Empathy Training

[deleted77919]

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I've seen a few threads recently about the spread of empathy training, and small group PBL things into med schools. We have managed to combine our empathy training with small groups and the result is this:

" . . . role model physicians practice medicine in such a way that their relationships with patients is itself therapeutic - they have the healing touch. Describe a case in which a doctor patient relationship was therapeutic. What did the physician do to establish a relationship? In what way was the relationship therapeutic? Papers should be approximately 300 words. Be prepared to read your responses aloud in your seminar."

I almost wish I could go back a week and still be studying the head and neck. I understand it's important to think about these topics, but to write a paper and read it to 7 other people (and have to listen to theirs)? Ugh . . .

Anyone else have any "good" empathy training stories?

 

[ForbiddenComma]

Just remember that these classes are not designed to benefit the students. Nor are they designed to benefit the patients.

They are designed to benefit the people teaching the class, to help them feel better about themselves.

 

[Law2Doc]

Just remember that these classes are not designed to benefit the students. Nor are they designed to benefit the patients.

They are designed to benefit the people teaching the class, to help them feel better about themselves.

Agree. It's sometimes called window dressing. Something to point to by the administration to say "see, we do this, so our students are clearly well prepared".🙂

 

[deleted77919]

Just remember that these classes are not designed to benefit the students. Nor are they designed to benefit the patients.

They are designed to benefit the people teaching the class, to help them feel better about themselves.

I'd never thought about it that way. But yes, makes much more sense now.

 

[QofQuimica]

I've seen a few threads recently about the spread of empathy training, and small group PBL things into med schools. We have managed to combine our empathy training with small groups and the result is this:

" . . . role model physicians practice medicine in such a way that their relationships with patients is itself therapeutic - they have the healing touch. Describe a case in which a doctor patient relationship was therapeutic. What did the physician do to establish a relationship? In what way was the relationship therapeutic? Papers should be approximately 300 words. Be prepared to read your responses aloud in your seminar."

I almost wish I could go back a week and still be studying the head and neck. I understand it's important to think about these topics, but to write a paper and read it to 7 other people (and have to listen to theirs)? Ugh . . .

Anyone else have any "good" empathy training stories?

I thought that I had it bad until I read about yours.

FC, I don't understand how these classes can make anyone feel good about anything. They are universally despised by all students to the point where whenever the administration makes the mistake of asking us for some feedback about the curriculum, it winds up being an endless b**** session about this one class. Unless you are suggesting that the faculty enjoy hearing us complain for hours on end and find that to be therapeutic. There have been some times when I did wonder.... 😛

 

[deleted77919]

I think the key is to either not ask the students what they think of it, or to simply ignore feedback (these kids don't know what's good for them!), or to listen to the feedback but change the course constantly rather than abolish it. That way they can say "See, we're making empathetic doctors! They took a whole class on it!"

I suppose in the overall scheme of things, there are greater injustices, however.

 

[ForbiddenComma]

Right, or they can just consider complaints as "intolerance" or "hurtful words by Eurocentric patriarchals locked into a dead mode of thinking" or whatever sounds best to a humanities M.A. holder.

You can't really feel morally superior about yourself by teaching students about Salmonella or the glycolysis pathway... but you can feel morally superior by telling the students how they need to be better people and how you hold the path to a better way. A few generations ago, these people would have been revival preachers.

 

[StevenRF]

What if the patient was a hot nympho and you helped her with her addiction by forming a strong relationship?

 

[Trail Boss]

it sounds like all schools are pushing this "empathy" thing. I call it part of the modern "queer eye/touchy feely" effect. Someone should tell the liberals running the system that just because you don't seem caring doesn't mean you don't care. I personaly don't like doctors that get all emo with me and want to know "how that makes me feel" I just want them to do their job. I would rather have a less than super empathetic physician who was competent than some guy that started crying because he felt my pain and did even 1/1000 less good of a job. But alas, we must be touchy feely. Apparently someone thinks it is important.

 

[Law2Doc]

Someone should tell the liberals running the system that just because you don't seem caring doesn't mean you don't care.

The issue is not about actually caring. The issue is that patients over the years have been complaining about medicine and/or suing their doctors, and this is a consumer driven service industry, whether you like it or not. Perception is reality. If a patient feels his doctor is not caring, then his doctor isn't doing it adequately. Sure competence is important, but unless you are able to be both competent AND have patients like you, you are actually failing in your task.

I have no problem with this (having come from another service industry profession where similar things were emphasized). However I am fairly sure the way to teach these skills has little to do with the type of assignment Dakota described.

