UNIVERSITY OF MICHIGAN MEDICAL SCHOOL
33rdrd Annual Patient and Family-Centered Care Annual Patient and Family-Centered CareConferenceConference
University of Michigan Health SystemUniversity of Michigan Health SystemNovember 30, 2011November 30, 2011
The “15-Second Conversation”The “15-Second Conversation”The “15-Second Conversation”The “15-Second Conversation”
“What is empathy?”
If a central ingredient of patient- and family-If a central ingredient of patient- and family-centered care is empathic healthcare providers, centered care is empathic healthcare providers,
then we should ask:then we should ask:
UNIVERSITY OF MICHIGAN MEDICAL SCHOOL
Arno K. Kumagai, M.D., DirectorEric P. Skye, M.D. Assistant Director
The Family Centered ExperienceThe Family Centered ExperienceThe Family Centered ExperienceThe Family Centered Experience
N. Schon, The Dialogue, 1964
The foundation of the FCE: listening to the The foundation of the FCE: listening to the stories that patients tell.stories that patients tell.
The Family Centered ExperienceThe Family Centered ExperienceThe Family Centered ExperienceThe Family Centered Experience
SEPTEMBER OCT-NOV. JANUARY APRIL
Home Visit 1 Home Visit 2 Home Visit 3 The Clinic Visit
Home Visits with Volunteers
Illness: Impact on
Self & Family
Patients & Physicians
Views of Doctoring
Breaking Bad News
Home Visit 4 Home Visit 5 Home Visit 6
Stigma “Family’s Choice”
Lessons Learned
SEPTEMBER OCT-NOV. FEBRUARY
M1
M2
Discussion as ExplorationDiscussion as ExplorationDiscussion as ExplorationDiscussion as Exploration
E. Kyeyune The Conversation, 1963
Learners bring their own “cultural surround” (Kegan) to the interactions.
N. Schon, The Dialogue, 1964
What are the students learning?
A.K. Kumagai, P.T. Ross, and E.A. MurphyAdv Health Sci Edu 14:315-26, 2008
Diabetes Stories: Use of Illness Narratives to Teach Patient-Centered Diabetes Care
What are the students learning?What are the students learning?What are the students learning?What are the students learning?
Stories have emotional power:“I think that you can read about the disease and understand the cause of the disease, but you don’t really get the full effect about just finding out about [it] from the beginning…when you go to the hospital and figure out why you’re feeling the way you are and the shock of what to expect…
At home, when they talked about when she first found out she had diabetes and how she sat in bed and cried, you can’t get that from a book. You can’t get the full effect of what it’s like.”
-- Third-year Medical Student
What are the students learning?What are the students learning?What are the students learning?What are the students learning?
“More and more of medicine is becoming the chronic sorts of thing…and in that aspect I think the FCE changed that for all of us and made it more personal with the families.”
-- Second-year Medical Student, UMMS
The Dialogue, 1964
The FCE Interpretive ProjectThe FCE Interpretive ProjectThe FCE Interpretive ProjectThe FCE Interpretive Project
• During Winter Term of the M1 year.
• Students work in teams of 2-3 (representing 2-3 different volunteer families).
• Task: To develop a project that best represents the lived experience of illness from the patient’s perspective.
• Students are encouraged use any medium to express their understanding of this experience.
A Portrait of IllnessA Portrait of IllnessA Portrait of IllnessA Portrait of Illness
Sean KellySalma Noorulla
andKevin Mundy Cover Art
Academic Medicine May 2009
FCE Interpretive Project: “FCE Interpretive Project: “LullabyLullaby””FCE Interpretive Project: “FCE Interpretive Project: “LullabyLullaby””
Caitlin Collins, Ben Kaplan-Singer & Heiko Yang
Presented at the International Academy for Communications in Healthcare meeting, Miami, FL
October 2009
http://www.youtube.com/watch?v=Lbj129Cxwes
Family Centered Experience: GoalsFamily Centered Experience: GoalsFamily Centered Experience: GoalsFamily Centered Experience: Goals
Auguste Rodin Auguste Rodin Unfinished WorkUnfinished Work
Can one “Can one “learn”learn” empathy and compassion? empathy and compassion?
Arno K. Kumagai, M.D., [email protected]
Eric P. Skye, M.D., Assistant [email protected]
Heather Wagenschutz, M.A., Program Administrator
[email protected] Office tel 734 615-4886
Family Centered Experience Website: www.med.umich.edu/lrc/fce/
index.html
Selected ReferencesSelected ReferencesSelected ReferencesSelected References
• Kumagai AK, Murphy EA, Ross PT. Diabetes Stories: Use of illness narratives to foster patient-centered care. Advances in Health Sciences Education. 2008;14:315-326.
• Kumagai AK, White CB, Schigelone A. The Family Centered Experience: Using patient narratives, student reflections, and discussions to teach about illness and care. ABSAME Journal. 2005;11(2):73-78.
• Kumagai AK. A conceptual framework for use of illness narratives in medical education Academic Medicine. 2008;83(7):653-658.
• Kelly S, Noorulla S, Mundy K, Skye E, Perlman RL. Teaching and learning moments: Portrait of a Chronic Illness: artists' statement. Academic Medicine. Apr 2009;84(4):485.
• Li L, Carulli A, Nayak-Young S, Barnosky A, Kumagai AK. Artist' Statement: The Face of Illness. Academic Medicine. 2011;86(6):723.
• Abella IB, Vladescu I, Turgeon DK, Kumagai AK. Imagination, art, and learning: a web of support. Academic Medicine. Mar 2009;84(3):353.