Since the publication of the eye-opening revelations "To Err is Human" and "Quality Chasm" Patient Centered Care (PCC) has been promoted as an important concept which every medical student in 21st century ought to learn and internalize.
This slide set is based on recent articles published on PCC and how to effectively teach and learn in health sciences curricula. A recent doctoral research conducted by the author and his team, which has revealed robust evidence of 8-fold improvement in patient satisfaction after the postgraduates underwent intensive training of skills for effective PCC.
Patient Experience Defined. Patient experience encompasses the range of interactions that patients have with the health care system, including their care from health plans, and from doctors, nurses, and staff in hospitals, physician practices, and other health care facilities.
Patient Experience Defined. Patient experience encompasses the range of interactions that patients have with the health care system, including their care from health plans, and from doctors, nurses, and staff in hospitals, physician practices, and other health care facilities.
Medical Records: Intro, importance, characteristics & issuesSrishti Bhardwaj
Unit 1 of MHA SEM- III's syllabus of Medical records Management
(Bharati Vidyapeeth- Center for Health Management Studies & Research, Pune)
Self made- study purpose- reference presentation
avoid hyperlinks on certain slides- inactive
sources shared on last slide as REFERENCES
Hope it helps :)
Medical education is changing to meet the demands of our evolving health care system. One of these changes is the development and implementation of competency-based medical education (CBME).
Definition: Patient-Centered Care
Definition Patient-centered care (patient centred care): “Is a model in which providers partner with families to identify and satisfy the full range of patient needs and preferences.”
To expand this definition, patient-centered care is dependent on the involvement of the staff and care team as well.
“To succeed, a patient-centered approach must also address the staff experience as staff’s ability and inclination to effectively care for patients is unquestionably compromised if they do not feel care for themselves" (Picker Institute).
Researchers from Harvard Medical School, on behalf of Picker Institute and The Commonwealth Fund, defined seven primary dimensions of patient-centered care model.
These factors are identified as:
Respect for patients’ values, preferences and expressed needs
Coordination and integration of care
Information, communication and education
Physical comfort
Emotional support and alleviation of fear and anxiety
Involvement of family and friends
Transition and continuity
Care in hospital settings is all about the care which is provided in the hospital to the patient. The word patient comes from the Latin word patiens, originally meant “one who suffers”. Care in hospital is the attention or watchful oversight and attentive assistance or treatment for the increasing proportion of population and with the shift in disease patterns from acute illnesses to chronic...
Interoperability is one of the most critical issues facing the health care industry today. A universal exchange language is needed to assist health care providers in sharing health information in order to coordinate diagnosis and treatment, while maintaining privacy and security of personal data. Health Information Exchanges (HIE) allow for the movement of clinical data between disparate systems; they enable providers to electronically share health records through a network. This presentation provides an overview of HIE and the Meaningful Use requirement related to the exchange of clinical information as well as information about standards of exchange and the recommended "next steps" for providers.
The presentation describes in brief the patients need, expectations and how to develop the patient care and feedback system to obtain maximum patient satisfaction.
Patient-Centered Communication: A Useful Clinical ReviewZackary Berger
Patient-centered communication is important because of the 5 E's: ethics, emotions, efficiency, effectiveness, and equity. This talk was originally given October 1, 2014, at the Baltimore City Medical Society.
Satisfactions Among Admitted Patient of Tertiary Level Hospital in Dhaka City.DR. S A HAMIDI
I am Dr. Saleh Ahmed Hamidi, successfully Conducted a dissertation & also presented by me (08/01/2016) about patient satisfaction level in tertiary level hospital.
This is a simple presentation about Hospital Information System. The following are the contents.
1) What is Hospital Information System?
2) Problems associated with traditional paper based systems.
3) Purpose of Hospital Management System
4) Functions
5) How it works?
6) System Requirements
7) Advantages
This is my first upload, hope you like it.
Some slides are taken from different textbooks of medicine like Davidson, Kumar and Clark and Oxford, and some from other presentations made by respected tutors. I'm barely responsible for compilation of various resources per my interest. These resources are free for use, and I do not claim any copyright. Hoping knowledge remains free for all, forever.
