MMI Comfort Stations

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BigBlueBear

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I looked around but couldn't find any advice for this one.

In several of the Mock MMI's I've looked at, there is a station where you have to comfort somebody, whether it be a patient dying of a terminal disease or someone who lost a family member, etc.

Does anybody have any advice for these? I know I'm going to find it difficult to comfort them for 7-8 whole minutes. What else can you do other than say "I'm really sorry to hear that." and "You know you can always talk to me if you ever need anything" and stuff like that?
 
I looked around but couldn't find any advice for this one.

In several of the Mock MMI's I've looked at, there is a station where you have to comfort somebody, whether it be a patient dying of a terminal disease or someone who lost a family member, etc.

Does anybody have any advice for these? I know I'm going to find it difficult to comfort them for 7-8 whole minutes. What else can you do other than say "I'm really sorry to hear that." and "You know you can always talk to me if you ever need anything" and stuff like that?


This is why they are assessing you. It shouldn't really be "prepared." What you will experience isn't the same as what you have seen for examples. The acting stations are interesting. Good luck.
 
I think this is dumb...whether or not someone naturally knows how to comfort a patient, this is something that becomes much easier after some training. This is part of what they teach you in medical school...why should it count against you if you don't innately know the right stuff to say? And I just thought I'd add, I don't think I would have a problem with this station, but it seems unfair to others that might.
 
I think this is dumb...whether or not someone naturally knows how to comfort a patient, this is something that becomes much easier after some training. This is part of what they teach you in medical school...why should it count against you if you don't innately know the right stuff to say? And I just thought I'd add, I don't think I would have a problem with this station, but it seems unfair to others that might.

When you have 6000 applications to boil down to 900 interviews (almost all of which go well), which must be cut down to (ultimately) 300 acceptances (for 150 matriculants), you have to do find something that DQs people with some level of legitimacy. Further, this IS an important innate ability. Teaching someone to have the right approach, attitude, etc. to comfort others is quite difficult and an unnecessarily loss of time. IMO, the community is far better off if their schools takes a 28/3.5 with excellent interpersonal skills (which is one of the primary things the MMI, and esp. this scenario type, measures) than they are if it attempts to train a 35/4.0 with weak interpersonal skills. The first will probably become an excellent doctor in 8-13 years. The latter... much more risky.
 
Don't people usually gorge themselves on delicious food when sad? Try offering them cake. Or maybe give them a puppy.
 
Hahaha!

I don't know why I read this as "MMA (as in Mixed Martial Arts) Comfort Stations"
 
I had a situation similar to this at an interview this year. What I did was talk from personal experience having to do with the emotional/social side of illness. It's not easy, but they're looking to see if you are empathetic and can keep a cool head.
 
I had a situation similar to this at an interview this year. What I did was talk from personal experience having to do with the emotional/social side of illness. It's not easy, but they're looking to see if you are empathetic and can keep a cool head.


The difference is that those MMI scenarios are generally of the acting/full role-play variety. They are meant to be "similar" to the OSCEs we have prep for as medical students (and later do as part of Step 2). (I am using "similar" in a very liberal way here... but the MMI does claim this to be true, laughable as that may be.) They really are testing your natural response to the situation. They want to know whether you have some natural ability when it comes to giving bad news, calming down agitated people, working as a team, giving/receiving instructions, etc.
 
When you have 6000 applications to boil down to 900 interviews (almost all of which go well), which must be cut down to (ultimately) 300 acceptances (for 150 matriculants), you have to do find something that DQs people with some level of legitimacy. Further, this IS an important innate ability. Teaching someone to have the right approach, attitude, etc. to comfort others is quite difficult and an unnecessarily loss of time. IMO, the community is far better off if their schools takes a 28/3.5 with excellent interpersonal skills (which is one of the primary things the MMI, and esp. this scenario type, measures) than they are if it attempts to train a 35/4.0 with weak interpersonal skills. The first will probably become an excellent doctor in 8-13 years. The latter... much more risky.

