scholarly journals Challenges of Communication Skills Transfer of Medical Students in the Cultural Context of Indonesia

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Mora Claramita ◽  
Yayi Suryo Prabandari ◽  
Abraham Graber ◽  
Albert J. J. Scherpbier
Keyword(s):  
Medical Students ◽  
Group Dynamics ◽  
Cultural Context ◽  
Communication Style ◽  
Communication Styles ◽  
Patient Centered ◽  
Skills Transfer ◽  
Student Centered ◽  
Teacher Student ◽  
Centered Care

Medical schools worldwide are promoting a student-centered and patient-centered care curriculum by using problem-based learning (PBL) strategy, emphasizing group dynamics and discussions. This approach facilitates student engagement, participation, and partnership interaction. However, in the context of the wide power-distance or the existence of socio-hierarchical gaps in Indonesia, two-way dialogue is limited. Few studies describe the one-way paternalistic communication styles between physician-patient, teacher-student, and parents-children, which can lead to less effective learning and healthcare environments. In this study, we investigated if students in an Indonesian medical school, who have been learning and practicing a partnership style of communication in a PBL curriculum for three years, are using the same style of communication with their junior peers outside the classroom. We examined the communication style between senior and new medical students, using surveys, observations, and focus group discussions, during a three-day orientation at the beginning of medical education. The results indicated that senior students used a one-sided communication style with their juniors, whereas new students expressed the need for egalitarian interaction with seniors. A classic dilemma of nature versus nurture was found and discussed. To change the traditional values, robust, constructive, and systematic formative training is key.

The Diabetes Simulation Challenge: Enhancing Patient Perspective-Taking for Medical Students

2022 ◽  
Author(s):  
Emily Shaffer-Hudkins ◽  
Sara Hinojosa Orbeck ◽  
Kathy Bradley-Klug ◽  
Nicole Johnson
Keyword(s):  
Type 1 Diabetes ◽  
Medical Students ◽  
Perspective Taking ◽  
Patient Centered Care ◽  
Chronic Health Condition ◽  
Health Condition ◽  
Patient Centered ◽  
Training Tool ◽  
Centered Care

The Diabetes Simulation Challenge is a unique training tool to foster empathy, a key facet of patient-centered care, for medical students. Thirty-two medical students participated in a 24-hour perspective-taking activity as part of their curriculum, during which they simulated some common experiences of living with a chronic health condition, specifically type 1 diabetes. Students’ written reflections were analyzed using a phenomenological qualitative approach to provide a composite description of the experience. An exhaustive, iterative method of thematic analysis that included manual coding was used to determine whether this activity led to expressions of empathy or thoughts and beliefs consistent with patient-centered health care. Nine unique themes emerged, six of which indicated that students adopted the perspective of an individual with a chronic illness. Most of the students’ reflections illustrated an understanding of the behavioral, social, and emotional challenges related to living with type 1 diabetes, as well as increased empathy toward individuals with the disease. Medical students who aim to provide patient-centered care benefited from this perspective-taking exercise, and training programs should consider using such methods to extend learning beyond traditional didactic education.

scholarly journals Medical Authority under Siege: How Clinicians Transform Patient Resistance into Acceptance

2020 ◽  
Vol 61 (1) ◽  
pp. 60-78 ◽  
Author(s):  
Tanya Stivers ◽  
Stefan Timmermans
Keyword(s):  
Treatment Recommendations ◽  
Communication Styles ◽  
Treatment Recommendation ◽  
Pediatric Epilepsy ◽  
Patient Centered ◽  
Medical Authority ◽  
Professional Authority ◽  
External Pressures ◽  
Centered Care ◽  
Patient Resistance

Over the past decades, professional medical authority has been transformed due to internal and external pressures, including weakened institutional support and patient-centered care. Today’s patients are more likely to resist treatment recommendations. We examine how patient resistance to treatment recommendations indexes the strength of contemporary professional authority. Using conversation analytic methods, we analyze 39 video recordings of patient-clinician encounters involving pediatric epilepsy patients in which parents resist recommended treatments. We identify three distinct grounds for parental resistance to treatments: preference-, fear-, and experience-based resistance. Clinicians meet these grounds with three corresponding persuasion strategies ranging from pressuring, to coaxing, to accommodating. Rather than giving parents what they want, physicians preserve their professional authority, adjusting responses based on whether the resistance threatens their prerogative to prescribe. While physicians are able to convert most resistance into acceptance, resistance has the potential to change the treatment recommendation and may lead to changed communication styles.

scholarly journals Attitudes of medical students in Pakistan toward the doctor-patient relationship

