Advancing professionalization in human simulation: perspectives of SP educators from around the world on the Association of SP Educators Standards of Best Practice

Introduction Between 2013 and 2017, the Association of SP Educators (ASPE), a global organization of educators dedicated to the work of human simulation, developed Standards of Best Practice (SOBP) for working with human role players in simulation. These individuals are known by diverse terms, including simulated or standardized patients or participants (SPs). This study had two aims: (1) to understand the ways in which the ASPE SOBP are relevant to the practices of SP educators around the world, and (2) to identify improvements to the ASPE SOBP from a global perspective. Methods This qualitative study was undertaken between January 2020 and July 2022. Subjects consented to audio-recorded interviews. A collaborative, inductive coding approach was adopted, followed by thematic analysis, aligned with the methods described by Braun and Clarke. Themes were further updated following reflexive conversations amongst the investigators at meetings over the course of several months and were aligned with the study aims. Results Twelve SP educators from six continents participated. Four primary themes were identified (each with multiple subthemes): influencing SP educator practices; advancing professionalization; identifying challenges to implementation; and bridging gaps in the ASPE SOBP. Discussion A diverse group of SP educators from around the world identified the ASPE SOBP in general as relevant and applicable to their practice. The standards provided both guidance and flexibility for working with SPs in a safe, effective and quality-based way. At the same time there were challenges noted and recommendations made that can help to inform future iterations of the standards

Talking about dying and death: Essentials of communicating about approaching death from the perspective of major stakeholders.

OBJECTIVES Although caring for dying patients and their family caregivers (FC) is integral to patient care, training in communication about approaching death is almost inexistent in medical and nursing curricula. Consequently, many health professionals have insufficient knowledge about conducting these conversations. In order to gain a broader insight into essential aspects of this communication from different perspectives, we conducted focus groups with key stakeholders. METHODS Medical specialists, nurses, medical students, bereaved FC and patient representatives participated in five focus groups (n = 30). Following a focus group schedule, we elicited relevant aspects of communication about approaching death, associated emotions, and appropriate communication frameworks. We analyzed data thematically. RESULTS Four main themes were central to conversations about approaching death: (1) embracing care within medical expertise, (2) preparing the conversation while remaining open to the unexpected, (3) recognizing and reflecting on own emotions and reactions, and (4) establishing a meaningful connection with others. SIGNIFICANCE OF RESULTS Communicating about approaching death with dying patients and their FC can be complex and challenging at a professional and personal level. With the recognition of the dying phase, a process is initiated for which health professionals need solid clinical knowledge about but also effective communication skills, constant self-reflection and self-care strategies. Comprehensive training and supervision while dealing with the challenges of communicating approaching death to dying patients and their FC are key, particularly for trainees, less experienced physicians and nurses. The essential components identified in this study can help health professionals to master these conversations