Unless you're going to back this up with some sort of data, this is all a bunch of speculation. Does this station actually measure one's interpersonal skills? Does it measure something that is unteachable? Does success (or failure) in this interview actually reflect an applicant's performance during medical school or real patient interactions?

Sure we have to weed out thousands of applicants, but that's no reason to ignore obvious flaws in our selection methods. There's no reason a medical school cannot use other methods to select their applicants. Unless the threshold needed for success at this stage is rather low such that only exceptionally cold/stiff applicants will fail, it's very likely this could simply be capturing which students feel the most confident going into the interview, which students have the most experience in service/comforting situations (which is something that can be learned, it's not magic), or students that know about these various stages and have rehearsed ahead of time how to handle it.

Part of real interpersonal skills involves establishing trust and believability. I wouldn't be surprised if a lot of applicants that are actually very good in one on one situations with real patients finds the rehearsed scenario on which they are being watched awkward, unrealistic, forced, and thus hard to emotionally engage in. I'd want these doctors over the ones that have no real empathy or believability in actual situations but know the right stuff to say for a 5 minute interview stage because he/she practiced and rehearsed for all his/her interviews ahead of time. It's a nice idea, but there is no reason for us to assume this tactic is effective until proven otherwise.
 
Unless you're going to back this up with some sort of data, this is all a bunch of speculation. Does this station actually measure one's interpersonal skills? Does it measure something that is unteachable? Does success (or failure) in this interview actually reflect an applicant's performance during medical school or real patient interactions?
Meh, frankly not worth my time to go find data for some petty thing on SDN. From what I have observed, physicians with excellent interpersonal skills are better liked and I am told there is plenty of data supporting this (I have simply not gone and looked at it...not really something I care much about). The MMI was evaluated with a quasiexperimental model of trial as I recall, yes. You can go do some research on that as well if you'd like. If you had any reasonable amount of clinical experience that involved psych pts, you'd know how silly your question about teaching interpersonal skills sounds. Yes, they can be "taught" however, they are FAR harder to teach than most things. It is far easier to tutor someone in the sciences than it is to change their personal approach to things (even if they are willing).
Sure we have to weed out thousands of applicants, but that's no reason to ignore obvious flaws in our selection methods. There's no reason a medical school cannot use other methods to select their applicants. Unless the threshold needed for success at this stage is rather low such that only exceptionally cold/stiff applicants will fail, it's very likely this could simply be capturing which students feel the most confident going into the interview, which students have the most experience in service/comforting situations (which is something that can be learned, it's not magic), or students that know about these various stages and have rehearsed ahead of time how to handle it.
Sure... but keep in mind you will have to pass standardized tests of this (Step 2) as well as rotations and if you're that lacking in confidence, well, good luck....
Part of real interpersonal skills involves establishing trust and believability. I wouldn't be surprised if a lot of applicants that are actually very good in one on one situations with real patients finds the rehearsed scenario on which they are being watched awkward, unrealistic, forced, and thus hard to emotionally engage in. I'd want these doctors over the ones that have no real empathy or believability in actual situations but know the right stuff to say for a 5 minute interview stage because he/she practiced and rehearsed for all his/her interviews ahead of time. It's a nice idea, but there is no reason for us to assume this tactic is effective until proven otherwise.
Once again, good luck with standardized patients, Step 2, etc.

I certainly acknowledge that you make some good points, but then the MMI came about for the very reason that interviews were found to be ineffective at selecting applicants, so....
 
Part of real interpersonal skills involves establishing trust and believability. I wouldn't be surprised if a lot of applicants that are actually very good in one on one situations with real patients finds the rehearsed scenario on which they are being watched awkward, unrealistic, forced, and thus hard to emotionally engage in. I'd want these doctors over the ones that have no real empathy or believability in actual situations but know the right stuff to say for a 5 minute interview stage because he/she practiced and rehearsed for all his/her interviews ahead of time. It's a nice idea, but there is no reason for us to assume this tactic is effective until proven otherwise.

