with our patient educators is a high point in their training.”
Communication Skills Training
The M Simulation team partnered with the hybrid entry level doctoral program in OT to further support their Rochester as well as Twin Cities students, and the College of Pharmacy, Duluth to help learners practice communication skills.
Working with pharmacy faculty, the M Simulation team developed cases around equity. This included how to have challenging conversations about vaccine hesitancy, ethnicity and race in health care, and educating transgender patients in hormone therapy. They recruited SPs who identified with case topics to consult and co-create simulation activities in order to bring in lived experiences and create authentic scenarios.
Together with OT faculty, M Simulation helped develop online and in-person simulation activities surrounding mental health, conflict resolution, and having students practice interacting with SPs, who act as clients, around tasks of daily living.
Occupational therapists serve a vital role in helping people perform everyday activities. They are often on a team with a physical therapist, social worker, and speech-language pathologist after an incident like a stroke or joint replacement has happened. They intervene to facilitate and improve functional participation in activities of daily living. Students need to be able to articulate the role of an occupational therapist to both clients and others on the team to advocate and talk through the safest plan. M Simulation helps prepare learners for interprofessional experiences in the real world.
“M Simulation is willing to pull in people who work in different areas, and their skillset is topnotch, they know so much and are so valuable to the experience. This has been a great partnership—the team is open and honest with feedback and really helps you think through your curriculum and goals. We could not replicate what the simulation center does,” says Traci Kruse, director of experiential learning for OT. “You can’t emulate these scenarios with a faculty member pretending to be a patient, with SPs [faculty] are able to watch and observe from a distance. Working with SPs provides student buy-in so they treat this like a real encounter.”
The team will continue to expand these partnerships in 2023 and beyond.