I would like to take the opportunity to expand upon your well-written and informative March 27 article, “Oregon medical students taught compassion,” and enlighten the readers on the similarities of the curriculum being taught at the Elson S. Floyd College of Medicine.
I certainly applaud the work Dr. Susan Tolle and her colleagues are doing at Oregon Health and Science University, and for their pioneering approach to best practices in communication, ethics and professionalism. We too have taken this responsibility very seriously. Assuring that future generations of patients will be served by sensitive, caring health care professionals who listen should be a paramount goal for all schools.
As developers of what we believe to be one of the most novel medical school curriculums in the nation, our school has spent countless hours collaborating with colleagues from around the U.S. and beyond to instill in our graduates an emotional intelligence that many of my generation were never shown, nor told of its importance.
As a family physician and hospice and palliative care specialist, I know full well the importance of bedside compassion, and recognize that such skills can and should be taught. Carefully orchestrated opportunities for our students to see these techniques demonstrated, to practice them, to receive ongoing thoughtful, constructive, real-time feedback, and then do it all over again until a level of proficiency is measured and achieved, is now the new educational mantra.
As such, we at your Washington State’s community-based medical school began facilitating mindfulness, compassionate self-care and interprofessional collaboration in our inaugural students upon their arrival last August. Our courses in case-based learning, art and practice of medicine and even anatomy have been developed with competency-based assessments toward helping our students not only understand the benefit of being expert diagnosticians, but to realize the critical need to master the art of the conversation. How best to have a sensitive dialogue with your patient; to deliver bad news; to understand the goals of care? Why the need to address spirituality and advanced directives in the context of palliative care and hospice? And then, to be afforded a safe space in which to practice those skills is critical.
Our new state of the art Virtual Clinical Center is where simulated learning with standardized patients and one-on-one training with classmates can occur under the careful tutelage of experienced faculty trained in the “how and why” such delicate conversations demand. Multiple opportunities for mastery are already built into our entire curriculum and are to be spread across our distributed statewide campuses here in Spokane, the Tri Cities, Everett and Vancouver as they enter their third and fourth years.
Our first 60 students were selected because of their passion to uphold our mission and vision of “improving the patient experience of care, keeping populations healthy … and inspiring people to solve problems in challenging health care environments.” They were also chosen because of who they are as human beings. Maintaining the importance of being present and caring, while sensing and understanding the needs and desires of the patient they are entrusted to serve, is critical to changing the landscape of what today’s doctor-patient relationship has unfortunately become.
We are confident that our present and future cohort of learners will, by careful design, be different from those whose exam scores were often the most important criteria for entrance into med school. Although scientific and clinical expertise are clearly essential qualities, their ability to show concern for each patient is every bit as important … and maybe more.
The days of focusing on the computer screen rather than being present, and not actively listening nor watching the patient’s face, can no longer be the acceptable norm. Neither is saying “There’s nothing more I can do,” for there are always opportunities to provide comfort, even when a cure is no longer likely.
Knowing how and when to do it is what we are working hard to achieve. Your future WSU medical school graduates will be steeped in the values of humanity, the ethics of good practice and the sensitivity to be focused on one’s goals and quality of life. The health care terrain needs to change, and we are committed to doing our best to lead that quest. Be well, all.
Dr. Steven Grossman is a clinical professor and assistant dean at the Elson S. Floyd College of Medicine.
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