👍

Plus, MMI favors extroverts according to this:

http://www.ucdmc.ucdavis.edu/publish/news/newsroom/6802

I'd be screwed, since I definitely don't fall into the extrovert category.
 
I think it's all about being well rounded. Being able to empathize with patients and have good interpersonal skills are important features of being a physician. Although the way of assessing this might not be perfect, I can see the point of these type of scenarios in MMIs. IMO, I think the beauty of medicine is that it requires a broad range of skills...
 
I had a hypothetical comfort situation in my MMI. What was annoying about it was that the actor wasn't very skilled and kept changing the story to keep the conversation going into a tricky direction. Basically, every time I did/said the right thing, they moved it into a direction to try to trick me into saying something thoughtless.

Do:
Acknowledge their feelings: "I'm sorry. That must be sad/frustrating/difficult"
Validate their experience: "You have every right to feel that way"/"In your position I would also feel sad/etc.."
Admit if you can't actually relate to their experience: "I've never lost a close family member, I can't even imagine what it would be like..."
Encourage them to let their feelings to run their course: "It's healthy to grieve, give yourself time to adjust to this loss"
Suggest that they reach out for help when they need it: "Do you have any friends/family/church/etc that you can call when you are feeling very sad?"
Give them hope that their pain will lessen: "It may not seem like that now, but time heals all wounds"
Ask them lots of questions: "How can I help? Is there anything you can think of that would help you to feel better/less sad?"
Wait for them to speak.

Don't:
Express your own discomfort with their feelings: "Don't cry!" (or godforbid "Stop crying!")
Tell them how they should feel instead: "Cheer up! Go watch a movie! Get a puppy!"
One-up them by relating a personal experience of your own: "Your grandpa died in his sleep? Yeah mine died after a lengthy battle with stage IV cancer!"
Make the conversation about yourself, babbling about your feelings/problems to try to distract/detract from theirs: "When my mom died I was depressed for weeks and blah blah blah blah"
Imply that they are at fault for not snapping out of it fast enough, or doing enough to get over it. Everyone recovers in their own time.
Fill the silence because you are uncomfortable or they are taking too long to respond.

If in doubt:
If you're stumped or have run out of things to say, either be quiet or ask them questions to keep them talking. It's better to say "I don't know what else to say, other than I know this is hard and I'm sorry for what you're going through" than to babble on or start digging a deeper hole.
 
I would honestly walk out of the interview if they asked me to do that.
 
When you have 6000 applications to boil down to 900 interviews (almost all of which go well), which must be cut down to (ultimately) 300 acceptances (for 150 matriculants), you have to do find something that DQs people with some level of legitimacy. Further, this IS an important innate ability. Teaching someone to have the right approach, attitude, etc. to comfort others is quite difficult and an unnecessarily loss of time. IMO, the community is far better off if their schools takes a 28/3.5 with excellent interpersonal skills (which is one of the primary things the MMI, and esp. this scenario type, measures) than they are if it attempts to train a 35/4.0 with weak interpersonal skills. The first will probably become an excellent doctor in 8-13 years. The latter... much more risky.

And your data for this is where exactly...?
 
Whether you like them or not, you should get used to them. They are not only being used for med school interviews but have been increasingly used during med school as well. Most schools have some form of OSCEs which put students in situations such as this. One of the USMLE exams addresses/grades the ability to perform in these situations. Some residency programs are also using them for interviews as well.
 
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And your data for this is where exactly...?

Not necessary. Observation. Not everything needs to be data-driven all the time. Life isn't that objective.

But go back and reread my statement...maybe you need some work on your verbal/communication skills if you're asking that question. 😉

(Opinions don't require data to back them up. That's why they are called opinions.)
 
