Teaching personal awareness

Department of General Internal Medicine, College of Human Medicine, Michigan State University, East Lansing, MI 48824, USA.
Journal of General Internal Medicine (Impact Factor: 3.42). 03/2005; 20(2):201-7. DOI: 10.1111/j.1525-1497.2005.40212.x
Source: PubMed


Educators rarely consider the attitudes that determine whether a learner will use the clinical skills we teach. Nevertheless, many learners and practitioners exhibit negative attitudes that can impede the use of patient-centered skills, leading to an isolated focus upon disease and impairing the provider-patient relationship. The problem is compounded because these attitudes often are incompletely recognized by learners and therefore are difficult to change without help. We present a research-based method for teaching personal awareness of unrecognized and often harmful attitudes. We propose that primary care clinicians without mental health training can follow this method to teach students, residents, faculty, and practitioners. Such teachers/mentors need to possess an abiding interest in the personal dimension, patience with a slowly evolving process of awareness, and the ability to establish strong, ongoing relationships with learners. Personal awareness teaching may occur during instruction in basic interviewing skills but works best if systematically incorporated throughout training.

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    • "This is consistent with the above theoretical perspectives [12] [27] and addresses the learner's emotions and ability to self-reflect. These are the key determinants of whether learners will actually use patientcentered skills to address psychosocial and mental health problems [25] [28] [29]. Additionally, only this personal work can produce the motivation, state of mind, and professional identity needed for becoming a more broadly based physician [12] [27]. "
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    ABSTRACT: Many express concern that modern medicine fails to provide adequate psychosocial and mental health care. Our educational system has not trained the primary care providers who care for most of these patients. Our objective here is to propose a quantum change: prepare residents and students during all years of training so that they are as effective in treating psychosocial and mental health issues as they are medical problems. We operationalize this objective, following Kern, by developing an intensive 3-year curriculum in psychosocial and mental health care for medical residents based on models with a strong evidence-base. We report an intensive curriculum that can guide others with similar training interests and also initiate the conversation about how best to prepare residency graduates to provide effective mental health and psychosocial care. Identifying specific curricula informs education policy-makers of the specific requirements they will need to meet if psychosocial and mental health training are to improve. Training residents in mental health will lead to improved care for this very prevalent primary care population.
    Patient Education and Counseling 09/2013; 94(1). DOI:10.1016/j.pec.2013.09.010 · 2.20 Impact Factor
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    • "Essential in developing skills, we focused on attitude development in three areas: (1) using learner-centered approaches to foster life-long learning and collaborative agenda setting [29–32]; (2) enhancing learner–teacher relationships using the same interactional skills with trainees that we were teaching them to use with patients; e.g., NURS; (3) focusing on personal awareness of one's own emotions in a group setting [33]. As basic PCC skills were mastered, more time was spent on personal awareness, frequently addressing emotional issues that can interfere with successful team work; e.g., feeling humiliated or afraid of failure [15]. "
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    ABSTRACT: To train medical residents and nurses to work together as a patient-centered care (PCC) team on a medical ward and test its feasibility, nurses' learning, and patient outcomes. Working with administrative leadership, we consolidated residents' patients on one 32-bed ward. Already training residents in an evidence-based patient-centered method, we now trained 5 nurse leaders similarly, and they then trained all staff nurses. A national consultant visited twice. Specific team-building activities for nurses and residents fostered ward interactions. We used a retrospective pre/post/6-month post-design to evaluate nurses' knowledge and self-efficacy of patient-centered skills. Patients were assigned non-randomly to our unit or comparison units from our emergency room; using a post-test only design, the primary endpoint was patient satisfaction. 28 trained nurses showed improvement in knowledge (p=0.02) and self-efficacy (p=0.001). 81 treatment patients showed no improvement in satisfaction (p=0.44). Training nurses in patient-centered practices were effective. Unique in this country, we also trained nurses and residents together as a PCC team on a medical ward and showed it was feasible and well accepted. We provide a template for team training and urge that others explore this important new area and contribute to its further development.
    Patient Education and Counseling 07/2011; 84(1):90-7. DOI:10.1016/j.pec.2010.05.018 · 2.20 Impact Factor
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    • "Many educators teach self-awareness to achieve attitudinal objectives within the context of communication skills training. The educator helps participants to reflect on their thoughts and emotions directly after interactions, and to consider the origins of their thoughts, feelings and attitudes to deepen personal awareness (Smith et al, 2005). "
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    ABSTRACT: Healthcare professionals and organizations, policy makers, and the public are calling for safe and effective care that is centered on patients' needs, values, and preferences. The goals of interprofessional shared decision making and decision support are to help patients and professionals agree on choices that are effective, health promoting, realistic, and consonant with patients' and professionals' values and preferences. This requires collaboration among professionals and with patients and their family caregivers. Continuing professional development is urgently needed to help healthcare professionals acquire the knowledge, skills, and attitudes necessary to create and sustain a culture of collaboration. We describe a model that can be used to design, implement, and evaluate continuing education curricula in interprofessional shared decision making and decision support. This model aligns curricular goals, objectives, educational strategies, and evaluation instruments and strategies with desired learning and organizational outcomes. Educational leaders and researchers can institutionalize such curricula by linking them with quality improvement and patient safety initiatives.
    Journal of Interprofessional Care 06/2011; 25(6):401-8. DOI:10.3109/13561820.2011.583563 · 1.40 Impact Factor
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