When people ask me what I do for a living, and I reply “I’m a general internist, and I teach bedside manner,” the response nearly always is a variation on how much it is needed, followed by a story of ineffective communication from a clinician to themselves or a family member. Patient-provider communication is an area of fundamental clinical competence that has become increasingly recognized as a critical component of medical education. Unfortunately, interviewing skills of medical students and residents decline throughout their training. The paucity of effective curricula to address this basic educational need has been cited as a cause for these disturbing national trends. My goal as a leader in medical education is to develop and refine teaching of patient-provider communication, to expand its importance by training other educators across the country, and to begin to link communication skills teaching with patient outcomes.
To further develop my own interviewing and teaching skills, in 2003 I completed a rigorous four-year training program with the Academy on Communication in Healthcare (ACH), an organization of nationally prominent educators and researchers in patient-physician communication. Now as a faculty member of the ACH, every year I teach participants from all health professions in the ACH ENRICH national faculty development course. I have also facilitated workshops on communication skills at prominent medical centers across the country, including the Mayo Clinic, Cleveland Clinic, Stanford University, and New York University, where I consistently garner top ratings from learners as an effective teacher and facilitator.
In developing the VALOR (VA Longitudinal Rotations) Program for UCSF third-year medical students, I have incorporated weekly sessions for third-year students on basic clinical skill-building, self-reflection on personal and professional development, and observations on hidden curricular issues. I am optimistic that these changes will enhance patient care and humanize the occasionally oppressive culture of medicine.
Finally, as Academy Chair for the Scholarship of Teaching and Learning at UCSF, my charge is to demonstrate how education can lead to patient outcomes. It is my conviction that by training physicians and students in effective communication skills, they can not only motivate patients to take charge of their health issues, but also create effective interdisciplinary teams to reduce medical errors.