Todd M. Poret, MD, Patricia L. Lanter, MD, Adam R. Weinstein, MD, Toni Lamonica, MSW, Alison D. Ricker, BA, Dartmouth Medical School, Lebanon, NH
Background: Family-centered care (FCC) helps optimize healthcare outcomes. Many medical schools report teaching FCC through required activities outside of the clinical setting. FCC is also modeled to medical students during bedside rounds. However, there is a paucity of literature on curricular models to explicitly teach family-centered communication skills to medical students in clinical encounters. Objectives: To create and implement a curriculum in FCC utilizing students’ clinical experiences on their pediatric rotation. Methods: A committee of “family faculty” of parents of children with special health care needs was convened. The family faculty developed four FCC questions for students to use when talking to patients and their families, using student and family feedback to modify them over time. Students were introduced to the concept of FCC during clerkship orientation and then employed the four questions during clinical encounters. They wrote reflections documenting the encounter, answers to the questions, and what they learned from the experience. Students attended a wrap-up session with the family faculty in which they discussed their reflections and had the opportunity to ask the family faculty candid questions about their experiences in healthcare. Results: We will show representative examples of student reflections and qualitative comments from learners on the educational value of the program. We will summarize comments to demonstrate elements that facilitated or impaired the educational process. Discussion: Many students reported that asking the four questions yielded additional information that was beneficial not only to their understanding of the patient/family context, but often also to the medical problem at hand. They had increased satisfaction with the patient encounter and, in some cases, perceived an improvement in patient care. Students appreciated the opportunity to ask sensitive questions to family faculty. Our results suggest that this process improved the quality of our clerkship and that giving students a specific tool to facilitate family-centered communication skills may improve education in FCC. Future study could examine patient/family perceptions of encounter with students before and after the intervention as well as carry-over of this experience into future clinical rotations.