Social Determinants of Health: A Multilingual Standardized Patient Case to Practice Interpreter Use in a Telehealth Visit.

Introduction: The growing diversity of the United States population and strong evidence of disparities in health care make it critically important to educate health care professionals to effectively address issues of culture. To that end, we developed a simulation for teaching interpreter use in a telehealth setting. Our contribution of non-English language preference (NELP) patient cases in Spanish, Tagalog, French, and Igbo advances existing literature by combining the skills of interpreter use and telehealth while widening the array of cultures represented. Methods: Simulations were implemented for two cohorts of 60 first-year medical students. In the pilot, nine groups of six to seven students and one faculty met via Zoom with an NELP patient complaining of fatigue, weakness, and cough. When students determined the need for an interpreter, faculty admitted one to the meeting, and the telehealth visit continued. Postsession activities included debriefing and writing a progress note. Results: Course evaluation comments from the first cohort and a postencounter survey of the second cohort were positive. They revealed that students learned to speak slower, in shorter phrases, and directly to the patient. Learners completed note documentation according to a rubric. Discussion: This low-stakes activity provides faculty with a resource for introducing cultural competence into the curriculum. The original Spanish version of the case has been translated into three additional languages, providing a diverse representation of the NELP population. Important points for communicating through an interpreter are practiced in a telehealth setting with a fatigue case.

An evaluation of mental health simulation with standardized patients.

Interviewing standardized patients (SPs) trained to model psychiatric disorders can promote student nurses' interview skills and therapeutic communication, while at the same time increasing their confidence and decreasing anxiety. From a constructivist view of education and Kolb's (1984; Experiential learning: Experience as the source of learning and development. Edgewood Cliffs, NJ: Prentice-Hall) theory of experiential learning, this article describes the development and use of SPs as a learning strategy. The use of SPs helps faculty in overcoming some of the challenges of competing for clinical sites and meeting objectives in limited clinical time. In this simulation, baccalaureate nursing students had the opportunity to interact with SPs, who had been trained to demonstrate symptoms of bipolar disorder, anxiety, and schizophrenia. During debriefing, students critiqued their performances, identifying strengths and weaknesses. The advantage to nursing students was the ability to improve their interviewing skills in a safe educational environment before encountering these patients in a clinical experience. Both faculty and student evaluations of this experience support its integration into psychiatric undergraduate courses.