2014 ◽  
Author(s):  
Waqas Ahmad ◽  
Edward Krupat ◽  
Yumna Asmaa ◽  
Noor-E- Fatima ◽  
Rayan Attique ◽  
...  
Keyword(s):  
Medical Students ◽  
Patient Centered Care ◽  
Cross Sectional Study ◽  
Individual Characteristics ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Patient Centered ◽  
Cross Sectional ◽  
Centered Care ◽  
Academic Year

Background. We initiated this study with the aim to assess the leaning of medical students towards either a doctor-centered or a patient-centered care and explore the effects of personal attributes on it like gender, academic year etc. of the students. Methods. A cross-sectional study was conducted between July-Sep 2013. The study population consisted of 1274 medical students in years 1-5 from two medical colleges. English version of PPOS was used to assess attitudes of medical students towards doctor-patient relationship. The relationship between PPOS scores and individual characteristics like gender, academic year etc. were examined by using Independent t-test and one way ANOVA. Results. A total of 792 students formed the final sample. Characteristics associated with most patient-centered attitudes were being in 4th academic year, married, being a foreigner and belonging to a Private college (p<0.05). Characteristics associated with most doctor-centered attitudes were being in 2nd academic year, divorced, having a local origin and belonging to a Govt. college (p<0.05). Gender and having doctor parents had no bearing, statistically, on the attitudes. Conclusion. Despite ongoing debate and emphasis on a patient-centered curriculum, our study suggests that current curriculum and its teachings are not producing the results they are designed to achieve. Students should be adequately exposed to the patients from the beginning of their medical education in clinical settings which are more sympathetic to a patient-centered care.

scholarly journals A Systematic Review of Educational Interventions and Their Impact on Empathy and Compassion of Undergraduate Medical Students

2021 ◽  
Vol 8 ◽  
Author(s):  
Prianna Menezes ◽  
Salman Y. Guraya ◽  
Shaista Salman Guraya
Keyword(s):  
Systematic Review ◽  
Medical Students ◽  
Well Being ◽  
Educational Interventions ◽  
Patient Centered Care ◽  
Technology Enhanced Learning ◽  
Long Term Effects ◽  
Undergraduate Medical Students ◽  
Patient Centered ◽  
Centered Care

Introduction: A compassionate and patient-centered care leads to improved clinical outcomes. Promoting empathy and compassion of medical students is a forerunner of their well-being, emotional stability, and a patient-centered care. However, there is slender evidence about best educational interventions that can inculcate empathy and compassion skills. Our objective was to conduct a systematic review of research evaluating the associations between spectrum, effectiveness, frequency of teaching modalities and their outcomes on compassion and empathy to highlight best practices.Methods: We searched the Web of Science, PubMed, Scopus, and EBSCO Host on 22nd July 2020. We adapted our search strategy from a previously published systematic review on education for compassion and empathy. Selected studies were required to have used unique educational interventions for promoting empathy and compassion of medical students. The research questions were based on Participants (medical students), Intervention (empathy and/or compassion related teaching), Comparison, and Outcome.Results: We analyzed 24 articles from the initial yield of 2,861. Twenty-two were quantitative studies with a mean of 12.8 on MERSQI. Twelve were randomized controlled trials while 5 measured outcomes with single group pre- and post-tests. There was no association found between duration, frequency and complexity of an educational intervention and its effectiveness. Twenty used multimodality curricula, and of those 18 reported statistically significant positive improvement in empathy, while 3 of 4 single modality were effective. Only three studies looked for long-term effects of educational interventions. Fourteen studies evaluated Kirkpatrick's level one (self-reported knowledge), 2 level three (behavior), and 6 level four (patient outcomes). We identified six major educational constructs of teaching empathy and compassion; communication, mindfulness, early clinical exposure, technology-enhanced learning, comics and arts and culture.Discussion: Our review couldn't identify a standard teaching construct in place and highlighted that different teaching tools carry similar impact in promoting compassion and empathy and a sustainable program rather than a single training activity is essential.

Hospice Patient Care Goals and Medical Students’ Perceptions: Evidence of a Generation Gap?

2020 ◽  
Vol 38 (2) ◽  
pp. 114-122
Author(s):  
Kathryn Levy ◽  
Pei C. Grant ◽  
Christopher W. Kerr ◽  
David J. Byrwa ◽  
Rachel M. Depner
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Patient Care ◽  
End Of Life ◽  
End Of Life Care ◽  
First Year ◽  
Life Care ◽  
Patient Centered ◽  
Hospice Patients ◽  
Centered Care