Whether you like them or not, you should get used to them. They are not only being used for med school interviews but have been increasingly used during med school as well. Most schools have some form of OSCEs which put students in situations such as this. One of the USMLE exams addresses grades the ability to perform in these situations. Some residency programs are also using for their interviews as well.

Exactly. Even if they are not the best thing to have evaluating you as an applicant, you're going to be dealing with them A LOT in medical school (if you get in).
 
What schools have MMI?
 
Not necessary. Observation. Not everything needs to be data-driven all the time. Life isn't that objective.

But go back and reread my statement...maybe you need some work on your verbal/communication skills if you're asking that question. 😉

(Opinions don't require data to back them up. That's why they are called opinions.)

So you are making blanketing generalizations based off admittedly nothing but your own observation? Gotcha.

I also take issue with you saying that "most" medical school matriculants with a 28/3.5 will "probably" become excellent doctors, regardless of their interpersonal skills.
 
Meh, frankly not worth my time to go find data for some petty thing on SDN. From what I have observed, physicians with excellent interpersonal skills are better liked and I am told there is plenty of data supporting this (I have simply not gone and looked at it...not really something I care much about). The MMI was evaluated with a quasiexperimental model of trial as I recall, yes. You can go do some research on that as well if you'd like. If you had any reasonable amount of clinical experience that involved psych pts, you'd know how silly your question about teaching interpersonal skills sounds. Yes, they can be "taught" however, they are FAR harder to teach than most things. It is far easier to tutor someone in the sciences than it is to change their personal approach to things (even if they are willing).

I have also known well liked interpersonally skilled doctors to misdiagnose stage III cancer. Quite frankly, I don't care if my doctor is a butt-hole if he/she isn't a fool. If he/she can do his/her job very well, that's the most important thing to me.

Also without hard evidence your opinion is just that, an opinion. So if you feel your opinion is "worth time" writing with a tone of superiority while pointing out flaws in another's opinion, you should take that time to provide evidence. Or post kindly and discuss your opinion that way.

I don't like the thought of this during interviews. However, it is what it is. As an evaluating tool, I view it as far less useful than a normal interview. It places an expectation of experience on the applicant rather than who the applicant is. Get a feel for the person. If you feel the person is a good fit, YAY. If not, oh wells, NEXT!
 
Being able to empathize with patients and have good interpersonal skills are important features of being a physician.

I don't think anyone would dispute this.

Although the way of assessing this might not be perfect, I can see the point of these type of scenarios in MMIs.

Nope, still think standardized patient exams are pointless feel-good bull**** that waste your time in medical school and are even more pointless as an applicant. How good of an actor you are (which is a major part of what these exams test) has little bearing on how you are as a physician.
 
So you are making blanketing generalizations based off admittedly nothing but your own observation? Gotcha.

I also take issue with you saying that "most" medical school matriculants with a 28/3.5 will "probably" become excellent doctors, regardless of their interpersonal skills.

I said that IMO a person with excellent interpersonal skills and a 28/3.5 is preferable to someone w a 35/4.0 without good interpersonal skills. A 28/3.5 is well above the high-risk for failing in med school line but is very much borderline for admissions due to high levels of competition. That is why I used that.



I don't think anyone would dispute this.



Nope, still think standardized patient exams are pointless feel-good bull**** that waste your time in medical school and are even more pointless as an applicant. How good of an actor you are (which is a major part of what these exams test) has little bearing on how you are as a physician.


I agree with you insofar as these exercises require good acting. That said, I do think they can at least give some good places to work from, although we have not done much w standardized pts yet, so I cannot give much of an opinion. I speak to this more from my clinical background in the hospital than as a medical student. From that perspective, I feel that my background has made the practice scenarios we have done in med school easier for me. Additionally, I see the MMI as a reasonably screen for students that one would not want in his/her class. Sure, no screen is perfect, but at least the MMI gives more people an opportunity to pick up on your d*ckish behavior/attitude before you are admitted. The MMI, at least for me, seemed to pull the guard down, which I think makes it, perhaps, a bit less of an "interview" and, therefore, less likely to encounter the same faking issues that traditional interviews deal with.



