GHHS Biennial 2012 Workshops

William Mobley, MD, PhD, University of California, San Diego

Tensions are inherent in trying to show empathy and compassion while dealing with stressful clinical situations. Virtually all of us begin medicine with the view that empathy and compassion are an integral part of being a physician but early clinical experiences often blunt our ability to maintain these behaviors. Some root causes have been suggested but those most informed about the phenomena– physicians – have rarely been queried. Learning the real world tensions they face – their type, power, dynamics, and modes of resolution are essential to building a credible neuroscience-based examination of empathy and compassion.

This workshop seeks the participation of physicians at all levels of training and practice in an interactive session to explore experiences. What conditions have been most frustrating? What concerns have been raised? How were tensions resolved? Did the resolution foster empathy and compassion? What benefits resulted – for the patient, for the physician? What undesirable effects occurred? What can one do to anticipate and prepare for difficult circumstances? Can institutions make a difference? What other sources of support can be brought to bear?

Pedro “Joe” Greer, Jr., MD, Marin Gillis, PhD, LPh, Christine McFarlin, MD, MPH, Florida International University

In this workshop, faculty from the Herbert Wertheim College of Medicine at Florida International University will present how a new medical school developed and learned from our first 3 years of existence. We will present our competency-based curriculum, heavily dependent on community involvement, ethics, social determinates, IPE–how we have integrated it, and where we have found success and failure. This will be interactive and fun.

The objectives are to understand the phenomena of a new medical school, the lessons learned in the curriculum, and how to save the world!

Benjamin Blatt, MD, George Washington University School of Medicine.

Mary T. White, PhD, Boonshoft School of Medicine, Wright State University

This workshop will introduce the G-TRR Reflective Rounds, an innovative curriculum developed at the George Washington Institute for Spirituality and Health that is currently being piloted at eight medical schools. The purpose of the curriculum is to foster professional development of medical students in their clinical years by providing an educational forum in which to explore the personal, emotional and spiritual meaning of their patient experiences.

After a brief introduction, workshop participants will break into small groups for “mini-reflective rounds.” In these groups, participants will be invited to share their stories of meaningful patient encounters. Narrators will be encouraged to mention their emotional reactions to the patient, any values, beliefs and assumptions that impacted their reactions, the spiritual significance, if any, of the encounter, and any lessons learned. Individual stories will be followed by group discussion. Questions for consideration will be provided. Breakout groups will reconvene for the last 15 minutes for a wrap-up discussion.

Jonathan Amiel, MD, Columbia University College of Physicians and Surgeons

Bryan McColgan, MD, Columbia University Medical Center

This discussion will focus on education in medical schools and residencies regarding lesbian, gay, bisexual, and transgender (LGBT) health. Studies have shown that this is a neglected area in the current U.S. curriculum. How to address this need will start with a historical view of the culture of medicine with regard to LGBT physicians and patients and how this culture has evolved in the 21^st century. The discussion will also include personal experiences of LGBT patient encounters. This combination of history, culture, and personal experiences will be utilized to try and develop ideas on practical ways to teach physicians and physicians-in-training how best to completely and sensitively address complex health issues of the LGBT community. (Recommended readings/blogs)

Rachael Bedard, MD, Cambridge Health Alliance, Harvard Medical School

Elizabeth Gaufberg, MD, MPH. , Cambridge Health Alliance, Harvard Medical School

Rachel Stark MD, MPH, Cambridge Health Alliance, Harvard Medical School

Public narrative is the art of translating values into action. It is an organizational strategy used by groups as diverse as the Climate Change movement, the Episcopal Church, and the Democratic Party. Because it engages both “head” and “heart”, narrative can both instruct and inspire. Individuals engage in public narrative to interpret themselves to one another, to forge a sense of shared community, and inspire action on challenges that a community must face. The process involves learning to tell a story of self, a story of us, and a story of now, in the service of motivating collective action toward a common goal.

Objectives for the session will be to introduce the concept of public narrative, review and practice elements of motivational storytelling, and to explore applications of public narrative at participants’ home institutions.

After a brief review of Public Narrative, participants will have the opportunity to craft and share ‘stories of self’ in small groups. Connections to the “story of us” (collective values and mission) will be made, and participants will have the opportunity to brainstorm applications at their home institutions.