Medical Records: Intro, importance, characteristics & issuesSrishti Bhardwaj
Unit 1 of MHA SEM- III's syllabus of Medical records Management
(Bharati Vidyapeeth- Center for Health Management Studies & Research, Pune)
Self made- study purpose- reference presentation
avoid hyperlinks on certain slides- inactive
sources shared on last slide as REFERENCES
Hope it helps :)
Medical education is changing to meet the demands of our evolving health care system. One of these changes is the development and implementation of competency-based medical education (CBME).
Definition: Patient-Centered Care
Definition Patient-centered care (patient centred care): “Is a model in which providers partner with families to identify and satisfy the full range of patient needs and preferences.”
To expand this definition, patient-centered care is dependent on the involvement of the staff and care team as well.
“To succeed, a patient-centered approach must also address the staff experience as staff’s ability and inclination to effectively care for patients is unquestionably compromised if they do not feel care for themselves" (Picker Institute).
Researchers from Harvard Medical School, on behalf of Picker Institute and The Commonwealth Fund, defined seven primary dimensions of patient-centered care model.
These factors are identified as:
Respect for patients’ values, preferences and expressed needs
Coordination and integration of care
Information, communication and education
Physical comfort
Emotional support and alleviation of fear and anxiety
Involvement of family and friends
Transition and continuity
Care in hospital settings is all about the care which is provided in the hospital to the patient. The word patient comes from the Latin word patiens, originally meant “one who suffers”. Care in hospital is the attention or watchful oversight and attentive assistance or treatment for the increasing proportion of population and with the shift in disease patterns from acute illnesses to chronic...
Interoperability is one of the most critical issues facing the health care industry today. A universal exchange language is needed to assist health care providers in sharing health information in order to coordinate diagnosis and treatment, while maintaining privacy and security of personal data. Health Information Exchanges (HIE) allow for the movement of clinical data between disparate systems; they enable providers to electronically share health records through a network. This presentation provides an overview of HIE and the Meaningful Use requirement related to the exchange of clinical information as well as information about standards of exchange and the recommended "next steps" for providers.
The presentation describes in brief the patients need, expectations and how to develop the patient care and feedback system to obtain maximum patient satisfaction.
Patient-Centered Communication: A Useful Clinical ReviewZackary Berger
Patient-centered communication is important because of the 5 E's: ethics, emotions, efficiency, effectiveness, and equity. This talk was originally given October 1, 2014, at the Baltimore City Medical Society.
Satisfactions Among Admitted Patient of Tertiary Level Hospital in Dhaka City.DR. S A HAMIDI
I am Dr. Saleh Ahmed Hamidi, successfully Conducted a dissertation & also presented by me (08/01/2016) about patient satisfaction level in tertiary level hospital.
This is a simple presentation about Hospital Information System. The following are the contents.
1) What is Hospital Information System?
2) Problems associated with traditional paper based systems.
3) Purpose of Hospital Management System
4) Functions
5) How it works?
6) System Requirements
7) Advantages
This is my first upload, hope you like it.
Some slides are taken from different textbooks of medicine like Davidson, Kumar and Clark and Oxford, and some from other presentations made by respected tutors. I'm barely responsible for compilation of various resources per my interest. These resources are free for use, and I do not claim any copyright. Hoping knowledge remains free for all, forever.
Patient Directed Care; Why it’s important and what does it really mean?Spectrum Health System
Understanding the importance of effective patient centered communication for patient engagement and improved health outcomes. Will discuss the importance of patient directed care and its relationship to the quadruple aim. Will discuss the barriers and a framework for conversations that are critical to patient directed care and cultural competency.
A Career in Nursing Essay example
Nursing Exemplar
What Is Nursing? Essay
The nursing process Essay
Public Health Nursing Essay
Essay on Nursing Care Plan
Krames Patient Education is the only choice for enterprise-wide patient education. In this presentation, practices will learn who Krames Patient Education is and What we can do for you.
We will review Patient-Centered Care and Patient Education; The Case for a Patient Education Investment, The Krames Differencet; Return on Investment; and Krames Solutions.
