Medical education glossary

Plain language definitions of the frameworks, roles, and assessment methods used in clinical communication training. Each sourced term includes related concepts so readers can follow the system around it.

AI Standardized Patient: An AI standardized patient is software that plays a patient role in a training encounter, responding to what a learner says in real time, usually by voice, and then scoring the conversation against a named standard, with the learner's own words quoted under each score.Read the full definitionRelated: SP, Virtual Patient Simulation, Deliberate Practice
AIDET (Acknowledge, Introduce, Duration, Explanation, Thank You): AIDET is a five-step framework for how staff talk with patients and families, standing for Acknowledge, Introduce, Duration, Explanation, and Thank You.Source: Studer Group AIDET framework, described in Liang et al., Supportive Care in Cancer, 2025Read the full definitionRelated: HCAHPS, Teach-Back Method, SBAR, Bedside Manner, Rapport (Clinical)
Ask-Tell-Ask: Ask-tell-ask is a three-step communication move in which the clinician first asks what the patient already understands, then tells them what they need to know in plain words and small amounts pitched to that understanding, then asks the patient to say back what they took from it.Source: Back et al., CA: A Cancer Journal for Clinicians, 2005Read the full definitionRelated: Teach-Back Method, SPIKES, High-Stakes Conversations, Debriefing
Association of Standardized Patient Educators (ASPE): The Association of Standardized Patient Educators is the international membership organization for educators who work with standardized patients and other human role players in health professions education.Source: Association of Standardized Patient Educators, Standards of Best PracticeRead the full definitionRelated: SP, Standardized Patient Case, CHSE
Bedside Manner: Bedside manner is the everyday name for how a clinician conducts themselves with a patient: whether they greet the person, sit down, let the patient finish, respond to distress, and explain things the patient can repeat back.Source: Makoul G, Academic Medicine, 2001 (Kalamazoo Consensus Statement)Read the full definitionRelated: Rapport (Clinical), AIDET, Teach-Back Method, High-Stakes Conversations, HCAHPS
Certified Healthcare Simulation Educator (CHSE): The Certified Healthcare Simulation Educator is a credential from the Society for Simulation in Healthcare for clinicians and educators who teach or assess learners using simulation.Source: Society for Simulation in HealthcareRead the full definitionRelated: ASPE, SP, OSCE
Clinical Competency Committee (CCC): A Clinical Competency Committee is a group of faculty that reviews assessment data for each resident or fellow and makes recommendations about progression, milestone ratings, and remediation.Source: ACGME Common Program RequirementsRead the full definitionRelated: Milestones, Remediation, GME, CBME
Clinical Judgment Model: A clinical judgment model describes how a nurse moves from noticing something about a patient to deciding what to do about it, and two different models carry the name.Source: Tanner, Journal of Nursing Education, 2006Read the full definitionRelated: Clinical Reasoning, CBME, Miller's Pyramid, Debriefing, Deliberate Practice
Clinical Reasoning: Clinical reasoning is the cognitive process by which clinicians gather and interpret information, generate and refine hypotheses, and arrive at diagnostic and management decisions.Source: Norman GR and colleagues, Academic Medicine, 2017Read the full definitionRelated: EPA, OSCE, Virtual Patient Simulation, Dreyfus Model of Skill Acquisition, MAL
Competency-Based Medical Education (CBME): Competency-based medical education is an approach to training that organizes curricula and assessment around demonstrated abilities (competencies) rather than time spent in training.Source: ACGME / AAMCRead the full definitionRelated: EPA, Milestones, CCC, GME
Debriefing: Debriefing is the facilitated conversation after a simulated clinical encounter in which learners revisit what happened, examine the reasoning behind their decisions, and work out what they will carry into real patient care.Source: INACSL Healthcare Simulation Standards of Best Practice: The Debriefing Process (2021)Read the full definitionRelated: Prebriefing, PEARLS, Plus-Delta Debriefing, Psychological Safety in Simulation
Deliberate Practice: Deliberate practice is a structured method of skill development in which a learner works on focused tasks with clear objectives, repeats them, and receives immediate, specific feedback aimed at correcting performance.Source: Ericsson KA, Academic Emergency Medicine, 2008Read the full definitionRelated: SP, Virtual Patient Simulation, Remediation, MAL, OSCE