I have also known well liked interpersonally skilled doctors to misdiagnose stage III cancer. Quite frankly, I don't care if my doctor is a butt-hole if he/she isn't a fool. If he/she can do his/her job very well, that's the most important thing to me.
Everyone misses diagnoses. This is when those interpersonal skills are [often] most important. Medical schools focus on training you to make those diagnoses. Sure, measures such as intelligence have some predictive value; however, a test like the MCAT is measuring only a few aspects of that factor, as does something like the MMI. To me, each factor is of some value. I do not think the MMI or traditional interview is perfect; however, there have been papers that argued for the effectiveness of hybrid MMI-traditional interview approaches.
Also without hard evidence your opinion is just that, an opinion. So if you feel your opinion is "worth time" writing with a tone of superiority while pointing out flaws in another's opinion, you should take that time to provide evidence. Or post kindly and discuss your opinion that way.

I don't like the thought of this during interviews. However, it is what it is. As an evaluating tool, I view it as far less useful than a normal interview. It places an expectation of experience on the applicant rather than who the applicant is. Get a feel for the person. If you feel the person is a good fit, YAY. If not, oh wells, NEXT!
It places an expectation of both experience AND who you are. Both are important. However, in many ways, your entire app is about "who you are," which makes the personal interview somewhat redundant, really. Having interviewed candidates for jobs before becoming a medical student, I much prefer watching candidates actually work. It gives me a much better feel for how they might operate on a day to day basis than just asking them a bunch of largely hypothetical questions on which they could EASILY lie.
 
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I had a doctor tell me that I better get used to giving myself shots, because it looked like I'm Type A diabetic. Up until that time, he had been saying, for a good 4 months, that my diabetes was gestational and soon I'd be able to eat anything I ever wanted without a worry. After my son was born prematurely, in an incubator with wires and tubes everywhere, he's telling me I better get used to taking insulin again. (I had about a day reprieve.) All through that pregnancy, I went to this endocrinologist. He looked and talked like a "genius", but I'd walk out from my appointment, wondering what I had learned. I was as confused as ever. He certainly "seemed" as if he's one of those guys with a 4.0 from Harvard, but his interpersonal skills were deplorable.

I am all for these kinds of interviews. That horrible doctor should never have been allowed to work with patients, and these kinds of interviews will hopefully screen some out.
 
It places an expectation of both experience AND who you are. Both are important. However, in many ways, your entire app is about "who you are," which makes the personal interview somewhat redundant, really. Having interviewed candidates for jobs before becoming a medical student, I much prefer watching candidates actually work. It gives me a much better feel for how they might operate on a day to day basis than just asking them a bunch of largely hypothetical questions on which they could EASILY lie.

But are we not trying to get to medical school to learn how to be a doctor and gain experience? It's not so much a job interview (which I agree with you for jobs. Actually, I love google's methods of trying to test one's problem solving skills), but an interview for more schooling. Seeing how someone works is a valuable thing, but I don't exactly like this MMI scenario for med school interviews, I feel it's flawed due to the wide variety of backgrounds and experiences medical school wants. A job is more specified.

Also, while the application gives someone a sense of who you are and what you've done, it tells one nothing about energy. Talk to people, read their body language, get a feel for them. That's what I feel would be the most important information to obtain about an applicant. It's flawed, but I feel optimal for this case.
 
I actually feel this is a remarkably good test for how someone's going to behave when they DON'T feel sympathy for a patient (or they dislike the patient).

Obviously it's not perfect, but I fail to see it as less perfect than "so tell me about your research for 10 minutes."
 
