Funded by the inaugural Elizabeth Shafernich Coulson Award for Innovation in Teaching and Learning, the latest installment in the “Meeting the Sodos” series of simulated patient encounters was filmed in July 2023 at RFU’s Center for Advanced Simulation in Healthcare at the Northwestern Medicine Huntley Hospital.
A professional film crew was hired. Actors included faculty members representing nursing, physician assistant practice, allopathic medicine, podiatric medicine, physical therapy and pharmacy. Numerous other faculty and staff served as behind-the-scenes consultants on the case-based scenarios, which were written by Dr. Robin Dyer, Ms. Tamzin Batteson and Dr. Sarah Garber.
“Our clinical faculty sat down with our very talented standardized patients with a case description and story board,” Dr. Dyer said. “Then they just interacted. It was very in-the-moment and very real. People were crying on set. It was so powerful.”
Daniel and Simone Sodo are struggling. The couple have two young children and are expecting a third. Simone, with a history of uncontrolled high blood pressure, develops life-threatening preeclampsia. Daniel, a veteran of the Afghanistan War, is experiencing phantom limb pain after a combat-related foot amputation. Diagnosed with PTSD, he has developed an opioid dependency.
The underinsured Sodos have a hard time accessing health care despite their compelling need. They live in rural Ohio, 90 minutes from the closest hospital. Gas is expensive. Their old car is unreliable. They can’t afford child care, so they work different shifts at hourly jobs — Simone is a server at a busy restaurant. The couple is clearly tired and stressed as they meet separately with their various care providers and finally together in a patient care conference.
The Sodos and the challenges they face are representative of millions in the U.S. who don’t get the healthcare services they need. The couple are patient actors in the latest “Meeting the Sodos” series of video simulations under development since 2016 by Tamzin Batteson, BSc, interprofessional research specialist; Sarah S. Garber, PhD, College of Pharmacy, director of Interprofessional Studies; and Lori Thuente, PhD, RN, College of Nursing, founding chair for the Master of Science in Nursing for Entry into Nursing Practice program. The latest simulations are designed to reflect the social determinants of health (SDH) that affect residents of communities served by RFU and to emphasize diagnosis and care within an SDH perspective.
RFU first-year clinical students, all of whom take the Foundations for Interprofessional Practice course, have learned from the simulated experience of extended Sodo family members, including Sam, Daniel’s brother, who is in an abusive relationship and whose same-sex partner has HIV; and Jack, Daniel’s father, a widower who lives in a food desert and cuts his diabetes and blood pressure pills in half to save on the cost.
“We want our students to think about other issues that might be impacting their patients,” said Ms. Batteson. “If a patient isn’t taking their meds properly, maybe they can’t afford them. Let’s try and find a different way. That kind of thinking can change health care.”
“In our latest videos, you can see how Simone is trying to juggle her family’s needs during a complicated pregnancy and, as we follow her case, the detrimental effects of not getting adequate care,” said Robin Dyer, MD, OTR, assistant professor of interprofessional education and clinical simulation. “The case puts a face and brings humanity to struggles with depression, anxiety, substance use disorder and poverty.”
“We need collaboration, we need value-based care and we need holistic treatment to improve patient outcomes.”
“In the final video, Daniel and Simone sit down together with their IP team,” said Dr. Garber. “They are finally able to access the care they need. We need collaboration, we need value-based care and we need holistic treatment to improve patient outcomes.”
The realistic IP simulations create an accessible way to convey those messages while achieving competencies and objectives. The simulations can also help fill curricular gaps. Simone Sodo’s character, for instance, targets specific ethnic disparities in obstetric and gynecologic health outcomes and severe maternal morbidity for BIPOC women in rural communities.
The goal is to build a library of virtual simulations that include learning assessments and can be deployed across programs and institutions. RFU collaborates with the University of New England to test and implement the interprofessional education modules that encompass the videos. The team recently presented a paper on the latest simulation and its efficacy as a tool of IPE to the Jefferson Center for Interprofessional Practice and Education.
“We’re helping our students understand that the patient is the most important person on the interprofessional healthcare team,” Dr. Dyer said. “That’s becoming more important as value-based care takes hold.”
Judy Masterson is a staff writer with RFU’s Division of Marketing and Brand Management.