Newswise — Some students from Michigan State University's College of Human Medicine will soon put down the books, leave the practice exam rooms, and have their first experiences with "real live" patients.
What's different about this is the participating students are first-year students and they'll be meeting the patients in the comfort of the patients' homes.
Called the "Longitudinal Patient-Centered Experience (LPCE)," the program matches MSU students with patients suffering from a chronic disease. The students and patients will get together several times over the course of the year, getting to know one another and giving the students a look at the real world of health care.
Not only does this give the students a jump start on honing their communication skills, it also teaches them many of the ins and outs of today's often-confusing field of medicine.
"Using this approach, the students get to know the patients in some context other than a doctor's office," said Leonard Fleck, a professor in MSU's Center for Ethics and Humanities in the Life Sciences who helped develop the course. "This way, they see the world from the patient's perspective rather than from the physician's point of view."
"At first we thought of having them tail a doctor and getting the doctor's perspective, but we wanted them to have a patient-centered approach," said Jane Turner, LPCE director and the college's assistant dean for preclinical curriculum.
The bottom line, said Turner, is to make sure all of the college's students graduate with finely tuned communication skills.
"We stress that it's not so much asking the right question as it is listening, asking open-ended questions, and encouraging the patient to talk," she said. "We focus on what I call the etiquette of the interview " eye contact, appropriate body language, not interrupting, introductions and closure."
The program also gives students the opportunity to increase their knowledge of chronic diseases, which, said Turner, is what health care today is all about.
"Economically speaking, more than 75 percent of our health care dollars go to chronic illness, and that doesn't include nursing home care," she said. "A high percentage of doctor visits are for chronic illness and at least 55 percent of emergency room visits are about a chronic health condition.
"It's what we do and we haven't been teaching to it," she said.
Between January of the students' first year and March of the second, the students will make at least eight home visits. Two students will be paired up with one patient.
The initial visits are designed to help the students and patients develop a relationship. Subsequent visits will focus on specific tasks, including conducting a physical exam, learning family dynamics and how they affect health care, and learning some of the intricacies of health care economics.
"After each visit, the students get together in small groups to talk about it," Fleck said. "They share information and learn from one another. If someone runs into a problem, they can talk about it and come up with ways to solve it."
This experience will come in handy for the students, especially later this year when they begin taking a clinical skills examination as part of the process to become a certified physician.
The national Board of Medical Examiners is instituting a new component to the U.S. Medical Licensure Examination that will examine the students' clinical skills " specifically their communication and interpersonal skill, physical examination skills, and so on.
"We did not develop the LPCE to prepare our students for that exam," Turner said. "That exam is very much about a focused clinical encounter. The LPCE is about understanding the patient in a much broader and deeper context."
Since its founding more than 30 years ago, communication and the doctor-patient relationship have been a major focus of medical education at the MSU College of Human Medicine.
"We were among the first institutions in this country to do this in a systematic, structured way," she said. "The LPCE is quite unique because the students maintain the relationship with the patients over a long period of time."
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