Creating an optimal healing environment through salutogenesis for yoga therapyK Raman Sethuraman
Optimal Healing Environment (OHE) is a post modern concept that aims to promote healing through positively influencing and supporting the four domains of OHE, viz, Personal, Interpersonal, Behavioral and External domains. Sense of coherence approach to wellbeing (Salutogenesis) fits in well with interpersonal and behavioral domains of OHE. Yoga therapy uses holistic approach to mind-body healing and can focus on promoting optimal healing as a complementary healthcare service to Evidence-based modern medicine in an integrative practice of holistic care.
In 21st Century, when medical information is freely available to everyone, soft skill-set combined with technical competence is the key to professional success as a clinical care provider. The various components of soft-skills viz, Professionalism Humanism, Communication skills are discussed. Research findings on how to enhance patient satisfaction 8-fold by improving communication skills is highlighted.
Using Sense of Coherence and 'ikigai' for holistic view of Humanity's respons...K Raman Sethuraman
Humanity's responses to the Covid-19 pandemic has been variable and often chaotic. This presentation attempts to use 'Sense of coherence' and 'Ikigai' as 2 lenses to gain a holistic perspective of the varied human responses to the pandemic crisis of 2020.
Comprehension or understanding, Manageability or coping-behavior, and Meaningfulness are the three components of Sense of Coherence (SOC), first proposed by Antonovsky. Ikigai is a Japanese concept of one's 'Purpose of Life', which has been modified by a life-coach from the West. Using SOC and Ikigai, we can try to get a holistic understanding of the varied responses of humanity across the globe.
Ikigai (reason for being) versus Maslow's Hierarchy of Needs K Raman Sethuraman
Ikigai is a Japanese word that signifies "sense of Purpose" in one's life. Ikigai fulfillment promotes wellness. Maslow's needs are hierarchically arranged from Basic needs to Psychological and Self-actualization needs. According to Maslow's theory, fulfillment of the "lower deficiency needs' can curb one's motivation, while fulfillment of "growth needs" would further increase the motivation to excel.
While E-health is based on networked I-C-T devices of the humans, operated by the humans for human healthcare and wellness, IOMT is a network of the ‘smart-devices’, operated by the devices for human healthcare and wellness. An estimated 160 million smart medical devices are expected to be connected in 2020. This number will increase exponentially. We need to be prepared for the disruptive influence of IOMT on the present-day healthcare paradigm. A major concern is the sheer magnitude of digital healthcare data generated by IOMT. Are we creating a "Digital Black hole" is a question for deep introspection.
In view of advances in artificial intelligence and global connectivity, tomorrow's doctors need to develop skills set that would help them to outperform the AI-gadgets and stay relevant in the 21st Century. Critical thinking, Creative Problem solving, Communication skills and Collaborative team-work are among the top skills needed for healthcare professionals of the future.
The estimated delay of 17 years for scientific discovery to reach clinical practice is a matter of great concern. The current flow-charts do not even acknowledge the important role of Effective Teaching of Basic sciences that is oriented to real-life clinical practice. This brief PPT set addresses this issue.
Salutogenic approach is based in promoting sense of coherence by making the person i) comprehend the situation or the challenge ii) find ways to manage it, using general and specific resistance resources and iii) find it meaningful to cope with the challenge and accept the outcome. Using real-life case narratives, this slide set explains how to practice salutogenic approach in patients with diabetes and its complications.
The essence of authentic assessment is to focus on real-life tasks and competencies relevant to later day professional practice. Since 2018, there is a national move in India to adopt Competency-based medical curriculum to produce IMG (Indian Medical Graduate) who would possess the competencies to be a competent clinician, an effective Communicator, a team-leader, an ethical Professional and a life-long learner. This slide-set looks at an authentic curriculum and how to develop an authentic assessment 'for', 'as' and 'of' learning.
Attitude, Ethics and Communication-skills for the Teacher and the TaughtK Raman Sethuraman
Imparting education to inculcate ethical values, professional attitude and effective inter-personal communication is much stressed in current curricula for Medical and other Health-professions. This talk stresses the need for the teachers to evolve themselves as positive role models if they wish to be effective in their mission to empower their students with values and professional identity.