Designated Institutional Official (DIO): A Designated Institutional Official is the individual a Sponsoring Institution identifies to hold, in collaboration with a Graduate Medical Education Committee (GMEC), authority and responsibility for the oversight and administration of that institution's ACGME-accredited residency and fellowship programs.Source: ACGME Institutional RequirementsRead the full definitionRelated: GME, CCC, Remediation, Milestones
Dreyfus Model of Skill Acquisition: The Dreyfus model of skill acquisition describes learning as a progression through five stages, from novice through advanced beginner, competent, and proficient, to expert.Source: Dreyfus SE and Dreyfus HL, 1980, adapted to clinical skills in Carraccio CL and colleagues, Academic Medicine, 2008Read the full definitionRelated: CBME, Milestones, Deliberate Practice, MAL, Clinical Reasoning
Embedded Participant: An embedded participant is a person given a role inside a simulation scenario to help guide it, and the guidance may be positive, negative, neutral, or a deliberate distractor depending on the objectives, the level of the participants, and the scenario.Source: SSH Healthcare Simulation DictionaryRead the full definitionRelated: SP, ISS, Simulation Fidelity, Manikin
Entrustable Professional Activities (EPAs): Entrustable Professional Activities are the units of professional work that a trainee can be trusted to perform once they have demonstrated the necessary competence.Source: AAMCRead the full definitionRelated: CBME, Milestones, Clinical Reasoning, OSCE
Family Meeting: A family meeting is a scheduled conversation between the clinical team and a patient's family or surrogate decision makers, usually covering prognosis, the treatment options that remain, and what the patient would want in a situation where the patient cannot say so.Source: Lautrette et al., New England Journal of Medicine, 2007Read the full definitionRelated: GOC, High-Stakes Conversations, SICG, SPIKES
Goals of Care: Goals of care are the overarching aims of medical care for a patient that are informed by the patient's underlying values and priorities, established within the existing clinical context, and used to guide decisions about the use of or limitations on specific medical interventions.Source: Secunda et al., Journal of General Internal Medicine, 2020Read the full definitionRelated: SICG, High-Stakes Conversations, SPIKES, Clinical Reasoning
Graduate Medical Education (GME): Graduate medical education is the phase of physician training that follows medical school, comprising residency and fellowship programs in which physicians train in a specialty under supervision.Source: ACGMERead the full definitionRelated: DIO, CCC, Milestones, CBME
HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems): HCAHPS is the national survey CMS uses to collect and publicly report how patients experienced their hospital stay, including how the hospital's clinicians communicated with them.Source: CMS HCAHPS, Crosswalk of Updated HCAHPS Survey Questions into Publicly Reported Sub-MeasuresRead the full definitionRelated: AIDET, Teach-Back Method, Bedside Manner, Rapport (Clinical), SBAR
High-Fidelity Simulation: High-fidelity simulation is a simulation experience that is highly realistic and highly interactive for the learner.Source: SSH Healthcare Simulation DictionaryRead the full definitionRelated: Simulation Fidelity, Manikin, ISS, SP
High-Stakes Conversations: High-stakes conversations are the clinical encounters where the words a clinician chooses change what a patient understands, what they decide, and what they carry away afterward.Read the full definitionRelated: SPIKES, GOC, SICG, Teach-Back Method, Remediation
Hybrid Simulation: Hybrid simulation is the combined, simultaneous use of two or more simulation methods within a single activity.Source: SSH Healthcare Simulation DictionaryRead the full definitionRelated: Task Trainer, Manikin, SP, Simulation Fidelity
In Situ Simulation (ISS): In situ simulation is a simulation activity that takes place in the actual patient care setting, with team members working in their own environment rather than in a dedicated simulation facility.Source: SSH Healthcare Simulation DictionaryRead the full definitionRelated: High-Fidelity Simulation, Simulation Fidelity, Sim Lab, Embedded Participant
Interprofessional Education (IPE): Interprofessional education is training in which learners from two or more health professions learn with, from, and about each other so they can work together once they are caring for patients.Source: World Health Organization, Framework for Action on Interprofessional Education and Collaborative Practice, 2010Read the full definitionRelated: GME, SP, OSCE, CBME, Deliberate Practice
Manikin: A manikin is a full or partial body patient simulator, built to human scale, that learners can examine and treat as if it were a patient.Source: SSH Healthcare Simulation DictionaryRead the full definitionRelated: Task Trainer, High-Fidelity Simulation, Simulation Fidelity, Sim Lab