I had a doctor tell me that I better get used to giving myself shots, because it looked like I'm Type A diabetic. Up until that time, he had been saying, for a good 4 months, that my diabetes was gestational and soon I'd be able to eat anything I ever wanted without a worry. After my son was born prematurely, in an incubator with wires and tubes everywhere, he's telling me I better get used to taking insulin again. (I had about a day reprieve.) All through that pregnancy, I went to this endocrinologist. He looked and talked like a "genius", but I'd walk out from my appointment, wondering what I had learned. I was as confused as ever. He certainly "seemed" as if he's one of those guys with a 4.0 from Harvard, but his interpersonal skills were deplorable.

I am all for these kinds of interviews. That horrible doctor should never have been allowed to work with patients, and these kinds of interviews will hopefully screen some out.
Those are very different kinda of interpersonal skills (yes, shockingly the blanket term "interpersonal skills" isn't just some single atomos trait). Being able to explain complex things in a simple way that most people could understand is invaluable, and that is actually one of the few interview tests I wouldn't object to and see merit in.
 
I had a hypothetical comfort situation in my MMI. What was annoying about it was that the actor wasn't very skilled and kept changing the story to keep the conversation going into a tricky direction. Basically, every time I did/said the right thing, they moved it into a direction to try to trick me into saying something thoughtless.

Do:
Acknowledge their feelings: "I'm sorry. That must be sad/frustrating/difficult"
Validate their experience: "You have every right to feel that way"/"In your position I would also feel sad/etc.."
Admit if you can't actually relate to their experience: "I've never lost a close family member, I can't even imagine what it would be like..."
Encourage them to let their feelings to run their course: "It's healthy to grieve, give yourself time to adjust to this loss"
Suggest that they reach out for help when they need it: "Do you have any friends/family/church/etc that you can call when you are feeling very sad?"
Give them hope that their pain will lessen: "It may not seem like that now, but time heals all wounds"
Ask them lots of questions: "How can I help? Is there anything you can think of that would help you to feel better/less sad?"
Wait for them to speak.

Don't:
Express your own discomfort with their feelings: "Don't cry!" (or godforbid "Stop crying!")
Tell them how they should feel instead: "Cheer up! Go watch a movie! Get a puppy!"
One-up them by relating a personal experience of your own: "Your grandpa died in his sleep? Yeah mine died after a lengthy battle with stage IV cancer!"
Make the conversation about yourself, babbling about your feelings/problems to try to distract/detract from theirs: "When my mom died I was depressed for weeks and blah blah blah blah"
Imply that they are at fault for not snapping out of it fast enough, or doing enough to get over it. Everyone recovers in their own time.
Fill the silence because you are uncomfortable or they are taking too long to respond.

If in doubt:
If you're stumped or have run out of things to say, either be quiet or ask them questions to keep them talking. It's better to say "I don't know what else to say, other than I know this is hard and I'm sorry for what you're going through" than to babble on or start digging a deeper hole.

This.

And also, I have to say that as someone who feels like I'd be a good doctor in part because I'm good at this kind of stuff, I'd be happy that they include this in the interview instead of just asking me things like "tell me about your research" for half an hour. I feel like it'd give me a chance to show off what I'm good at. For sure, the MMI is more geared toward people like me (if you know Myers Briggs, I'm talking about people who are more F than T) but a lot of other interviews that focus on objectively discussing your achievements are on the other end of the spectrum, so I feel like we both get our chance to shine.

In any case, good luck on your interviews, everyone!
 
Not sure if this is germane to this particular discussion, but IHI talks about people's spiritual beliefs in their "Dignity and Respect" online course and one of the parts I found interesting was that patients tend to be more spiritual than their care providers. It seems like (at least in my experience) a lot of physicians don't really like to "go there" or tread on spiritual ground even though it can be really important for patients, especially in times of crisis. The course suggests the HOPE assessment for figuring out where patients derive a sense of hope/meaning/comfort/etc., whether they are involved in organized religion, what matters to them in terms of personal spirituality, and how their personal beliefs impact their expectations for/concerns about medical care and end-of-life issues. I haven't seen this used ever, but it did seem to me like it might help link patients/families with the kind of support that would really help them.

http://app.ihi.org/lms/coursedetail...alogGUID=6cb1c614-884b-43ef-9abd-d90849f183d4 if you're interested.

