Diagnosing what’s wrong with a patient might be a doctor’s ultimate goal. But good communication skills are just as vital to patient care and can play a critical role in health outcomes
Recognizing that effective communication is a basic competency of the medical profession, Rutgers Robert Wood Johnson Medical School recently affiliated with the Alan Alda Center for Communicating Science, to help its medical students and residents become better doctors. The medical school is one of three in the nation affiliated with the center.
“The medical school dean and I attended a session at the Association for American Medical Colleges and witnessed Alan Alda’s ability to tell a story and make a point and we were hooked,” said Carol A. Terregino, a former emergency medicine physician and now the senior associate dean for education and associate dean of admissions at the medical school. “There are numerous opportunities to advance a communication research agenda among the affiliates and there was no question that we wanted to bring this back to enhance the curriculum for our students.”
The goal of the Alda center, located at Stony Brook University in Long Island, is to enhance scientific understanding by training doctors, scientists and other health care professionals to communicate more clearly with their patients, the public and the media.
Alda, who played the character Hawkeye in the television series “M*A*S*H” and hosted “Scientific American Frontiers” on PBS, believes that doctors who connect with their patients are more likely to have patients that listen, share their symptoms and take their advice.
Improvisation is one of the techniques used at the center to show doctors how they can have better relationships with patients if they make human rather than just professional connections. At a two-day train the trainer retreat centered on improvisation and storytelling exercises, physicians in the Patient Centered Medicine course and the clerkships learned how medical information can be delivered to patients and their families in a more engaging and clear manner.
“I think these sessions are important because telling a personal story about something that is important in your life makes you understand as a doctor how critical these communication tools are when it comes to your patients and their families,” said Terregino who took part in a number of exercises, including one in which she described from an imaginary picture the details of her daughter’s wedding including the fact that her mother was hospitalized the next day and almost died of kidney failure.
Valerie Lantz-Gefroh, improvisation coordinator at the Alda center told the group that while patients come to them for their medical expertise it is their humanness that will make them more effective communicators.
“They want you to feel their pain,” she said discussing the need to understand a doctor patient interaction from the patient’s perspective. What she described as “the two-minute rant exercise” displayed by many, often frightened patients, should be looked at as a bridge and not dismissed or taken personally,” she said.
Joyce Afran, director of Medical Student Education in the Department of Family Medicine and Community Health at Robert Wood Johnson, who participated along with about two dozen other physicians, said the exercises are important for medical students who often don’t know what it is like to be a patient and haven’t had the life experiences needed to understand how being human will help to make them more effective communicators.
“They learn that their role is not just to collect information but to develop a therapeutic relationship with their patients,” said Afran, a physician who specializes in family medicine and has been teaching medical students for the past 20 years. “They need to learn and genuinely appreciate that communication is the most important tool in their toolbox.”
Medical students today have an advantage, Terregino said, because they are receiving more extensive communication skills training. Robert Wood Johnson has been teaching patient centered medicine – in a course with the same name, which focuses medical attention on the patient’s needs and concerns rather than the doctors’ – since 2006. This new affiliation with the Alan Alda Center for Communicating Science will add another level of communication training, Terregino said. The incoming class of 2015 will be introduced to improvisation on the first day of class in August.
“A physician can have an incredible knowledge base, great surgical skills and excellent clinical judgement but if he or she is not able to relate to the patient, information flow and understanding in both directions is going to suffer,” said Afran.