Master Adaptive Learner (MAL): The Master Adaptive Learner model describes how clinicians learn to keep learning, treating self-regulated learning as a skill that can be taught rather than a trait someone either has or lacks.Source: Cutrer WB and colleagues, Academic Medicine, 2017Read the full definitionRelated: Deliberate Practice, CBME, Dreyfus Model of Skill Acquisition, Clinical Reasoning, Remediation
Milestones (ACGME): ACGME Milestones are specialty-specific descriptions of the abilities a resident or fellow is expected to develop across training, organized by competency domain and described in progressive levels.Source: ACGME Milestones 2.0Read the full definitionRelated: CCC, CBME, EPA, Remediation
Miller's Pyramid: Miller's Pyramid is a four-level framework for assessing clinical competence that moves from knowledge at the base, up through the application of knowledge, then demonstration of a skill under observation, and finally what a clinician does in real practice.Source: Miller GE, Academic Medicine, 1990Read the full definitionRelated: OSCE, CBME, EPA, Milestones, Clinical Reasoning
Motivational Interviewing: Motivational interviewing is a collaborative, goal-oriented style of communication with particular attention to the language of change, used to strengthen a person's own motivation and commitment to a specific goal by drawing out and exploring their reasons for it in an atmosphere of acceptance and compassion.Source: Miller WR and Rollnick S, Motivational Interviewing: Helping People Change, 3rd edition, 2013Read the full definitionRelated: Ask-Tell-Ask, Teach-Back Method, Rapport (Clinical), High-Stakes Conversations, GOC
Moulage: Moulage is the use of makeup, molds, attachable props, and smells to simulate injury, disease, aging, or other physical findings on a standardized patient or a manikin.Source: Society for Simulation in Healthcare, Healthcare Simulation DictionaryRead the full definitionRelated: SP, Standardized Patient Case, OSCE
Objective Structured Clinical Examination (OSCE): An Objective Structured Clinical Examination is a performance-based assessment in which learners rotate through a series of timed stations, each presenting a standardized clinical task scored against a predefined rubric.Source: Harden RM, Stevenson M, Downie WW, and Wilson GM, British Medical Journal, 1975Read the full definitionRelated: SP, Clinical Reasoning, Miller's Pyramid, Deliberate Practice
Patient Simulator: A patient simulator is any device or software that stands in for a patient so a learner can practice on it, which covers three things that are routinely treated as one category.Source: Hayden et al., Journal of Nursing Regulation, 2014Read the full definitionRelated: Manikin, High-Fidelity Simulation, Virtual Patient Simulation, Simulation Fidelity, AI Standardized Patient, Task Trainer
PEARLS Debriefing: PEARLS stands for Promoting Excellence And Reflective Learning in Simulation, a blended debriefing framework published by Walter Eppich and Adam Cheng in 2015.Source: Eppich and Cheng, Simulation in Healthcare, 2015;10(2):106-115Read the full definitionRelated: Debriefing, Plus-Delta Debriefing, Psychological Safety in Simulation
Plus-Delta Debriefing: Plus-delta is a debriefing strategy in which the facilitator asks learners to assess their own performance with a paired question: what went well, and what would you do differently next time.Source: Cheng, Eppich, Epps, Kolbe, Meguerdichian, and Grant, Advances in Simulation (2021)Read the full definitionRelated: Debriefing, PEARLS, Deliberate Practice
Prebriefing: Prebriefing is everything a program does before a simulation scenario starts to get learners ready for it, and the INACSL standard splits it into two parts: preparation, which situates learners in a common mental model and readies them for the educational content, and briefing, which conveys the ground rules of the encounter.Source: INACSL Healthcare Simulation Standards of Best Practice: Prebriefing: Preparation and Briefing (2021)Read the full definitionRelated: Debriefing, Psychological Safety in Simulation, SP
Psychological Safety in Simulation: Psychological safety is the belief that an environment is safe for interpersonal risk taking, so learners can speak up, ask for help, test an idea that may be wrong, and admit a mistake without expecting embarrassment or retribution.Source: Edmondson, Administrative Science Quarterly, 1999;44(2):350-383; Rudolph, Raemer, and Simon, Simulation in Healthcare, 2014;9(6):339-349Read the full definitionRelated: Prebriefing, Debriefing, PEARLS
Rapport (Clinical): Rapport is the working trust and understanding between a clinician and a patient that the rest of the encounter depends on.Source: Makoul G, Academic Medicine, 2001 (Kalamazoo Consensus Statement)Read the full definitionRelated: Bedside Manner, Ask-Tell-Ask, High-Stakes Conversations, AIDET, Motivational Interviewing
