By Valerie Fulmer
Dr. Elcin is family physician and associate professor of medical education at the Dept. of Medical Education & Informatics at Hacettepe University in Ankara, Turkey. He is also the Medical Director of the Standardized Patient Program at Faculty of Medicine and is involved not only in the medical school curriculum but also in SP training. He graciously answered some questions about himself and his work that might be of interest to ASPE members, like me.
Ǫ Would you tell us a bit about how you were first exposed to SP methodology and what about it interested you?
As a part of the program evaluation process at Hacettepe, we analyzed that we had some gaps in our curriculum. We designed ‘Good Medical Practice’ program in 2003 and implemented it in 2004. Communication skills training were one of the sections of the program. We evaluated the methods to teach communication skills and learned more about standardized patients. We had a Canadian visiting faculty, Kirsten Ward, in our department and she really encouraged us to work with SPs. We, together with her, participated in a workshop. Jan Joost Rethans was one of the presenters, and that was the golden touch to my life. That summer I visited Morchand Center at MSSM, New York. I met Devra Cohen-Tigor and learned everything I could from her. I joined ASPE that year.
Ǫ What challenges did you encounter when starting the Hacettepe Standardized Patient program in 2003?
We had a dean, Iskender Sayek who was the pioneer of medical education in Turkey, and he was implementing a new curriculum. He encouraged us in learning and using SP methodology. We built a center with digital capturing and archiving system in 2003; many institutions were using VHS at that time. We recruited the first SPs of Turkey and trained them for a ‘headache’ scenario.
Ǫ How has use of Standardized Patients changed or improved in your experience since 2003? What are some reasons for its success at your University?
In the beginning year, we had only two cases for the first year medical students. Today we are using SPs in the first three years of medical school including giving bad news, discussing ethical issues; in residency courses like hypertension management, plastic surgery and in certification programs like organ recruitment coordinators. We also have SPs for training of various topics in the schools of nursing, dentistry, pharmacy, physiotherapy and child development. We introduced the methodology, helped faculty to develop the courses and cases, provided them trained SPs. They experienced the impact of methodology on the students’ achievement and received positive feedback from the students.
Ǫ In October of 2010, you chaired the Simulation in Medical Education Conference; what were some positive outcomes from hosting this Regional Meeting?
It was a meeting organized for the 10th anniversary of our department, and became the first of new conference series. The educators working in Eastern European and Middle Eastern countries have been using SPs for years but have not able to get so much chance to present their work on the international scene. This meeting provided such an occasion. We are organizing the second conference in November 2012.
Ǫ While some may view differing languages, societal attitudes and beliefs as a challenge, some would also suggest that these differences are at the center of the International Committee’s mission. When attending or hosting international conferences, what excites you most about the future of Standardized Patients programs?
Cultural differences (language, religion, color, cultural beliefs) sometimes may cause a kind of chaos when the people cannot have lenience about the ones that are not like themselves. Sometimes people cannot bear to hear English with a different accent. They should think that the presenter is just trying to express himself and trying to share his experiences and they should show patience. I always regard those events as the lucky moments to learn more about the others. After years in SP work, I see many people all around the world using SPs, and it is a widening educational methodology fostering the boundaries and finding new areas to study.
Ǫ How do you respond when met with skepticism regarding the integration of Standardized Patients into the education process (either peers or students)?
I never give up telling. I try to make my colleagues to use the methodology and see the results. It always works. We always have students who consider SP encounters as childish play. I always tell them to focus on themselves instead of the SPs. It is their very special moment to see their own performance and to achieve something. After two or three encounters, I find those students in front of the door trying not to forget to introduce themselves or to summarize at the end.
Ǫ As Chair of the International Committee, what will your approach be to the networking and collaboration of Standardized Patient educators from around the world?
Unfortunately, ASPE has a very limited number of international members. We will present ourselves more at the international conferences, and emphasize collaborations between other associations. We will invite more people to participate in our activities. Instead of waiting for them to join, we will find them in their institutions, and we will promote them to join us. We, as ASPE, will work more, do our best and become really a world organization.
Ǫ With your interest in Drama and Story Writing the Standardized Patient work you do must be very rewarding. How do you approach your Standardized Patients during training to help them to focus on the learning objectives and goals?
I have spent years in university drama clubs as a player and director. I began when I was a student in high school and had my last performance three years ago in the Medical Humanities Congress held at Hacettepe. I published my story book in 1999. Before my current position, I worked as a practitioner in various parts of Turkey and had so many memories about the patients and health care. All those experiences helped me to have a deeper insight and a wider observation about the people and the environment. When designing the scenarios, creating characters and training SPs, I take the advantage of all my experiences. Sometimes only a critical word may make everything seem easier.