 

[jvencius]

What if the patient was a hot nympho and you helped her with her addiction by forming a strong relationship?

All is forgiven in that circumstance...

 

[Dookter]

I actually like our course on this topic. Well, it is actually a course that covers a lot of things, like interviewing skills, etc. But the empathy part is definitely built into the course. The course definitely can be awkward, and it sure takes up a lot of a Tuesday afternoon that was originally set aside by the science faculty so the students could have a break. But Law2Doc is right in what he said. People always say, "I would rather have a good doctor who doesn't care than a complete quack who cares a lot." Well, I want a good doctor who does care. And that is what most patients want. Unfortunately the classes we have to take to learn this stuff are sometimes slightly unrealistic. Fortunately, my teacher for this class has a no B.S. policy. She knows her stuff, and doesn't make us feel like we have to cry ourselves to sleep at night over this stuff. In the end, I feel it will be a valuable course. Now whether or not it will be more valuable than a free Tuesday afternoon, only time will tell.

 

[Instatewaiter]

As part of our empathy training at my school, during our standardized patient encounters we actually get graded on empathy. So when fake Jo Patient feigns a headache and stress from loosing his job we have to fake caring and ask all sorts of questions just to prove we care. And if we don't fake-care enough we lose a lot of credit that really should go to how well we do the physical exam we are supposedly practicing.

It's almost as though they are training us to be able to fake like we care instead of actually care.

 

[DoctorFunk]

It's almost as though they are training us to be able to fake like we care instead of actually care.

This should serve us well in our future careers as actors.

 

[lilnoelle]

As part of our empathy training at my school, during our standardized patient encounters we actually get graded on empathy. So when fake Jo Patient feigns a headache and stress from loosing his job we have to fake caring and ask all sorts of questions just to prove we care. And if we don't fake-care enough we lose a lot of credit that really should go to how well we do the physical exam we are supposedly practicing.

It's almost as though they are training us to be able to fake like we care instead of actually care.

Yeah, I got a bad comment about that from my standardized patients. Apparently I didn't ask her more personal questions about her upcoming wedding so I acted like I didn't care about her as a person. My thoughts about that were, "but I'm pretty sure that your not getting married in a month, if I thought this was real, I probably would've been more interested in your wedding."

 

[Dookter]

That is why anything that comes out of the mouth of a standardized patient has to be taken lightly. They purposely withhold information unless you specifically ask for it, and then they critique you in ways real patients won't even be thinking about.

 

[ForbiddenComma]

The standardized patients pretty much go off a list with their evaluations, unless you go out of your way to piss them off. Don't blame them; blame the ones (usually M.A.-holding non-doctors) who write the list in the first place.

While empathy is important to have, it's just not something that you can teach in a classroom. This is just another useless P.C. fad.

 

[indo]

My school has this half ass PBL thing that exists just so they can put "PBL" in their MSAR profile.

 

[sandg]

OK, so I might not be the most charismatic or outgoing guy, but I like to think I'll be able to be empathic when 3rd year and the rest of my career roles around. Why? Because any situation that demands it will be real and I'll have a real reaction. Right now, however, with standardized patients, etc. it is hard to be empathic because it's just faking in a fake encounter. I want to equal parts cringe and laugh cynically whenever we watch a classmate interview a patient in a small group and he/she whips out the textbook phrase "that must be hard for you." Ehh gads😱

 

[Trail Boss]

The issue is not about actually caring. The issue is that patients over the years have been complaining about medicine and/or suing their doctors, and this is a consumer driven service industry, whether you like it or not. Perception is reality. If a patient feels his doctor is not caring, then his doctor isn't doing it adequately. Sure competence is important, but unless you are able to be both competent AND have patients like you, you are actually failing in your task.

I have no problem with this (having come from another service industry profession where similar things were emphasized). However I am fairly sure the way to teach these skills has little to do with the type of assignment Dakota described.

THis is why I am going to be a surgeon. I will be posting a "I reserve the right to refuse service to anyone with a laywer or bad attitude" sign in my clinic window.

 

[Trail Boss]

I kid. but really, sometimes I think people are to concerned with how much I seem to care instead of how much I actually do. And still, I would rather be a good doctor and seem like a jerk than to have my skills visa versa. (and yes I know that someone is going to say "WELL, part of being a good doctor is being personable..."

 

[deleted77919]

THis is why I am going to be a surgeon. I will be posting a "I reserve the right to refuse service to anyone with a laywer or bad attitude" sign in my clinic window.

Actually surgeons have a tougher time with this issue than you might expect. When a surgery goes bad and there are consequences for the patient, they are less likely to sue if they think the Doctor is caring, open, and sorry.

