An interesting new paper by Wong and colleagues (1) discusses how they used excerpts from two television shows to help teach their internal medicine residents better communication skills. As has long been understood, good communication skills are a necessary part of patient care; these skills help build trust, help communicate information at a level the patient can understand, and therefore also help to increase patient satisfaction. While communication skills are now a core competency within the medical profession, I am not certain that this is the case within chiropractic. Certainly, within Palmer College, attention is given in practice management courses to better communication, and there is also our SPEAK organization, which is designed to provide opportunity and training to our students in public speaking. This is but another form of communication, of course. However, a standardized curriculum or teaching approach does not exist.
In 1999, medical educators met in Kalamazoo, Michigan to develop such guidelines (2).There model had seven essential elements: building a relationship, opening the discussion, gathering information, understanding the patient’s perspective, sharing information, reaching agreement on problems and plans, and providing closure. As Wong et al note, no formal teaching method for this model exists in the literature. There therefore tried to develop such a model based on what is know as cinemeducation, or the use of clips from popular television and movie clips.
Their project used clips from the programs House, MD and Grey’s Anatomy. Episodes were carefully selected to demonstrate important and/or sensitive situations in doctor-patient relationships. The scenarios helped to demonstrate the importance of the seven competencies provided by the Kalamazoo model. Here, the scenarios looked at end-of-life issues, psychosocial aspects of illness, and disclosure of medical errors. After watching, residents were asked to answer questions related to the seven aspects of the Kalamazoo model, and to have interactive reflection about what they experienced while watching.
While it is true that television programs have a heightened sense of reality, and are drama driven, their use as a teaching tool may not be used as effectively, or even as much, as possible. Within my field of bioethics, House, MD provides significant grounds for discussion. I have even posted an earlier blog post using one of its episodes as grounds for discussion. I’d like to suggest that some consideration be given to using this mode of teaching, which will engage our students at a cultural, as well as an educational, level.
1. Wong RY, Saber SS, Ma I, Roberts JM. Using television shows to teach communication skills in internal medicine residency. BMC Med Educ 2009;9:9 doi:10.1186/1472-6920-9-9
2. Makoul G. Essential elements of communication in medical encounters: the Kalamazoo consensus statement. Acad Med 2001;277:390-393