Remediation: Remediation is the structured process of identifying a learner who is not meeting expected competency standards and providing targeted instruction, practice, and reassessment to close the gap.Source: ACGME Common Program RequirementsRead the full definitionRelated: CCC, Milestones, Deliberate Practice, High-Stakes Conversations
SBAR (Situation, Background, Assessment, Recommendation): SBAR is a four-part structure for a clinical handoff or an urgent escalation: Situation, a concise statement of the problem; Background, the pertinent and brief history; Assessment, what you found and what you think; and Recommendation, what you want to happen.Source: Institute for Healthcare Improvement SBAR tool; Haig KM et al., Joint Commission Journal on Quality and Patient Safety, 2006Read the full definitionRelated: IPE, AIDET, Psychological Safety in Simulation, High-Stakes Conversations
Serious Illness Conversation Guide: The Serious Illness Conversation Guide is a one-page set of patient-tested questions that clinicians use to talk with seriously ill patients about their understanding of their illness, how much information they want, what may lie ahead, and what matters most to them.Source: Ariadne Labs, Serious Illness Conversation Guide, May 2023Read the full definitionRelated: GOC, High-Stakes Conversations, SPIKES, Deliberate Practice
Sim Lab: Sim lab is the everyday name for a dedicated simulation facility, meaning the physical setting where simulation activities take place together with the people and equipment that form part of the experience.Source: SSH Healthcare Simulation Dictionary (Simulation Environment)Read the full definitionRelated: ISS, Manikin, Task Trainer, High-Fidelity Simulation
Simulation Fidelity: Simulation fidelity is the level of realism of a simulation activity, meaning the degree to which it reproduces the reactions, interactions, and responses of the real event or workplace.Source: SSH Healthcare Simulation DictionaryRead the full definitionRelated: High-Fidelity Simulation, Manikin, Hybrid Simulation, ISS
SPIKES Protocol: The SPIKES protocol is a six-step sequence for delivering bad news to patients, published by Walter Baile, Robert Buckman, and colleagues in The Oncologist in 2000.Source: Baile et al., The Oncologist, 2000Read the full definitionRelated: High-Stakes Conversations, Ask-Tell-Ask, GOC, SP
Standardized Patient (SP): A standardized patient is a person trained to portray a patient's history, symptoms, and emotional state consistently so learners can practice and be assessed on clinical encounters.Source: Society for Simulation in Healthcare, Healthcare Simulation DictionaryRead the full definitionRelated: OSCE, Virtual Patient Simulation, Deliberate Practice
Standardized Patient Case: A standardized patient case is the written package that defines what an SP portrays in an encounter: the patient's history and presenting problem, their affect and manner, how they respond to specific learner behavior, and the checklist or rubric used to score what happened.Source: Association of Standardized Patient Educators, Standards of Best PracticeRead the full definitionRelated: SP, OSCE, ASPE
Task Trainer: A task trainer is a device that models one part or region of the body so learners can drill the key elements of a single procedure, such as lumbar puncture, chest tube insertion, central line placement, or IV cannulation.Source: SSH Healthcare Simulation DictionaryRead the full definitionRelated: Manikin, Hybrid Simulation, Deliberate Practice, High-Fidelity Simulation
Teach-Back Method: The teach-back method is a way of checking understanding by asking a patient or caregiver to state in their own words what they need to know or do about their health.Source: AHRQ Health Literacy Universal Precautions Toolkit, 3rd edition, Tool 5Read the full definitionRelated: Ask-Tell-Ask, High-Stakes Conversations, SP, OSCE
Telehealth Communication: Telehealth communication is the set of skills a clinician uses to run a clinical encounter by video or telephone, covering the work that a shared physical room otherwise does for free: establishing presence, finding out who else is within earshot, holding a silence without visual confirmation that the other person is still thinking, and checking understanding when body language is cropped to a head and shoulders.Source: Bajra et al., Frontiers in Medicine, 2023Read the full definitionRelated: Bedside Manner, Rapport (Clinical), Teach-Back Method, High-Stakes Conversations
Virtual Patient Simulation: Virtual patient simulation uses interactive software to represent a patient that learners can interview, examine, or counsel, often through text or voice.Source: Society for Simulation in Healthcare, Healthcare Simulation DictionaryRead the full definitionRelated: SP, Clinical Reasoning, Deliberate Practice

Put the frameworks into practice

ClinicalSim maps voice-based practice to the competency framework that fits the learner's stage.