Background: The ability to perceive care goals of the dying may be an indicator of future quality patient-centered care. Research conducted on end-of-life goals indicates discrepancies between patients and physicians. Objective: The aim of this study is to compare end-of-life care goals of hospice patients and medical student perceptions of patient care goals. Design: Hospice patients and medical students were surveyed on their care goals and perceptions, respectively, using an 11-item survey of goals previously identified in palliative care literature. Medical student empathy was measured using the Interpersonal Reactivity Index. Settings/Participants: Eighty hospice patients and 176 medical students (97 first-year and 79 third-year) in a New York State medical school. Results: Medical students ranked 7 of the 11 care goals differently than hospice patients: not being a burden to family ( p < .001), time with family and friends ( p = .002), being at peace with God ( p < .001), dying at home ( p = .004), feeling that life was meaningful ( p < .001), living as long as possible ( p < .001), and resolving conflicts ( p < .001). Third-year students were less successful than first-year students in perceiving patient care goals of hospice patients. No significant differences in medical student empathy were found based on student year. Conclusions: Medical students, while empathetic, were generally unsuccessful in perceiving end-of-life care goals of hospice patients in the psychosocial and spiritual domains. Differences impeding the ability of medical students to understand these care goals may be generationally based. Increased age awareness and sensitivity may improve future end-of-life care discussions. Overall, there is a need to recognize the greater dimensionality of the dying in order to provide the most complete patient-centered care.

PP98 Educating Medical Students Toward Quality-Targeted Leadership

2019 ◽  
Vol 35 (S1) ◽  
pp. 56-56
Author(s):  
Orna Tal ◽  
Inbal Tal
Keyword(s):  
Medical Education ◽  
Medical Students ◽  
Real World ◽  
Early Stage ◽  
Patient Centered ◽  
Health Technologies ◽  
Centered Care ◽  
Leadership Group ◽  
Assessment Guidelines ◽  
Decision Making Processes

IntroductionClassic health technology assessment (HTA) is based on safety, efficacy, and costs. However, in the dynamic world of medicine, “real-world” experience is used to improve HTA. Aggregating evidence is a constant challenge. Physicians are traditionally trained in professionalism (knowledge and skills) and compassion, concentrating on the patient and disease rather than the technology. Currently, medical education also emphasizes quality of care by promoting standardization, and reducing mistakes by root cause analysis. We aimed to integrate the key parameters of safety, effectiveness, quality measures, economic aspects, and assessment guidelines for real-world experience in medical education.MethodsA group of medical students participated in a targeted HTA-orientated education program, which focused on the identification of challenges and barriers in the adoption of health technologies, and then completed a structured survey.ResultsThe program included 243 students. They raised four major emerging challenges: (i) to initiate a culture of quality and HTA-targeted perception for individual physicians; (ii) to better understand the role of different stakeholders in the health system; (iii) to be exposed to considerations of budget allocation; and (iv) to incorporate patient preferences, expectations, and engagement so that patient-centered care becomes a critical part of HTA.ConclusionsIncorporating values of HTA-targeted quality at an early stage of medical education, while future physicians are developing their professional identity, may create a professional, quality-focused leadership group in health care. The understanding and implementation of these “new” dimensions may serve as a platform for building smart capability to ensure better decision making processes among caregivers and medical managers.

scholarly journals Formation in Interprofessional Education in Nursing and Medical Students Globally. Scoping review

2020 ◽  
Vol 38 (2) ◽  
Author(s):  
Lylian Macías Inzunza ◽  
Víctor Rocco Montenegro ◽  
Jennifer Rojas Reyes ◽  
Marcela Baeza Contreras ◽  
Carolina Arévalo Valenzuela ◽  
...  
Keyword(s):  
Medical Students ◽  
Interprofessional Education ◽  
Review Process ◽  
Patient Centered ◽  
Level Of Evidence ◽  
Interprofessional Learning ◽  
Nursing Curricula ◽  
Mesh Terms ◽  
Centered Care ◽  
Academic Search

Objective. This work sought to know the state of the artrelated to the theme of Interprofessional Education (IPE)in the training of Nursing and Medical students and thelevel of evidence developed thus far. Methods. This wasan exploratory systematic review, declared as scopingreview by the Joanna Briggs Institute, JBI, in which asearch was performed in Embase, Science direct, PubmedMedline, Academic search complete, BVS, Scopus and ERIC databases, limiting between 2009 - 2019 byusing the DeCS and MeSH terms of Interprofessionaleducation, education research, healthcare professionals,nursing and medicine, selecting 39 original articles aftercarrying out the review process with the criteria by theJBI. Results. Four thematic nuclei emerged: Experiencesand perceptions of interprofessional learning, Didacticsrelated with IPE, Empirical indicators related with IPE,and Development of professional skills. The highest level of evidence is presented bythe articles dealing with didactics; on the contrary, no articles were found that dealtwith topics related with early inclusion of IPE in the medical and nursing curricula,which are currently necessary to complement the focus of patient-centered care. Conclusion. The thematic nuclei show that the level of evidence in the literatureis varied, although mostly descriptive in scope, highlighting the development ofprofessional skills as a result of interprofessional education.

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