Concepts and principles of bioethics for the students of health professionsK Raman Sethuraman
Students and many educators have difficulty in differentiating among Legal, Ethical and Moral viewpoints. After explaining these terms, the concept of biomedical ethics, a brief history of its origin in the post-War period and the components of ethics are explained. The final part is on Nursing ethics, attributes of an ethical nurse and ethical challenges faced by the nursing profession.
Novice medico to graduate doctor climbing the competency ladder K Raman Sethuraman
From the time of entry in to a medical college, over 4 to 6 years time, a novice medico is expected to acquire several competencies that go to make a competent doctor. The medical teachers need to construct the learning ladder as a progressive path to acquiring these competencies. This slide set explains the various "ladders" viz., Miller's Pyramid, Dreyfus competency stages and RIME framework and also Dunning-Kruger effect that explains why many novices do not acquire the competencies.
Authentic assessment of affective domain in medical educationK Raman Sethuraman
To be effective, Medical education needs to set up authentic methods for assessing and evaluating the affective domain, based on Bloom's taxonomy. This domain is the most difficult to assess. Checklists, Rating scales and Rubrics are useful tools, as explained in this slide-set.
Optimum assessment of cognitive domain in medical educationK Raman Sethuraman
To be effective, Medical education needs to set up authentic methods for assessing and evaluating all the domains of learning, based on Bloom's taxonomy. This slide-set is on cognitive domain.
This talk, delivered in the 4th international meet on Music Therapy at Sri Balaji Vidyapeeth, discusses the concept of Salutogenesis and highlights how a music therapist could help create an Optimal Healing Environment. Curing is not the same as Healing but they are complementary and both are perhaps essential for holistic wellness.
Innovations in Medical Education are needed to align it with 21st Century needs and aspirations. Globally efforts are under way since the release of Lancet Commission report in Dec-2010 on Transforming Health Professions in the 21st Century
Integrated teaching for effective learning in health professionsK Raman Sethuraman
Health professions education, being complex is ideally suited for integrated teaching-learning. This is a slide-set that will help you to conduct a 100-minute session set in a workshop mode. Suitable for Educators of Medicine, Dentistry, Nursing and allied health professions.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
Health Education on prevention of hypertensionRadhika kulvi
Hypertension is a chronic condition of concern due to its role in the causation of coronary heart diseases. Hypertension is a worldwide epidemic and important risk factor for coronary artery disease, stroke and renal diseases. Blood pressure is the force exerted by the blood against the walls of the blood vessels and is sufficient to maintain tissue perfusion during activity and rest. Hypertension is sustained elevation of BP. In adults, HTN exists when systolic blood pressure is equal to or greater than 140mmHg or diastolic BP is equal to or greater than 90mmHg. The
KEY Points of Leicester travel clinic In London doc.docxNX Healthcare
In order to protect visitors' safety and wellbeing, Travel Clinic Leicester offers a wide range of travel-related health treatments, including individualized counseling and vaccines. Our team of medical experts specializes in getting people ready for international travel, with a particular emphasis on vaccines and health consultations to prevent travel-related illnesses. We provide a range of travel-related services, such as health concerns unique to a trip, prevention of malaria, and travel-related medical supplies. Our clinic is dedicated to providing top-notch care, keeping abreast of the most recent recommendations for vaccinations and travel health precautions. The goal of Travel Clinic Leicester is to keep you safe and well-rested no matter what kind of travel you choose—business, pleasure, or adventure.
The global radiation oncology market size reached US$ 8.1 Billion in 2023. Looking forward, IMARC Group expects the market to reach US$ 14.5 Billion by 2032, exhibiting a growth rate (CAGR) of 6.5% during 2024-2032.
More Info:- https://www.imarcgroup.com/radiation-oncology-market
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
Letter to MREC - application to conduct studyAzreen Aj
Application to conduct study on research title 'Awareness and knowledge of oral cancer and precancer among dental outpatient in Klinik Pergigian Merlimau, Melaka'
LGBTQ+ Adults: Unique Opportunities and Inclusive Approaches to CareVITASAuthor
This webinar helps clinicians understand the unique healthcare needs of the LGBTQ+ community, primarily in relation to end-of-life care. Topics include social and cultural background and challenges, healthcare disparities, advanced care planning, and strategies for reaching the community and improving quality of care.