And remember, whether successful, or not, frivilous, or not, a law suit is a hassle you don't want if you can avoid it.

 

[Trail Boss]

Yes yes. I know you are right. I still get annoyed that I have to act fake to avoid being sued--which is what this all boils down to for someone like me. I care deeply about people or I would not be subjecting my self to medical school, but I didn't know that it would require me to prove it to every patient just in case I make a mistake so they will be less likely to sue me. That seems the lest empathetic of any sentiment.

 

[dilated]

The issue is not about actually caring. The issue is that patients over the years have been complaining about medicine and/or suing their doctors, and this is a consumer driven service industry, whether you like it or not. Perception is reality. If a patient feels his doctor is not caring, then his doctor isn't doing it adequately. Sure competence is important, but unless you are able to be both competent AND have patients like you, you are actually failing in your task.

Yeah, but this is all basic social skills you should have learned long ago (making eye contact, feigning interest, etc). The Bill Clinton "I feel your pain" classes do nothing but waste time - either you got it long ago or you're never going to get it. No doctors in practice (except psychs) are going to ask long open ended questions about the DEATH OF YOUR PET. Arrrgh.

So either you're socially competent or you're not. 90% of the people in my class are. If you're not, and patients don't like that, they're free to go see another doctor. Yay choice.

 

[Law2Doc]

Yeah, but this is all basic social skills you should have learned long ago (making eye contact, feigning interest, etc). The Bill Clinton "I feel your pain" classes do nothing but waste time - either you got it long ago or you're never going to get it. No doctors in practice (except psychs) are going to ask long open ended questions about the DEATH OF YOUR PET. Arrrgh.

So either you're socially competent or you're not. 90% of the people in my class are. If you're not, and patients don't like that, they're free to go see another doctor. Yay choice.

I doubt 90% of your class are going to be loved by patients, but even if they are, there is going to be things they could do better. This is a service industry job. You are in large part selling customer service, not faceless assembly line procedures. Medicine used to be about the doctor being paramount and the patient just a cog in the wheel. The world has shifted and now patients have numerous new rights, protections and expectations.
The profession, perhaps driven by the increase of governmental regulations, lawsuits, growth of patient oriented alternative medicine options, and growing hostility toward physicians and healthcare by the lay public generally, has chosen to embrace to this new standard.
While you would think a lot of the social stuff should be second nature, it frequently isn't. I know students of certain cultures who didn't know that it is appropriate in the US to look an older person directly in the eye. We've all seen classmates plow through taking a history without acknowledging that a patient is crying and needs a tissue break or some comforting words.
Perhaps you can teach this kind of thing, although likely not via the method suggested in the OP's post. Certainly you can try and select for it -- which is why the interview and various non-numerical stats are huge in some med school admissions processes. But at any rate, I think anything a school can do to make a doctor better able to get his patients to open up to him during a history, or like him enough not to sue him, is not wasted time. It just has to be an actually useful exercise, not window dressing. Thoughtful essays are probably window dressing. Lectures on empathy are probably window dressing. Practice with emotional standardized patients might help.
The goal shouldn't be to be faking empathy, although that is often the result. The goal should be that your knee-jerk reaction when someone starts crying is to ask them if they need a break, or if someone drops an emotional bomb, that you ask them if they found that difficult. A non-caring person may never care, but at least he can say the appropriate things. From what I've seen, unless empathy is expected of a med student, they don't offer it. So schools make it expected in hopes that it becomes the default reaction when the prompt comes up. Sorry for the ramble.

 

[deuist]

They are universally despised by all students to the point where whenever the administration makes the mistake of asking us for some feedback about the curriculum, it winds up being an endless b**** session about this one class.

When I had to review the Doctoring course last year, I wrote, "Going to Doctoring is like receiving a soft kick in the testicles ever Tuesday and Thursday afternoon." Naturally, we're still taking Doctoring this semester. I wonder if the administration just has a good laugh at our comments and then throws them away.

 

[DoctorFunk]

When I had to review the Doctoring course last year, I wrote, "Going to Doctoring is like receiving a soft kick in the testicles ever Tuesday and Thursday afternoon." Naturally, we're still taking Doctoring this semester. I wonder if the administration just has a good laugh at our comments and then throws them away.

My friend and I wrote feedback on our Cultural Competency class about how degrading and stereotype-ridden the class was when it came to discussing some ethnic groups. We kept our critiques professional, but made sure they knew that we thought the class needed a major revamp.

