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Difficult Conversations in Healthcare: Teaching and Practice


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Difficult Conversations in Healthcare: Teaching and Practice

  1. 1. in Healthcare: Teaching and Practice March 8, 2014 | May 17, 2014 | June 7, 2014 Boston Children’s Hospital | Waltham, MA USA Course Director Elizabeth Rider, MSW, MD Presented by re by
  2. 2. Course Description Difficult Conversations in Healthcare: Teaching and Practice is a 1-day faculty development course that offers the opportunity to learn about innovative philosophies and pedagogical approaches for teaching and enhancing relational capacities, communication skills, and professionalism in phsicians, social workers, nurses, and other health care professionals who work in a variety of academic and clinical healthcare settings. Evidence-based studies show that effective communication with patients is associated with improved healthcare outcomes, better quality of care, both patient and physician satisfaction, and reduced medical error and malpractice claims. Interpersonal and communication problems in healthcare are common, and the over 70% of malpractice depositions arise from communication errors. Studies also show that clinicians feel unprepared and lack confidence in communication skills, particularly advanced skills such as the ability to discuss end-of-life issues, giving bad news, dealing with the 'difficult' patient, and understanding the patients' and family’s perspectives. Medical schools, academic medical centers and other institutions are working to develop educational leaders and faculty who can teach and assess the core ACGME competencies, including interpersonal and communication skills and professionalism, that this faculty development course addresses. The program provides the most wonderful experience for implementing “difficult communication” teaching... The participants from different countries (Sweden, Lebanon, Taiwan and U.S.) provided different points of view and responses from their cultural perspectives for the same case scenario. All these impacted me greatly. International Participant
  3. 3. Course Description The course is designed for physicians in all specialties, medical education leaders, and multidisciplinary healthcare professionals interested and/or involved in teaching in the areas of interpersonal and communication skills, professionalism, relationship-centered care, patient-practitioner relationships and related topics. Course participants will learn about an innovative, collaborative relational learning model, known as the Program to Enhance Relational and Communication Skills (PERCS), which was developed by the Institute for Professionalism & Ethical Practice (IPEP) at Boston Children’s Hospital, for teaching and enhancing communication skills and relational capacities. We will create a safe environment for relational learning, use realistic enactments with professional actors, and integrate patient and family perspectives in innovative ways. Participants will experience and learn about a variety of educational strategies and pedagogy including: • The PERCS model of realistic enactments with professional actors, collaborative learning, and reflection and feedback. • Use of narratives • Videotape and discussion • Interactive didactic presentation • Appreciative inquiry • Small group team-based learning • Large group discussion • Facilitated reflections We will pause at several junctures, ask participants to step back from the learning process, and reflect together on our experience as learners and as medical educators. We will discuss the central pedagogic principles, outline their ethical and conceptual rationale, and consider how participants might usefully integrate the pedagogy (i.e., the method and practice of teaching) into educational endeavors in their home institutions. This course provides teaching and learning strategies for the interpersonal and communication skills and professionalism competencies required by many regulatory organizations including the ACGME and LCME (USA), CACMS, RCPSC, CanMEDS (Canada), General Medical Council (UK), Institute for International Medical Education, and others. This course is also offered as a pre-course for the Harvard Macy Institute’s Program for Educators in Health Professions and the Program for Leading Innovations in Health Care & Ediucation. This was wonderful and such a unique learning experience! Past Participant
  4. 4. Faculty David Browning, MSW, BCD Senior Scholar Emeritus, Institute for Professionalism & Ethical Practice, Boston Children’s Hospital Department of Social Services, Massachusetts General Hospital Cancer Center Meg Comeau, MHA Family Faculty, Institute for Professionalism and Ethical Practice, Boston Children’s Hospital Co-Principal Investigator The Catalyst Center: Improving Financing of Care for Children and Youth with Special Health Care Needs Health and Disability Working Group Boston University School of Public Health Elaine Meyer, PhD, RN Director, Institute for Professionalism & Ethical Practice, Boston Children’s Hospital Director, Program to Enhance Relational and Communication Skills (PERCS), Boston Children’s Hospital Associate Professor of Psychology, Department of Psychiatry, Harvard Medical School Elizabeth Rider, MSW, MD (Course Director) Director of Academic Programs, Director, Faculty Education Fellowship in Medical Humanism & Professionalism Institute for Professionalism and Ethical Practice, Boston Children’s Hospital Director of Programs for Communication Skills, John D. Stoeckle Center for Primary Care Innovation, Massachusetts