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A Developmentally-Based, Integrated Curriculum in Communication and Interpersonal Skills for Medical Students: Bringing this to your Home Institution. Joseph S. Weiner, MD, PhD; Alice Fornari , EdD ; Marie Barilla- Labarca , MD; Ruth Ellen Pearlman, MD; Judith Brenner, MD
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A Developmentally-Based, Integrated Curriculum in Communication and Interpersonal Skills for Medical Students: Bringing this to your Home Institution Joseph S. Weiner, MD, PhD; Alice Fornari, EdD; Marie Barilla-Labarca, MD; Ruth Ellen Pearlman, MD; Judith Brenner, MD Hofstra North Shore-LIJ School of Medicine Hempstead, NY
Overview • Summary of Communication Curriculum at the Hofstra North Shore-LIJ School of Medicine • Communication Training • Core Skills • Longitudinally refined skills • Faculty development • Assessment • Breakout tables will explore these topics in more detail
Hofstra Curriculum • Pedagogic Foundations • Values-Based Curriculum • Communication is a theme that weaves through all four years
Hofstra Curriculum • Pedagogic Foundations • Three Function Model [Cole and Bird] • Function 1: Establish an effective relationship. • Interpersonal skill development • Function 2: What is the problem or issue? • Information gathering and synthesis • Function 3: Shared education, motivation and treatment planning. • Decision making models • Motivational interviewing • Longitudinal patient care
Hofstra Curriculum • Pedagogic Foundations • Skills-Based Training • Minimal lecture • Knowledge is not an endpoint • Knowledge facilitates skill development • Guided Practice • Role play; Standardized patients; Immediate clinical exposure • Communication skills should be immediately applicable to the students’ clinical experiences.
Hofstra Curriculum • Pedagogic Foundations • Assessment • Multiple domains [Verbal/Written Communication, Self Assessment, Individual and Group Video Review] • Skills based assessment [standardized patients, coaching] • Formative and Summative • Assessment drives learning
Skills Relevant to the Student’s Professional Life • Intensive introductory course (7 weeks) • Deconstruction of basic, generalizable skills • Developmentally appropriate • Focus on function 1 [relationship building] • Focus on function 2 [information gathering and synthesis of the problem] • Clear demarcation in the curriculum with Function 3 [treatment planning and education] • Verbal and written communication skills
Relevant Skills : MS-1 Developmental Progression • Summer MS-1 [First 7 Weeks of Med School] • Core Communication Skills • Initial Engagement with a Patient • Chief Complaint and HPI • Highly Specific Empathy Skills • PMH, Medication,…., Social History • Practice an Interview with an SP • Trust Building • Cognitive Exam
Relevant Skills : MS-1 Developmental Progression • Fall MS-1 • Communication about screening tests • Obtaining a sexual history • Sharing difficult (“bad”) news • Winter MS-1 • Communication with Children/Adolescents: Chronic Illness • Readiness for Change • Screening for Problem Drinking
Relevant Skills : Developmental Progression • Winter MS-1 • Intimate Partner Violence: screening for a history of abuse • Screening for problem drinking • Spring MS-1 • Motivational Interviewing: Lifestyle Choices • Motivational Interviewing: Smoking Cessation
Faculty Development • Recruitment • Introduction to skills-based training • Philosophic shift from passive learning • Training in “Giving Feedback” • Training in Coaching/Role Play
Assessment • Interaction with Standardized Patient • Aligning the taught skills with assessment • Some unfamiliar scenarios to give the student a chance to apply taught skills [formative] • Formative assessment • Summative assessment
Resources • Core Communication Team • Faculty (Salaried and Voluntary) • Assessment Center • Medical Director • Standardized Patient Trainer • SP Rooms/Video/Data Storage • Standardized Patient Pool • Curriculum Time
Core Communication Skills Training • Initial Engagement with a Patient • Chief Complaint and HPI, Part I • Chief Complaint and HPI, Part II • Highly Specific Empathy Skills • Practice an Interview with an SP/Full History • Trust Building • Cognitive Exam Outcomes • Specific Skills-Based Learning Objectives: • Verbal Communication • Written Communication • Self Assessment • Exposure to Coaching Our 7-Week Core
A Sample Class • Goals • Learning Objectives • Pre-reading • Class Plan (Highly Structured) • Framing lecture (20 minutes) • Large or small group discussion (20 minutes) • Skills-based Practice/Role Play (60 minutes) • Discussion (10 minutes): • What will you immediately apply? • What are ongoing challenges?
Assessment Drives Learning A representative week Weeks devoted to Assessment
Sample Curriculum Map KEY T = Taught A = Assessed