So about a week later my buddy got an e-mail from the course director criticizing him for being negative about the course and accusing him of being unprofessional by even mentioning its deficiencies. Evidently our online feedback forms were not anonymous after all. Needless to say, we were all fairly horrified at the "Big Brother" antics of the powers-that-be in that particular course, and are now are content to skip as much of those classes as possible and keep our pretty little mouths shut. I certainly didn't feel like battling some uber-liberal MD from an Ivy League school.

 

[beefballs]

yup-I said it to surebrec in the other empathy b!tch fest-just dance the dance and don't make waves it isn't worth it-


...although whenever I am given a writing assignment I use that as an opportuity to be as over the top as possible-to the point of sounding mentally unstable and ready to burst with tears for my fellow man at any moment. The faculty can't really criticize me but my classmates get a big laugh out of it because they know what a heartless slob I really am.

seriously use the words "want to touch my patients on so many levels" & "my heart throbs to help others" If you read these out loud really emphasize the throbbing and touching using hand jestures- I really have to work to keep a straight face when I do this-One ridiculous turn deserves another, and yes the faculty knows I am making a mockery of the whole thing so I get that smidgeon of saisfaction

 

[QofQuimica]

When I had to review the Doctoring course last year, I wrote, "Going to Doctoring is like receiving a soft kick in the testicles ever Tuesday and Thursday afternoon." Naturally, we're still taking Doctoring this semester. I wonder if the administration just has a good laugh at our comments and then throws them away.

Heh. You could be right. One thing I have going for me is that at this point in my life, I'm already pretty much inured to being proselytized. 😉

 

[ShyRem]

I agree videotaping would be better for teaching -- seeing how you act means more than hearing words from someone else.

As a patient (during many different ages and for varying degrees of severity), I can't tell you how much the non-verbal comunication means. So much more than the verbal communication. I'm giving myself or my cherished loved one to your hands for care. CARE. Not just medical care - but CARE. When you come out to tell me how my son did during surgery, words don't mean much. When I see you when my grandfather is dying, words will be forgotten. Your non-verbal language won't. I've fired doctors for being patronizing, demeaning, degrading. A non-empathetic physician is a physician that often doesn't *listen* to what the patient says (and doesn't say). You don't need to go on and on about how sorry you are -- try a hug without saying a word. A touch on the shoulder that says "I'm sorry" more than the spoken word. Empathy is more than spoken language. It is how you make the patient feel.

The doctoring courses that are non-science are there to make you think about how you'll handle situations, what you'll say to patients, *how* you'll act. It is so much more important than you think. I know you think they're a waste of time... I'm asking you as a patient, a parent, a daughter, and a peer to please give it some thought.

 

[beefballs]

I agree videotaping would be better for teaching -- seeing how you act means more than hearing words from someone else.

As a patient (during many different ages and for varying degrees of severity), I can't tell you how much the non-verbal comunication means. So much more than the verbal communication. I'm giving myself or my cherished loved one to your hands for care. CARE. Not just medical care - but CARE. When you come out to tell me how my son did during surgery, words don't mean much. When I see you when my grandfather is dying, words will be forgotten. Your non-verbal language won't. I've fired doctors for being patronizing, demeaning, degrading. A non-empathetic physician is a physician that often doesn't *listen* to what the patient says (and doesn't say). You don't need to go on and on about how sorry you are -- try a hug without saying a word. A touch on the shoulder that says "I'm sorry" more than the spoken word. Empathy is more than spoken language. It is how you make the patient feel.

The doctoring courses that are non-science are there to make you think about how you'll handle situations, what you'll say to patients, *how* you'll act. It is so much more important than you think. I know you think they're a waste of time... I'm asking you as a patient, a parent, a daughter, and a peer to please give it some thought.

two things
1-people learn how to deal with these things thru actual life experiences, not thru asinine play acting-they aren't genuine

2-Do you think the uncaring, unfeeling doctors you talk about would be different if they had these cornball bs crap that we have now-if you think so you have been drinking the kool-aid

 

[beefballs]

When you come out to tell me how my son did during surgery, words don't mean much. .

alright in honor of shyrem I will not tell people how a procedure went I will perform an interpretive dance after it is done-you know so they don't forget, like they would my words

 

[DoctorFunk]

alright in honor of shyrem I will not tell people how a procedure went I will perform an interpretive dance after it is done-you know so they don't forget, like they would my words

If it's alright, I would like to compose the music you will be using for said dance. I can compose a few variations: "The Suite of Success", "The Death of a Patient" and "Laparoscopic Appendectomies Are Boring and I Really Zoned Out During Much of Your Son's Procedure."