During orientation at Fort Worth’s new medical school, no one was talking science just yet. Instead the inaugural class of 60 students dissected a poem on first-generation Americans.
Ivette Mota Avila said the words made her think of her own parents who moved from Mexico to Chicago — her dad a carpenter, her mother a school janitor.
“My friends would ask if I was embarrassed that my mom was cleaning my school,” Avila said, her voice trembling. “Why? My parents did this for me … so I could dare to dream to be a doctor.”
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The 28-year-old didn’t expect to share something so personal with her classmates.
But then, that was the point. Developing “empathetic scholars” is the central focus of the new School of Medicine, a collaboration by Texas Christian University and the University of North Texas Health Science Center.
And for the students, that starts with learning to empathize with each other, Avila said.
“I’m doing this to be my patient’s doctor,” she said. “I will need to learn from them and the only way I can be able to do that is to learn from the 60 of us first.”
Officials designed the new school with “compassionate practice” at its core so that future physicians learn how to effectively communicate with their patients to provide better health care.
Sure, patients expect their doctors to be well-trained in science and medicine after years of rigorous schooling. But more and more say they aren’t feeling heard. And their health can suffer when doctors don’t take time to truly understand what’s happening, medical school officials said.
A 2018 study found that, on average, doctors interrupted patients after only 11 seconds as they shared the reason for their visits. And when they did, physicians generally asked only yes or no questions that did little to allow patients to explain. Research suggests it takes 90 seconds for a patient to feel heard.
So TCU and UNTHSC officials have developed a school that — along with teaching medicine, encouraging research and demonstrating patient care — incorporates building communication skills and improving the doctor-patient relationship.
For example, when courses start next week, they will be flipped so that students view instructional videos and read lessons at home instead of sitting through lectures so that class time will be used for in-depth discussions.
When students do clinical rotations, they won’t be placed in various hospital settings for a few weeks at a time but instead in private practices and clinics for months on end, so they can see the same patients regularly.
The school even has an assistant dean dedicated to “narrative reflection” and patient communication, Dr. Evonne Kaplan-Liss.
The journalist-turned-doctor-turned-educator was a chronic patient herself — having 21 surgeries over the years related to ulcerative colitis. She said she was frustrated by how often miscommunication impacted her health and sometimes led to mistakes.
That’s what drove her to combine her experience in communications with medicine so she could teach other doctors, scientists and researchers better ways to work with patients.
She eventually become the founding medical program director at the Alan Alda Center for Communicating Science where she conducted training around the world. Alda is an actor known for his iconic role as a witty but caring surgeon on the television show M*A*S*H. and for being the longtime host of Scientific American Frontiers.
“Compassion is not a part of medicine today for a multitude of reasons: either physicians don’t know they have the permission to, don’t know how to or don’t think they have the time because the system doesn’t allow for it,” Kaplan-Liss said. “We’re changing that paradigm. We’re teaching how to do this.”
During this week’s orientation, the students began their work toward being empathetic scholars.
Some of the activities were silly on the surface — a counting game that required a big “ta-da” pose whenever they made a mistake provided a chance to laugh together. Others were designed to mirror the frustration patients often feel by cutting off students as they shared personal stories about what has upset them lately.
In one exercise, they had to write the story of their name.
Brandon Mallory, 24, hadn’t thought much about it. Then he recalled how his parents, who spent much of their careers in the Air Force, would say they wanted him to do whatever made him happy and to build a name his own children could be proud of one day.
Each person in his small group shared quick personal stories from working with grandparents to life with a hyphenated name. Mallory said he appreciated how such a simple prompt quickly built an understanding among them. It’s that focus on compassion that made him choose Fort Worth’s medical school, he said.
Mallory worked in an emergency room of an area hospital as a scribe, entering information into electronic medical records as doctors conducted patient exams. He said he could see the difference between doctors who rushed through to get to the next patient and those who took the time to stop and listen.
“In the E.R. especially, you want to help the patient there, but you also want to make sure they don’t keep coming back to the E.R.,” Mallory said. “So you listen to them as to why they aren’t taking their diabetes medicine. ‘Oh, I can’t afford it.’ Then you know to talk to the pharmacist to see what kind of more affordable options they might have. That all goes back to listening and caring.”