Teaching learning methods for patient centred care
1. Teaching-Learning Methods to Cultivate
Skills for Patient Centred Care (PCC)
An oration to be delivered on 22-07-2020 for the Dept
of Medical Education, JIPMER. India.
By Prof K.R. Sethuraman.
Dean of Medicine, AIMST University, Malaysia.
{ a JIPMERian for 40 years}
2. ‘‘Please Keep Quiet; I can’t hear you while I’m listening’’
(Baron, Annals Int Med, Oct-1985)
A typical way to interrupt a patient; preoccupation with disease & technology;
ignorance or disinterest in a patient’s concerns and patient’s agenda.
It leads to a decrease in patients’ trust and respect for medicine in general
Dr, my
main
problem
is…
By listening only to
his steth, he misses
vital clues to the
diagnosis!
4. My Agenda Today…
• To introduce the concept of Patient Centred Care (PCC) from the
viewpoints of various stakeholders
• To discuss PCC as a System at Macro, Meso and Micro levels
• To highlight the importance of Humanistic approach as the great
motivator that drives PCC
• To discuss the communication strategies, which help mediate and deliver
PCC
• To consider various options for teaching-learning of PCC
5. PART - I
Patient Centred Care:
Viewpoints of Various
Stakeholders
6. Patient (Person) Centred Care (PCC) – Admin Viewpoint
PCC: a client-centric approach that sees
the patients as –
• equal partners in
– the planning,
– development and
– delivery of care,
• and active participants in
– the management of
– their health and
– wellbeing
7. PCC is:
- Competence
- Commitment
- Compassion
- Communication
- Courage
- Care
Admin View from NHS, UK
8. PCC –
Professionals’
Perspective
Fix GM, et al. How healthcare
employees conceptualize patient-
centred care?.
Health Expect. 2018;21:300–307.
DOI -10.1111/hex.12615
9. Spectrum of Doctors (Views of a senior ICU Nurse)
WHICH ONE OF THE FOLLOWING DOCTOR WOULD YOU LIKE TO TREAT YOU in ICU?
"Some were pompous yet very debonair, some boisterous and happy.
• Some were overall friendly. Some were filled with snobbery!
• There were a variety of narcissists peppered in the group.
• Many were "Science nerds", competent but awkward in dealing with people.”
• “I haven't mentioned the perfect doctor yet: Dr. Franklin. He was truly a wonderful MD.
I never met a better person in ICU—kind, patient, and never rude.
Up to date on every necessary condition, very experienced and not outdated, he was
one of the last of a dying breed.
He had the best bedside manner of any doctor who ever practiced at our hospital.
It was his practice to wheel his heart attack patients himself directly to the ICU bed.
He would tuck the patient into bed, all the while comforting the worried patient and
family.”
Angels on the Wall (witnessing it all): A Healthcare Worker's Witness of Life in an Intensive Care Unit during the 1980s - by Betsy McMillan. 2020. Page
Publishing Inc. USA. ( https://books.google.com.my/books?id=W3LpDwAAQBAJ )
11. PCC: Patients’ Expectations
Reasonable (in Doctor’s view):
• the need to be listened to
• the need to receive clear
explanation and instructions
about their condition
• to be treated by staff who show
care/concern/compassion
• to be treated by staff who are
competent and patient-centred
professionals
Unreasonable (in Doctor’s View)
• prescription to be given without
a consultation
• ability to call the physician
anytime of the day for any
problems
• the physician should know the
exact diagnosis at first
consultation and start treatment
immediately
Lateef F. Patient expectations and the paradigm shift of care in emergency medicine. J Emerg Trauma Shock. 2011 Apr-Jun; 4(2): 163–167.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3132352/
12. Part 1-a. PCC as a System*
* a set of inter-connected and inter-dependent parts
working together to form a functioning whole, which
serves a common goal.
