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., Directorakumagai@umich.edu

Eric P. Skye, M.D., Assistant Directoreskye@umich.edu

Heather Wagenschutz, M.A., Program Administrator

hmwags@umich.edu 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.