"I Guess I Didn't Like That Word Unfortunately": Standardized Patients' Unscripted Techniques for Training Medical Students.

INTRODUCTION: This article explores tacit techniques embedded in standardized patients' (SPs) unscripted dialog in a context of breaking bad news (BBN) education. It identifies a technique in which the SP explicitly repeats 1 or more of the medical student's words and analyzes the function and impact of this technique. METHODS: This film-based ethnographic inquiry used conversation analysis to examine so-called echo utterances, through which the SP repeats all or part of what the student has said. The data set includes 9 student encounters with 2 female SPs who specialize in the BBN simulation. RESULTS: The authors identified a technique of "repair request" used by the SPs to provide an opportunity for the student to reformulate their utterance in character. Repair requests emerged from 4 main types of student speech: speculative language, inappropriate utterances, awkward timing, and medical jargon. CONCLUSIONS: The technique of repair request is used to heighten the student's language sensitivity and foster the ability to respond to criticism or misunderstanding in character. Discovery of the tacit, unscripted technique of repair request in this study provides an opportunity to disseminate this technique in SP training for BBN and other simulation scenarios. These findings suggest the need for further research to identify additional tacit techniques used by SPs to improve medical education.

Simulated Encounters With Vaccine-Hesitant Parents: Arts-Based Video Scenario and a Writing Exercise.

Vaccine hesitancy is an increasing and urgent global public health challenge. Medical students' encounters with vaccine-hesitant parents, however, remain incidental and unexplored. During pre-clinical training, the vaccine-hesitant parents are typically represented through impersonal text-based cases, lists of their concerns, and sometimes a virtual patient. However, in reality, vaccine-hesitant parents have many health beliefs and arguments that are accompanied with intense emotions, and students remain unaware and unprepared for them. This study is an experimental pilot test in stimulating the medical students' understanding of, and ability to respond to, vaccine-hesitant parents' beliefs and questions. An arts-based video scenario and a writing exercise are used to demonstrate a rich case of vaccine hesitancy, including a simulated dialogue between a parent and a student. The study invites vaccine-hesitant parents to ask questions to medical students, then it incorporates these questions in a video scenario and subsequently invites the students to answer these questions as junior doctors. The study examines how the peer group discussion after the video viewing resembles a hospital breakroom conversation and how the written dialogue with a vaccine-hesitant parent simulates a consultation-room encounter.

Exploring Vaccine Hesitancy Through an Artist-Scientist Collaboration : Visualizing Vaccine-Critical Parents' Health Beliefs.

This project explores vaccine hesitancy through an artist-scientist collaboration. It aims to create better understanding of vaccine hesitant parents' health beliefs and how these influence their vaccine-critical decisions. The project interviews vaccine-hesitant parents in the Netherlands and Finland and develops experimental visual-narrative means to analyse the interview data. Vaccine-hesitant parents' health beliefs are, in this study, expressed through stories, and they are paralleled with so-called illness narratives. The study explores the following four main health beliefs originating from the parents' interviews: (1) perceived benefits of illness, (2) belief in the body's intelligence and self-healing capacity, (3) beliefs about the "inside-outside" flow of substances in the body, and (4) view of death as a natural part of life. These beliefs are interpreted through arts-based diagrammatic representations. These diagrams, merging multiple aspects of the parents' narratives, are subsequently used in a collaborative meaning-making dialogue between the artist and the scientist. The resulting dialogue contrasts the health beliefs behind vaccine hesitancy with scientific knowledge, as well as the authors' personal, and differing, attitudes toward these.