13. Ref: Santana et al. How to practice person-centred care: A conceptual framework.
Health Expectations. 2018;21:429–440. DOI: 10.1111/hex.12640
14. PCC: Enablers of the System
Int. J. Environ. Res. Public Health 2020, 17, 3050; doi:10.3390/ijerph17093050
&
15. PCC: Learning Needs Mapped by Students
Rosewilliam et al. Patient-centred orientation of students...BMC Medical Education (2019) 19:347. https://doi.org/10.1186/s12909-019-1787-4
16. PART – II
The Relevance of
Humanism and Communication Skills
to Compassionate PCC
17. Dr Francis Weld Peabody
- a Harvard Physician
(1881–1927)
“-- the secret of the care of
the patient is in caring for
the patient.”
The Patient and the Man (1922, 1922)
The Care of the Patient (JAMA 1927; 88:877-882)
19. Humanism vs. Professionalism
• Professionalism (Behavior)
– Behaving in accordance to a set of norms and
expectations
• Humanism (Values)
–deep-seated conviction about one’s obligations towards
others
(A Senior Surgeon’s insight into “situational power” and Humanism during Mumbai Riots
of 1992-’93**)
** https://books.google.com.my/books?id=XGOcBgAAQBAJ&pg=PA68&lpg=PA68&dq=situation+gives+power+sethuraman+in+trick+or+treat
20. Ability in a Crisis Situation Gives the Power to Help: a Story…
** https://books.google.com.my/books?id=XGOcBgAAQBAJ&pg=PA68&lpg=PA68&dq=situation+gives+power+sethuraman+in+trick+or+treat
21. Humanism versus Professionalism
Humanism
• Is Who you are
• Drives authentic
professional behaviors
• Harder to undermine
– when under duress
– when no one is
watching
Professionalism
• Is What you do
• Competent but without
humanistic qualities
– eg, “Robotic
professionals”
• Can be undermined
– when under duress
– when no one is
watching
22. An Example: a patient of CML during 1971-’73 at JIPMER
A young man, who was
“Too poor to kill himself”
A 25-year-old man, who had general weakness
and lassitude lost his job, his wife, who left him
lamented thus when he did not have the money
to buy rat-killer poison to consume: “I am so
unlucky, I can’t even kill myself!” He walked 20
km to JIPMER and fainted at the medical records
section…
He was admitted in Medical ward and later
diagnosed as Chronic Myeloid Leukemia…
23. Professionalism – – – – – – Humanism
Treating the man for
chronic myeloid
leukaemia until he
passed away was
professionalism
Giving emotional support
Getting him a job in the
hostel mess to give him
food and shelter was
Humanism at its best
24. Attitudes and Habits of Highly Humanistic Surgical
and Internal Medicine Faculty Staff
Swendiman RA et al. Attitudes and Habits of Highly Humanistic Surgeons. Acad Med. 2019;94:1027–1032.
25. Ethical sensitivity leads to Humanism
Rule of reciprocity:
➢ Do unto others as you
would have them do
unto you
➢ Reflects “concern for
others”
27. An Example of Unfocussed Communication…
Are you married?
No
How many children?
#*%(angry mutter)
Do you have kids
Yes, I do.
Are you Married?
You libelous fool…
Hey! Don’t worry.
Ask your questions the
other way around.
28. Routine Communication, out of context, can land one in trouble!
Do you have kids?
Yes, I do.
Are you Married?
You libelous fool…
29. IDEALISTIC YEAR-1
EXPERIENCED
COMMUNICATOR
Why Senior Medicos seem to Lose Rapport-building Skills?
• An hourglass is a metaphor of students' progression
of communication strategies, wherein the narrow
part of the hourglass corresponds to an instrumental
strategy during the final year & internship.
• The 'instrumental strategy' adopted by the senior
students is based on 'one-sided collection of mere
medical facts' and on 'avoiding rapport-building as a
waste of precious time'.
