Two weeks before renewing your license, you realize that you’re short 7 CME credits. Uh-oh…what to do now? Unfortunately, not enough time to go to a conference. Reading always gets boring after a while. Lie on your renewal application (NOT!)? If only there was a one-stop method of getting a variety of CME to keep you interested.
“To be or not to be?”
What could be more strange on a medical school curriculum than a theater training course? The authors of this study in Medical Humanities innovatively designed a 1-week elective course to help medical students at Mayo Medical School to improve their case presentation skills in partnership with the Guthrie Theater.
In this pilot course, seven medical students (six 1st year students, one 4th year student) participated. The learning objectives were:
- Hear stories: those told by patients, colleagues and in written narratives
- Identify the elements of a narrative, and examine stories for narrative structure
- Share stories: through case presentations, body movement, storytelling and acting
- Present a patient’s story with elements of traditional medical presentation and narrative
Students were evaluated for the following competencies:
- The cognitive capacity and flexibility needed to evaluate and acquire reliable clinical information.
- The ability to actively and generously observe and listen to another.
- An understanding of the components of narrative leading to effective story construction.
- A performance sensibility that ensures the delivery of a good story, otherwise known as stage presence.
- The finesse to communicate empathically with a patient to create an environment in which she or he feels safe, satisfied and heard.
Eleven sessions, over 25 hours, comprised of the following topics:
- Improvisation activities
- Introduction to case presentations
- Body language – contact improvisation
- Performance of story
- Neutral dialogue and elements of a narrative
- Narrative in context – what’s lost, what’s gained?
- Listening with a neutral mask
- Writing and presenting case histories
- The art of personal monologue
- Final presentations with professional critique
Survey responses uniformly found that students valued this creative, non-traditional approach to learning about interpersonal communications and oral presentations. The art of focused storytelling to an audience is exactly what physicians do every day when presenting clinical cases.
Hammer RR, et al. Telling the Patient’s Story: using theatre training to improve case presentation skills. Medical humanities. 2011, 37(1), 18-22. PMID: 21593246
In an interesting survey-based publication by Dr. Tabas (one of my colleagues) that just came out in Archives of Internal Medicine, we learn more about the ins and outs of CME activities. The authors set out to determine the audience members’ opinions about:
- Commercial/ pharmaceutical support and its impact on bias
- Their willingness to pay extra conference registration fees to eliminate outside support
Your capable resident comes to you, looking frustrated. He says, ‘What a difficult patient. I think you need to get involved.’
This article provides a framework for teachers to allow learners to appreciate these encounters in the Family Medicine. Their points are highly relevant to Emergency Medicine. Strategies include:
There is a constant tug-of-war between self-guided learning and supervised learning. With the advances in technology for medical education such as asynchronous learning modules, simulation, there has been a movement away from traditional, instructor-led teaching and towards more independent, self-guided learning. There is less supervision of learning.
But left unsupervised, are learners learning the right things and doing so optimally? The authors, in this review, say yes and no.
Can we apply what we know about the neurobiology and sociology of learning towards medical education? This review article in Academic Medicine presents 10 strategies to improve teaching and curricular development.