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Doctoring Course Shows Med Students the Importance of Strong Communication
During practice with a standardized patient, medical students Seneca Harberger and Ekene Ajufo learn the best ways to interact while evaluating symptoms. Lawrence Kaplan (background), Assistant Dean at Temple University School of Medicine, says good bedside manner is just as important to a doctor as excellent technical skills. Photo by Joseph Labolito, Temple University.
First-year medical students are quickly immersed in the technicalities of medicine — how the human body works, how diseases affect the body and how they are spread. But at Temple University School of Medicine, future doctors are learning an equally important part of the puzzle: how to effectively talk to patients.
As part of a doctoring course that runs during all four years of the curriculum through the William Maul Measey Institute for Clinical Simulation and Patient Safety, Temple medical students interact with actors trained to portray real patients.
"The old model of teaching medicine was lecture first, clinic second," said Lawrence Kaplan, Assistant Dean for Clinical Education at the medical school. "But there's been a movement to integrate clinical practices throughout the curriculum and build on those skills, so that when it's time for a student to begin really interacting with patients in their third year, they will be better prepared."
On a recent day at the simulation center, a group of first-year students pair off and enter exam rooms to talk with their assigned “standardized” patient. Seneca Harberger and Ekene Ajufo's patient has come in for a fictitious cough.
"Can you tell me a little bit about the cough? Is it toward the front or the back of your chest?"
The patient looks puzzled at first, then offers, "I would say toward the front more."
"Is it a dry cough?" Harberger prompts. "Anything coming out when you cough?"
Harberger and the patient continue for about 20 minutes, and then Ajufo asks him similar questions about his condition. Afterward, the students confer with Kaplan on how their interaction went.
Most of the students in Harberger and Ajufo's group say they were nervous when beginning the exercise, but became more comfortable as conversation continued.
"Beyond the comfort factor, having a good bedside manner will help us get more information out of our patients, so we'll be better equipped to treat them," said Harberger.
In addition to practicing with standardized patients, students listen to lectures in which doctors recount their personal experiences with patients. Through this form of narrative medicine, they learn the questions to ask to get the right answer quickly, as time is often a factor in clinical medicine.
"We teach them diagnostic reasoning," said Kaplan, "so that they can process what the patient is saying and tailor their questions as judiciously as possible."
"First- and second-year students can get so caught up in the technical side of medicine, which is why we have third- and fourth-year students talk to them about the importance of good bedside manner," he said. "If you've got all the technical skills in the world, it won't do any good if your patients feel like they can't talk to you."
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By Renee Cree
September 19, 2011