Wahlqvist M, ET AL. Instrumental Strategy: A Stage in Students' Consultation Skills Training? Scand J
Prim Health Care. . 2005 Sep;23(3):164-70. doi: 10.1080/02813430510018646
30. Do Communication Skills Need Formal Training in Medicine?
• Initiating the session
• Rapport: intermittent positive social reinforcement
• Rapport: sensitive and responsive to patient’s concerns
• Rapport: encourages questions at the end of interview
• Questioning skills: starts with open ended questions
• Questioning skills: summarizes data
• Smooth Transition: Makes transitional statements
• Timeline: interview follows progression of history
• Organization: elicits details for orderly documentation
• Documentation of data: has specificity and is verifiable
Aspegren K & Lønberg-Madsen P. Which basic communication skills in medicine...need to be taught? Medical Teacher, Vol. 27, No. 6, 2005, pp. 539–43
In these skills,
the senior
Registrars with
10-years of
clinical
experience
were no better
than 3rd year
Medicos!
31. Key Communication Skills in Medical Curricula for PCC
Silverman J, Kurtz S, Draper J. Skills for communicating with patients. Oxon: Radcliffe Medical Press, 1998.
32. Eliciting Patient’s Narrative –
Empathic communication with Scientific approach
Naldemirci Ö, et al. The potential and pitfalls of narrative elicitation in person centred care. Health Expect. 2020;23:238–246. https ://doi.org/10.1111/hex.12998
33. Levinson W, et al. Developing Physician Communication Skills For PCC. Health Affairs; 2010; 29: 1310-8
34. T-L Strategies to Foster Holistic Approach,
Communication Skills and
Attitude to Compassionate PCC
35. But where is person-centred care in the (medical) curriculum?
36. MCI’s Vision of IMG, who can deliver PCC
Communicator:
• communicate adequately, sensitively, effectively and respectfully with
patients in a language that the patient understands
• establish professional relationships with patients that are positive,
understanding, humane, ethical, empathetic, and trustworthy.
37. Start yr-1 with “Somato-Psycho-Socio-Semiotic” Concept of Holistic Health
*
* Semiotic = Making sense of the illness, e.g., “WHY ME? WHY NOW?”
41. T – L of Doctor-Patient Communication –
a hierarchy based on the difficulty level of the tasks
• Skills in interviewing and giving information—the first steps—are pre-
requisites for mastering the higher order tasks:
1. Structured interview, e.g. taking a history
2. Elicit Information, e.g. about results of tests, change of medication
3. Counselling, e.g. about reduction of weight, cessation of smoking
4. Complete first consultation
5. Breaking bad news, e.g. information about cancer, HIV infection, etc.
6. Handling difficult situations, e.g. aggressive patient
7. Existential conversation, e.g. about imminent death
Aspegren K & Lønberg-Madsen P. Which basic communication skills in medicine...need to be
taught and trained? Medical Teacher, Vol. 27, No. 6, 2005, pp. 539–543
42. T-L of Communication Skills as Per Miller’s Stages
M. Deveugele et al. Teaching communication skills to medical students, a challenge in the curriculum .
Patient Education and Counseling 58 (2005) 265–270
43. Various Options for T-L of Communication Skills
Lo and Hsieh / Tzu Chi Medical Journal 2020; 32(1): 19-25
44. Five phases and Two Conditions (Space & Safety)
in the Learning Process of Communication Skills –
Used in the Doctoral Research guided by me & done in IGIDS, SBV, Puducherry on
“The Effect of Communication Skills Training to the PGs in Prosthodontics on
Satisfaction of Edentulous Patients for Complete Denture Treatment.”*
Source: van den Eertwegh V, et al. Exploring Residents’ Communication Learning Process in the Workplace: A Five-Phase
Model. PLoS ONE 10(5): e0125958. doi:10.1371/journal.pone.0125958
* Varsha Murthy’s Doctoral work: The Effect of Communication Skills Training to the PGs in Prosthodontics on
Satisfaction of Edentulous Patients for Complete Denture Treatment. PhD Awarded in Jan 2020 by SBV.
48. Queries to ask about an
individual patient who has
this health problem
Current Scientific
knowledge about this
health problem
Humanistic
approach
Scientific
approach
Scientific +
Humanistic PCC
Take Home Message: Combining Scientific & Humanistic Medicine