General Hospital Assistant Professor of Pediatrics, Harvard Medical School Co-Chair, Medicine Academy, National Academies of Practice Co-Author, A Practical Guide to Teaching and Assessing the ACGME Core Competencies Robert Truog, MD Professor of Medical Ethics & Anesthesia (Pediatrics), Harvard Medical School Executive Director, Institute for Professionalism and Ethical Practice, Boston Children’s Hospital Director of Clinical Ethics, Division of Medical Ethics, Department of Global Health and Social Medicine, Harvard Medical School Chair, Embryonic Stem Cell Research Oversight Committee, Harvard University Senior Associate in Critical Care Medicine, Boston Children’s Hospital Pamela Varrin, PhD Family Faculty, Institute for Professionalism & Ethical Practice, Boston Children’s Hospital Coordinator of Family Support Services, Cotting School The most helpful aspects of the training were the multidisciplinary perspectives and rich dialogue. I learned from all participants. Past Participant
  5. 5. Teaching and Practice 9:30 – 9:45 Welcome 9:45 –10:25 Introduction - Elizabeth Rider, MSW, MD* Background and History - Robert Truog, MD* Objectives: Relational Learning, Reflection and Action - Elizabeth Rider, MSW, MD* 10:25–11:00 “Speaking the Same Language” Videotape and Discussion – Margaret Comeau, MHA*/ Pamela Varrin, PhD* 11:00 –11:20 Pedagogy: What We Have Learned – David Browning, MSW, BCD* / Elizabeth Rider, MSW, MD* / Elaine Meyer, PhD, RN* 11:20 –11:30 BREAK 11:30 –12:30 Values: The Foundation of our Work – Elizabeth Rider, MSW, MD* Sharing Our Experience: Narrative and Reflection 12:30 –1:00 LUNCH AND DISCUSSION – Faculty 1:00 – 2:00 Difficult Conversation I – David Browning, MSW, BCD*/ Elaine Meyer, PhD, RN* / Pamela Varrin, PhD* Debriefing & Feedback 2:00 – 2:50 Difficult Conversation II – David Browning, MSW, BCD*/ Elaine Meyer, PhD, RN*/ Pamela Varrin, PhD* Debriefing & Feedback 2:50 – 3:00 BREAK 3:00 – 3:20 Introduction to Appreciative Inquiry – Elizabeth Rider, MSW, MD* 3:20 – 4:30 Next Steps: Strategies for Implementation – Elizabeth Rider, MSW, MD* 4:30 – 5:00 Reflections and Take Home Lessons – Faculty Program changes/substitution may be made without notice
  6. 6. Learning Objectives Upon completion of this course, participants will be able to: • Identify educational strategies and facilitation skills in order to teach about communication, professionalism and relationships in health care • Discuss the philosophy and components of relational learning as practiced in the Institute for Professionalism and Ethical Practice’s (IPEP) Program to Enhance Relational and Communication Skills (PERCS) • Develop strategies to promote and implement relationship-centered teaching and learning within one’s home institution Target Audience The course is a faculty development course designed for multidisciplinary healthcare professionals (physicians in all specialties, social workers, nurses, medical educators and others) interested in and/or involved in teaching in the areas of interpersonal and communication skills, professionalism, relationship-centered care, patient-practitioner relationships and related topics. The course is open to local, national and international participants. Course attendees have come from across the US and around the world (28 states and 13 countries including Australia, Bahamas, Brazil, Canada, Japan, Lebanon, Qatar, Saudi Arabia, Sweden, Taiwan, New Zealand, the Netherlands, and the US), as well as regionally and locally. Accreditation The Harvard Medical School is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Physicians: The Harvard Medical School designates this live activity for a maximum of 6.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Social Workers: This program has been approved for 6.5 Continuing Education hours for relicensure, in accordance with 258 CMR 31.00. Collaborative of NASW-MA and the Boston College and Simmons College Schools of Social Work. Nurses: Nursing Staff Development of Boston Children’s Hospital #PA93 is an approved provider of continuingnursing education by the Massachusetts Association of Registered Nurses, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. 6.4 contact hours have been accepted for this course as it meets the definition of continuing nursing education and meets the criteria set by the American Nurses Credentialing Center’s Commission on Accreditation. Psychologists: The Division of Psychology, Department of Psychiatry at Boston Children’s Hospital is approved by the American Psychological Association to sponsor continuing education for psychologists. The Division of Psychology, Department of Psychiatry at Boston Children’s Hospital maintains responsibility for this program and its content. This program offers 6 continuing education credits. The Royal College of Physicians and Surgeons of Canada recognizes conferences and workshops held outside of Canada that are developed by a university, academy, hospital, specialty society or college as accredited group learning activities. AMA PRA Category 1 Credits™ claimed by physicians attending live events certified and organized in the United States for AMA PRA Category 1 Credits™ can be claimed through the agreement on mutual recognition of credits between UEMS and AMA, considered as being equal to the European Continuous Medical Education Credits (ECMEC©) granted by the UEMS. One AMA PRA Category 1 Credits™ is equivalent to one (1) hour of European EACCME Credit (ECMEC©), therefore up to 6.75 ECMEC© Credits are available. Each medical specialist should claim only those hours of credit that he/she actually spent in the educational activity.