Recent Rush University Graduates

This invited workshop presented by recent Rush University medical student graduates follows a reflective campus workshop enabling students to discuss experiences with non-humanistic behaviors and personally challenging encounters. Drawing on “Into the Water” published in the New England Journal of Medicine and discussing the effect of clinical clerkships on medical student professional development, these GHHS members will lead participants in sharing situations of inappropriate behavior exhibited by senior team members, students’ concerns over patient/team member treatment, rewarding experiences, and group discussion regarding how to voice concern about mistreatment and coping strategies. (Recommended article)

Andreea Seritan, MD, University of California, Davis

John Onate, MD, University of California, Davis

Most physicians are altruistic and will place their patients’ needs above their own or their families’. The current academic health center climate is characterized by budgetary constraints, low reimbursement rates for clinical services, faculty and staff furloughs at some institutions, strict requirements for medical schools accreditation, and tapering federal support for graduate medical education. In this context, physicians may neglect their own self-care, even more than in previous years. In this workshop, we will discuss strategies to recognize and prevent physician burnout at individual, institutional and professional organization levels.

A presentation on burnout, risk factors, and signs of burnout will be followed by participatory learning and practicing a strategy to prevent burnout—the Emotional Equation. Following this reflective exercise, participants will reconvene in the large group, discuss lessons learned, and share their individual strategies for work-life balance. At the conclusion of this workshop, participants will be better able to utilize strategies for burnout prevention.

Jason T. Lewis, Director, Writing and Humanities Program, University of Iowa Carver College of Medicine

There are two sides to every story. We’ve heard that a thousand times. But have you ever taken a moment to think about what it really means? For physicians, this question is of paramount importance. Patients come into the doctor’s office often at a moment of great vulnerability and need. What is another day at the office for the physician is potentially a critical day in the life of the patient.

Writing is an act of discovery. There’s a moment of magic when a writer goes beyond that conscious act of putting words to the page and enters the stream of the subconscious, where we seem to discover more about ourselves and the people around us than we thought possible.

Participants will choose a clinical encounter, either with the patient or someone close to the patient, and write that encounter from the point of view of the person on the other side. The workshop will promote an empathic view into lives of patients and perhaps a new technique to employ when considering patient encounters.

Lori Benson, Breast Cancer Survivor, Filmmaker

Join Lori Benson for a screening of “Dear Talula,” an HBO award-winning documentary, followed by a discussion on patient-centered care from the eyes of a breast cancer survivor. Lori filmed her experience with the belief that there had to be some purpose, something positive to extract, something to be gained from what was about to happen to her.

Dear Talula provides a rare opportunity to intimately participate in Lori’s journey, from day one of her diagnosis through medical decisions and treatments. In it, she shares the impact on her life as woman, wife, mother, daughter.

This interactive workshop will provide an up close and personal insight into the patient experience of illness, how patients and families navigate the unchartered waters of illness and healing and how physicians can aid or impede the journey. Participants will better understand how to create a more effective patient-physician partnership, how to listen and respond to patients’ questions and concerns, and how to provide more patient and family-centered care all of which lead to better patient experiences and outcomes.

Timothy F. Murphy, PhD, University of Illinois College of Medicine at Chicago

In this interactive workshop, participants will identify ways in which professional standards and ethical advisories contribute to humanism in clinical medicine.

Professional organizations offer numerous ethical principles and/or advisories to guide conduct in clinical care. For example, the American Medical Association offers principles of medical ethics and interpretations of those principles for physician-patient relationships, peer relationships among healthcare providers, and relationships with society at large, among other topics. These advisories reflect legal requirements, but they also function as aspirational ideals.

We will analyze three clinical encounters that challenge practitioners in regard to humane behavior: patients unable to pay for treatment, physician objections to certain treatments for moral or religious reasons, and patients who seem to be sabotaging their own health. After discussing each case, the group will formulate a proposed solution and then discuss that recommendation in light of professional advisories. We will also reflect on the adequacy of the standard in regard to the issues raised by the case. Finally, we will discuss ways of introducing professional standards into educational and clinical settings.