Two Roads Diverged: A Macro and a Micro Approach to Teaching Reflection and Empathy

Fred Helms* Travis Billingsley** Gwyn Richardson** Era Buck**

*Alabama College of Osteopathic Medicine, Dothan, AL** University of Texas Medical Branch, Galveston, TX

Centile Conference 2017

Overview

• Student Creativity at the Alabama College of Osteopathic Medicine• Developing Healing Presence at University of Texas Medical Branch• Discussion of program evaluation issues we all face

Teaching Professionalism in the Foundations of Modern HealthcareUnanticipated student creativity

The Physician Healer Track

Era Buck, PhDTravis Billingsley, MDGwyn Richardson, MD, JD

Students will develop habits of thought, feeling and action that will enable their development as compassionate, communicative and socially responsible physicians.

Cooke, Irby, O’Brien 2010

Program Mission

Thus cultivating a healing presence to the benefit of themselves and their patients

Program Mission

Bleeding Heart or Heart of Stone?

Year 1Dinner

meetings

Summer2 month

preceptorship

Year 2 Dinner

meetings

Year 3Dinner

meetings

Year 4 Dinner mtgs

1 electiveScholar Month

1 immersive review month

Program Overview

Program DescriptionYear 1

• Inner Work• Stress Awareness• Self Compassion• Cognitive behavioral therapy• Humor• Mindfulness

• Communication Skills• Non-Violent Communication

Program DescriptionPreceptorship

ClinicalClinical shadowing 15 clinical half days• Follow physicians

in clinical areas of interest to the students

Healer Psycho-social pain assessmentGladysPerinatal hospice• Intro to Breaking

bad news

Skills learningMind body stress reductionMotivational interviewingWellnessWeekend retreat –Mindfulness

Program DescriptionYear 2

• Inner Work Continued• Internal Family Systems Model – Parts Work• Naikan – Gratitude• Healing Presence• Seeing Bias

• Skill Building• Breaking bad news continued• Being with suffering

Program DescriptionYear 3

• Continued monthly sessions

• Topic review

• Skills practice in clerkships

Program DescriptionYear 4

• Month long immersive review course

• Healer selective month

• Monthly meetings

• Continued skills practice

Program Growth

0

20

40

60

Year 1 Year 2 Year 3

Student Growth by Year

0

5

10

15

Year 1 Year 2 Year 3

Faculty Growth by Year

Some Early Assessment DataTo what extent are the questions below true for you about the

PHT Preceptorship

very small

extent

small extent some large

extent

very large

extent

Positively impacted my personal development 0 0 4 44 52

Improved my ability to empathize and connect with others 0 0 4 48 48

Positively impacted my professional development 0 0 4 48 48

Confirmed my satisfaction with my decision to become a physician 0 4 8 40 48

Taught me skills I have used to take better care of myself 0 0 12 52 36

Helped me cope with stress 0 0 12 84 4

Increased my knowledge of techniques for personal development 0 8 28 52 12

Increased my ability to work collaboratively 0 16 24 48 12

Increased my self-confidence 0 16 24 24 12

Program Evaluation – Why?

Challenges?

• Complexity

• Confidence in tools

• Changeable

• Lack of definitions of construct

Learning in the Affective Domain

Characterizing (serves as coach, mentor role model)

Organizing (self-regulation, prioritizing competing emotions or

values)

Valuing (consistency between expressed values and reactions)

Responding (engaging challenges in affective domain including analysis of reactions)

Receiving (awareness of importance of affective issues, willingness to listen)

Triangulation

Multiple • Assessments• Facets of complex phenomenon• Sources of information• Points in time• Contexts

Thank you