There are a lot of really great courses at IHI that are available for free to students -- lots of interesting fodder for personal statements, interviews, etc..
 
I don't really agree with the above "observational" deductions ...
 
I really wonder who this music2doc guy is that makes posts with such condescending tone while talking about how to show empathy to patients. Such irony. Is this the way you talk to other people in everyday life as well or you are one of those internet tough guys that we see so often on SDN?
 
MMI serves to also help remove the subjectiveness of the interview process. By bumping the interviewer "n" up to 10, compared to (for example, at vcu) n=1, it helps remove the impact of bias/first impressions/etc.

A study was done which retrospectively analyzed the averaged overall scores of mmi performance. I'm on my phone, so cant cite it exactly... however, the accepted applicants ended up having higher scores than those that were not accepted -- so there is some traditional function behind it.
 
I don't really agree with the above "observational" deductions ...

Thank you.

I really wonder who this music2doc guy is that makes posts with such condescending tone while talking about how to show empathy to patients. Such irony. Is this the way you talk to other people in everyday life as well or you are one of those internet tough guys that we see so often on SDN?

See this thread: http://forums.studentdoctor.net/showthread.php?t=887528

It really shows off his "inter-personal skills."
 
The University of Arizona has them. I'm not sure of others that might also. I have mine in october 🙂 I'ts kind of scary because it is something that I can't really prepare for, but maybe that's a good thing--you can't practice for everything in life!
 
There are like 10ish schools that have them. UC Davis, NYMC, both Arizona schools, plus some more than I've forgotten about
 
Thank you.



See this thread: http://forums.studentdoctor.net/showthread.php?t=887528

It really shows off his "inter-personal skills."

:laugh: I remember this thread. I read and responded when it first came out. No wonder I got the feeling this is not the first time he talks down to people like this but not quite sure where I have seen his previous posts. Some longtime members like RogueUnicorn did mention that was not the first time he posted in such tone. Quite a character.
 
I thought this thread was going to be about comparing the comfort of the chairs in the MMI stations where you get to sit and do nothing.

Nice. I admittedly found those stations kind of boring...haha.
 
Not sure if this is germane to this particular discussion, but IHI talks about people's spiritual beliefs in their "Dignity and Respect" online course and one of the parts I found interesting was that patients tend to be more spiritual than their care providers. It seems like (at least in my experience) a lot of physicians don't really like to "go there" or tread on spiritual ground even though it can be really important for patients, especially in times of crisis. The course suggests the HOPE assessment for figuring out where patients derive a sense of hope/meaning/comfort/etc., whether they are involved in organized religion, what matters to them in terms of personal spirituality, and how their personal beliefs impact their expectations for/concerns about medical care and end-of-life issues. I haven't seen this used ever, but it did seem to me like it might help link patients/families with the kind of support that would really help them.

http://app.ihi.org/lms/coursedetail...alogGUID=6cb1c614-884b-43ef-9abd-d90849f183d4 if you're interested.

There are a lot of really great courses at IHI that are available for free to students -- lots of interesting fodder for personal statements, interviews, etc..

That really is kind of interesting. That topic reflects a lot of what we are seeing in medical School. Thanks for sharing it.
 
Would asking if a patient is spiritual/religious be totally a no-no for this situation? I ask because I feel it's something I'd actually do and I've read about doctors praying for/with their patients (Ben Carson, for example), but don't know if bringing up religion in such a setting (it IS an interview) would be a no-no.

