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Recognition, reflection, and role models: Critical elements in education about care in medicine

  • Anna L. Janssen (a1), Roderick D. MacLeod (a2) (a3) and Simon T. Walker (a4)
Abstract
ABSTRACTObjective:

Medical education can be described as a socialization process that has a tendency to produce doctors who struggle to convey to patients that they care. Yet, for people who are suffering, to enjoy the quality of life they are entitled to, it is important that they feel cared for as people, rather than simply attended to as patients.

Method:

This article addresses how we teach medical students the art of caring for the person rather than simply treating the disease—a question particularly relevant to end-of-life care where, in addition to the physical needs, attention to the psychosocial, emotional, and spiritual needs of the patient is paramount. Following an overview of what it is to care and why it is important that patients feel cared for, we investigate how we learn to care and develop caring human relationships, describing the development and display of empathy in adulthood and the developmental impact of human interaction.

Results:

We outline evidence of situational barriers to effective education about care in medicine including role models, ward culture, and the socialization process.

Significance of results:

We then propose a model for medical education based on patient contact, reflection, self-care, role model development, and feedback that will see students learn the art of human care as well as the science of disease management.

Copyright
Corresponding author
Address correspondence and reprint requests to: Anna Janssen, Faculty Education Unit, Faculty of Medical and Health Sciences, University of Auckland, 151 Park Road, Grafton, PO Box 92019, Auckland, New Zealand. E-mail: a.janssen@auckland.ac.nz
References
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Attree M. (2001). Patients' and relatives' experiences and perspectives of “Good” and “Not so good” quality care. Journal of Advanced Nursing, 33, 456466.
Bassett C. (2002). Nurses' perceptions of care and caring. International Journal of Nursing Practice, 8, 815.
Bellini L.M. & Shea J.A. (2005). Mood change and empathy decline persist during three years of internal medicine training. Academic Medicine, 80, 164167.
Birnbaum G.E., Orr I., Mikulincer M., et al. (1997). When marriage breaks up: Does attachment style contribute to coping and mental health? Journal of Social and Personal Relationships, 14, 643654.
Bliss M. (1999). William Osler: A Life in Medicine. New York: Oxford University Press.
Branch W.T. (2000). The ethics of caring and medical education. Academic Medicine, 75, 127132.
Brorsson A., Hellquist G., Bjorkelund C. et al. (2002). Serious, frightening and interesting conditions: Differences in values and attitudes between first-year and final year medical students. Medical Education, 36, 555560.
Carter H., MacLeod R., Brander P., et al. (2004). Living with a terminal illness: Patients' priorities. Journal of Advanced Nursing, 45, 611620.
Cohen D., Rollnick S., Smail S., et al. (2005). Communication, stress, and distress: Evolution of an individual support programme (ISP) for medical students and doctors. Medical Education, 39, 476481.
Coulehan J.L., Platt F.W., Egener B., et al. (2001). Words that help build empathy. Annals of Internal Medicine, 135, 221227.
Darwall S. (1998). Empathy, sympathy, care. Philosophical Studies, 89, 261282.
Gillett G. (1993). “Ought and well-being.” Inquiry, 36, 287306.
Glick S.M. (1993). The empathic physician: Nature and nurture. In Empathy and the Practice of Medicine, Spiro H., McCrea Curnen M.G., Peschel E. et al. (eds.), pp. 85102. New Haven: Yale University Press.
Hafferty F.W. (1991). Into the Valley: Death and the Socialisation of Medical Students. New Haven: Yale University Press.
Haidet P., Kelly A., & Chou C. (2005). Characterizing the patient-centredness of hidden curricula in medical schools: Development and validation of a new measure. Academic Medicine, 80, 4449.
Hojat M., Gonnella J.S., Nasca T.J., et al. (2002). Physician empathy: Definition, components, measurement, and relationship to gender and specialty. American Journal of Psychiatry, 159, 15631569.
Hunter J.J. & Maunder R.G. (2001). Using attachment theory to understand illness behaviour. General Hospital Psychiatry, 23, 177182.
James C.R. & MacLeod R.D. (1993). The problematic nature of palliative care education. Journal of Palliative Care, 9, 510.
Jaye C., Egan T., & Parker S. (2005). Learning to be a doctor: Medical educators talk about the hidden curriculum in medical education. Focus on Health Professional Education, 7, 117.
Larson P.J. (1984). Important nursing behaviours perceived by patients with cancer. Oncology Nursing Forum, 11, 4650.
Larson P.J. (1986). Cancer nurses' perceptions of caring. Cancer Nursing, 9, 8691.
MacLeod R.D. (2000). Learning to care: A medical perspective. Palliative Medicine, 14, 209216.
MacLeod R.D. (2001). On reflection: Doctors' learning to care for people who are dying. Social Science & Medicine, 52, 17191727.
MacLeod R.D. (2004). Challenges for education in palliative care. Progress in Palliative Care, 12, 117121.
MacLeod R.D., Parkin C., Pullon S., et al. (2003). Early clinical exposure to people who are dying: Learning to care at the end of life. Medical Education, 37, 5158.
MacLeod R.D. & Robertson G. (1999). Teaching about living and dying. Education for Health, 12, 185192.
Novack D.H., Epstein R.M., & Paulsen R.H. (1999). Towards creating physician–healers. Fostering medical students' self-awareness, personal growth, and well-being. Academic Medicine, 74, 516520.
Perner J., Ruffman T., & Leekham S.R. (1994). Theory of mind is contagious: You catch it from your sibs. Child Development, 65, 12281238.
Petersen Y. & Koehler L. (2006). Application of attachment theory for psychological support in palliative medicine during the terminal phase. Gerontology, 52, 111123.
Plack M.M. & Greenberg L. (2002). The reflective practitioner: Reaching for excellence in practice. Paediatrics, 116, 15461552.
Reynolds W.J. & Scott B. (2000). Do nurses and other professional helpers normally display much empathy? Journal of Advanced Nursing, 31, 226234.
Roter D.L., Stewart M., Putnam S.M., et al. (1997). Communication patterns of primary care physicians. JAMA, 277, 350356.
Thompson D. & Ciechanowski P.S. (2003). Attaching a new understanding to the patient–physician relationship in family practice. Journal of the American Board of Family Practice, 16, 219226.
Turner P., Sheldon F., Coles C., et al. (2000). Listening to and learning from the family carer's story: An innovative approach in interprofessional education. Journal of Interprofessional Care, 14, 387395.
Watson J. (1979). Nursing: The Philosophy and Science of Caring. Boston: Little, Brown and Company.
Weissman F., Branch W.T., Gracey C.F., et al. (2006). Role modelling humanistic behaviour: Learning bedside manner from the experts. Academic Medicine, 81, 661667.
Wilkinson T.J., Gill D.J., Fitzjohn J., et al. (2006). The impact on students of adverse experiences during medical school. Medical Teacher, 28, 129135.
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Palliative & Supportive Care
  • ISSN: 1478-9515
  • EISSN: 1478-9523
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