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How We Are Humanizing Medical Education

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when physicians are more humanistic in their interactions with ... Meryl Streep. Creating a Portrayal 'Living truthfully under imaginary circumstances... – PowerPoint PPT presentation

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Title: How We Are Humanizing Medical Education


1
How We Are Humanizing Medical Education
  • Peggy Wallace, Ph.D.
  • www.coachingsps.com

2
Humanizing Medical Education
  • …when physicians are more humanistic in their
    interactions with patients, their patients have
    more positive health outcomes.

Geoffrey Williams Annals of Internal Medicine,
1998
3
Humanizing Medical Education
  • …when medical educators are more humanistic in
    their training of students, the students become
    more humanistic in their care of patients.

Geoffrey Williams Annals of Internal Medicine,
1998
4
SP Disciplines
  • Education
  • Evaluation
  • Experiential Learning
  • Performance Assessment
  • Clinical Skills
  • Medical Knowledge
  • Psychology
  • Administration
  • Acting
  • Directing

5
Coaching
  • Active Learning
  • Performance Assessment
  • Creating a Portrayal
  • Accomplishments

6
Active Learning
  • Communication Skills
  • Feedback

7
Active Learning
  • Communication Skills
  • Most used clinical skill
  • 150,000 encounters in a physicians lifetime
  • Relationship
  • Happens as a process of experience
  • Awareness
  • What is true for this student that hes
    learning about himself in relationship to
    this patient that this SP is portraying?

8
The Healers Art
  • Kindness
  • Vulnerability
  • Honesty
  • Generosity
  • Holiness
  • Humanness
  • Tenderness
  • Inner peace
  • Heart
  • Justice
  • Wonder
  • Curiosity

9
Active Learning
  • Value self-awareness more than
  • Self-aggrandizement
  • Self-diminishment
  • Self-criticism
  • Denial

10
Self-Awareness
  • The piece that I feel more and more passionate
    about is that self-awareness is not a virtue in
    and of itself -
  • rather, it is a part of becoming a mindful
    practitioner, which is ultimately in the service
    of both compassion and competence.

11
Self-Awareness
  • Mindfulness is a commitment to knowing oneself
    (from ones ability to tie a suture to the
    personal feelings on losing a friend). Its a
    commitment to knowing oneself in every moment
    and to make every moment count.

12
Self-Awareness
  • But most important is that you be you.
  • Content may be less important than presence.
  • Ron Epstein, MD
  • 1999

13
Active Learning
  • Experience self-awareness
  • Practice communication skills

14
Performance Assessment
  • Accuracy of the data SPs are recording on
    students performances
  • Authenticity and accuracy of SPs
    performances

15
Performance Assessment
  • Selection of SPs
  • Quality of coaching
  • Clear checklist items
  • Coaches care about accuracy
  • Diligent in training
  • Rigorous in monitoring

16
Performance Assessment
  • If the data that the psychometrician receives
    is flawed, no psychometric technique can overcome
    the errors in the data.

Emil Petrusa, PhD 2006
17
Performance Assessment
  • SPs provide the fundamental material that is the
    foundation for interpretation of the data.

18
Performance Assessment
  • If that foundation is not solid, everything
    built on it is flawed.

Emil Petrusa, PhD 2006
19
Performance Assessment
  • Standardized patients have become the surrogates
    for direct faculty observation.

20
Performance Assessment
  • Data from SP-based examinations, in and of
    themselves, do not indicate the accuracy of the
    SPs recall or the correctness of the SPs
    judgments.

21
Performance Assessment
  • SP Educators are solely accountable for the
    baseline quality assurance of the data collected
    during clinical skills assessments.

22
Creating a Portrayal
  • SP Performance
  • Factual accuracy
  • Authenticity of portrayal

23
Language of SP Coaching
  • Play the part
  • Pose as
  • Train
  • Direct
  • Auditions
  • Call backs
  • Cast
  • Perform
  • Improvising
  • Scenario
  • Portray
  • Role
  • Character
  • Backstory

24
Creating a Portrayal
  • Training materials must include everything that
    the SP needs to be able to portray the patient
    accurately and authentically.

25
Creating a Portrayal
  • Remove the meaning from patients stories and
    they become unrecognizable - sanitized, dull,
    dry, as if they were being recited by a computer.
  • This is why meaning accounts for the crucial
    difference between disease and illness.

26
Creating a Portrayal
  • Illness is something that happens to persons,
    while disease is what happens to the organs of
    the body.
  • Illness is disease plus meaning.
  • Larry Dossey, MD
  • Meaning and Medicine

27
Creating a Portrayal
  • Meaning creates a context
  • Relationship to the doctor
  • Limited options and control in the
    clinical setting

28
Creating a Portrayal
  • SPs need to understand
  • Patients needs
  • Patients expectations
  • Patients fears
  • SPs own psychology

29
Creating a Portrayal
  • Acting is not about being someone different.
    Its finding the similarity in what is
    apparently different, then finding myself in
    there.
  • Meryl Streep

30
Creating a Portrayal
  • Living truthfully under imaginary
    circumstances…
  • Sanford Meisner
  • 1987

31
Creating a Portrayal
  • The closer our SPs come to realistically
    portraying the patients, the closer the
    simulation is to reality.
  • The closer the simulation is to reality the more
    likely it is that the student is going to respond
    in that interaction as she would if she were
    working with a real patient.

32
SP Accomplishments
  • Remember facts
  • Deliver facts
  • Believably portray emotional and psychological
    aspects
  • Observe students behaviors
  • Recall students behaviors
  • Accurately record the behaviors
  • Give beneficial feedback

33
SP Coach Accomplishments
  • Select SPs
  • Interpret case authors vision
  • Coach factual accuracy
  • Coach believable portrayals
  • Ensure item understanding
  • Monitor portrayals and checklist accuracy
  • Give feedback on all aspects

34
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35
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