Also, if I asked "are you religious" and they said 'yes,' smooth sailing from there. But if they're not and say no....awkward...
 
Would asking if a patient is spiritual/religious be totally a no-no for this situation? I ask because I feel it's something I'd actually do and I've read about doctors praying for/with their patients (Ben Carson, for example), but don't know if bringing up religion in such a setting (it IS an interview) would be a no-no.

Also, if I asked "are you religious" and they said 'yes,' smooth sailing from there. But if they're not and say no....awkward...

You will learn appropriate ways of asking that question in medical school. I would not ask, "Are you religious?" in an MMI situation if you are simply comforting the person. If it were a patient, you might ask them if s/he considers him/herself to be a spiritual person (or similar); however, most MMI scenarios do not involve that level of interviewing. I would not want to spend that much time getting to know my "patient" during an MMI scenario. On the OSCEs, however -- which is what the MMI is supposed to be modeled after -- I am told this is crucial as you are doing a full interview and H&P.
 
Also, I have an MMI tomorrow and I know it's ingenuine to prepare but I'm nervous about this because I've always felt helpless when giving bad news and comforting. I mean, if I tell you your son just died, nothing I saw can make you feel better, I can only make you feel worse (in my opinion). And usually the people I tell bad news to in my life are people I know and feel comfortable giving a hug and just silently being there.

Long story short, no clue how I'll handle it tomorrow but hopefully my true self will shine through and that will be good enough.

I'm an introvert tho, so....crap
 
This would be my biggest obstacle to getting into med school; it would be pretty tough for me to take this seriously if someone is faking it.

Edit: Haha, bring a bag of candy with you and say, "Would you like a lollipop?"

When you have 6000 applications to boil down to 900 interviews (almost all of which go well), which must be cut down to (ultimately) 300 acceptances (for 150 matriculants), you have to do find something that DQs people with some level of legitimacy. Further, this IS an important innate ability. Teaching someone to have the right approach, attitude, etc. to comfort others is quite difficult and an unnecessarily loss of time. IMO, the community is far better off if their schools takes a 28/3.5 with excellent interpersonal skills (which is one of the primary things the MMI, and esp. this scenario type, measures) than they are if it attempts to train a 35/4.0 with weak interpersonal skills. The first will probably become an excellent doctor in 8-13 years. The latter... much more risky.

I am still not sure if forcing someone to comfort an actor is a fair measure of empathy. What are you really measuring in a situation where the candidate is under pressure to perform in a staged scenario?
 
Unless you're going to back this up with some sort of data, this is all a bunch of speculation. Does this station actually measure one's interpersonal skills? Does it measure something that is unteachable? Does success (or failure) in this interview actually reflect an applicant's performance during medical school or real patient interactions?

Sure we have to weed out thousands of applicants, but that's no reason to ignore obvious flaws in our selection methods. There's no reason a medical school cannot use other methods to select their applicants. Unless the threshold needed for success at this stage is rather low such that only exceptionally cold/stiff applicants will fail, it's very likely this could simply be capturing which students feel the most confident going into the interview, which students have the most experience in service/comforting situations (which is something that can be learned, it's not magic), or students that know about these various stages and have rehearsed ahead of time how to handle it.

Part of real interpersonal skills involves establishing trust and believability. I wouldn't be surprised if a lot of applicants that are actually very good in one on one situations with real patients finds the rehearsed scenario on which they are being watched awkward, unrealistic, forced, and thus hard to emotionally engage in. I'd want these doctors over the ones that have no real empathy or believability in actual situations but know the right stuff to say for a 5 minute interview stage because he/she practiced and rehearsed for all his/her interviews ahead of time. It's a nice idea, but there is no reason for us to assume this tactic is effective until proven otherwise.

+1. Good point. I wonder if there's any studies that demonstrate preferably through longitudinal studies that MMI produces better physicians. And since MMI has only been around for so long, I wonder what substantive evidence there is.
 
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