  7. 7. ACGME Competencies This course is designed to meet the following Accreditation Council of Graduate Medical Education (ACGME) competencies: • Patient care • Interpersonal and communication skills • Professionalism Registration Information Tuition Fee: $495 (USD). Reduced Fee for Allied Health Professionals and nonphysician medical educators: $435 (USD) Registration by credit card (VISA or MasterCard) can be made at: Registration by check (draft on a United States bank), please make payable to Harvard Medical School and mail with registration form to Harvard Medical School—Department of Continuing Education, PO Box 417476, Boston, MA 02241-7476. Telephone or fax registration is not accepted. Registration with cash payment is not permitted. Upon receipt of your paid registration an email confirmation from the HMS-DCE office will be sent to you. Be sure to include an email address that you check frequently. Your email address is used for critical information including: registration confirmation, evaluation and certificate. Disclosure Policy Harvard Medical School (HMS) adheres to all ACCME Essential Areas, Standards and Policies. It is HMS’s policy that those who have influenced the content of a CME activity (e.g. planners, faculty, authors, reviewers and others) disclose all relevant financial relationships with commercial entities so that HMS may identify and resolve any conflicts of interest prior to the activity. These disclosures will be provided in the activity materials along with disclosure of any commercial support received for the activity. Additionally, faculty members have been instructed to disclose any limitations of data and unlabeled or investigational uses of products during their presentations. Refund Policy A handling fee of $60 is deducted for cancellation. Refund requests must be received by postal mail, email or fax one week prior to this activity. No refunds will be made thereafter. Inquiries By phone 617-384-8600, Monday through Friday, 10 a.m. to 4 p.m. (EST) or by email at: Course Location All sessions for this activity will be held in the Conference Center at Boston Children’s Hospital at Waltham, 9 Hope Avenue, Waltham, MA 02453. Accommodations/Travel Please do not purchase non-refundable airline ticket(s) until you have received an email from our office confirming your paid registration. For airline reservations contact the HMS Travel Desk toll free 1-877-4-HARVMD (1-877-442-7863) Monday - Friday 9 AM - 8 PM (EST). From outside the U.S., Canada and Virgin Islands, please call 617-559-3764. For Inquiries about the Course Itself Contact Allyson McCrary, Course Coordinator, by e-mail: or phone: (617) 355-5021.
  8. 8. REGISTRATION FORM Teaching and Practice Please select a date March 8, 2014 - Course #3424265 May 17, 2014 - Course #3424266 June 7, 2014 - Course #3424497 Register Early! Due to the highly interactive nature of this course, enrollment is limited. We encourage you to register now. Enrollment limited to 25. Registration Fee Physicians: Tuition $495 (USD) All other health professionals and nonphysician medical educators $435 (USD) Please print clearly. All fields required. Full Name ______________________________________________________________________ First Middle Initial Last Mailing Address _________________________________________________________________ Street ________________________________________________________________________________ City State Zip Code Daytime Phone (____)_____________________Fax Number (_____)_____________________ Please note: Your email address is used for critical information about the course, including registration confirmation, course evaluation and certificate. Please be sure to include an email address you check daily or frequently. Email Address___________________________________________________________________ Please check if you wish to be excluded from receiving email notices of future Harvard Medical School - Department of Continuing Education Programs Professional school attended ________________________ Degree______________________ Primary Specialty (Physicians only) ____________________ Board Certified: Yes No Professional School Attended (Physicians only) Harvard Medical School U.S. Medical School International Year of Graduation _______________________________________________________________ Online registrants—add the first three characters of the source code found here: Source Code: 1EM