A new medical school opening next year in Fort Worth will feature a four-year curriculum in communication, a program believed to be the first of its kind in the country.
What’s more, it’ll be run by the nation’s first medical school dean dedicated solely to that subject. The focus on communication is designed to improve not just the health of patients but of doctors, too.
The new medical school - TCU and UNTHSC School of Medicine - is a joint effort between Texas Christian University and the University of North Texas Health Science Center.
Dr. Evonne Kaplan-Liss will be the assistant dean for Narrative Reflection and Patient Communication. She's been teaching physicians how to coach future colleagues — medical students who will make up the inaugural class of the school in 2019.
“Every institution I was affiliating with had one of the ingredients or two of the ingredients, but not all the ingredients,” Dr. Kaplan-Liss says. “And this place has all the ingredients to make it successful.”
The pediatrician says by injecting regular lessons in communication as early as the first semester, graduates and their patients should emerge healthier.
“What’s different here is,” she says, “it’s embedded throughout their four years of curriculum. It’s not labeled as ‘communications.’ It’s part and parcel of everything that they’re doing.”
Kaplan-Liss says improving communication skills could help students be more empathetic. And studies show those with high empathy scores, for example, have healthier patients with fewer complications. The communications curriculum will also tackle medical jargon, the kind of language Kaplan-Liss says doctors get, but patients may not.
“If you ask a patient what ‘state-of-the art’ means,” Kaplan-Liss explains, “it means cutting edge, the best, I’m in and out of here, and I’m in the best hands.”
But to a doctor, Kaplan-Liss says, “state-of-the-art” means something else: treatment that’s totally new, even untried.
It’s like what happened to her when she was a teenager. She needed an operation. Her family OK’d what their doctor called “state-of-the-art” surgery, not knowing it meant — in her case — something that had never been done before. More than 20 surgeries later, doctors were still correcting problems from that first procedure.
That’s when it occurred to her that a doctor’s communication skills needed improvement.
“A lot of this curriculum is to avoid jargon,” Kaplan-Liss says. “But what we’re hoping to do, you know, the medical students are at the — I always call it the ‘window of opportunity.’”
In other words, catch these students before they get lost in shop talk.
“They’re still family members of patients,” she says. “And they still know how to talk when they come here like us.”
A growing trend
Granted, every medical school offers communication classes that emphasize empathy, the importance of listening to patients and how best to communicate with colleagues. But other schools don’t emphasize how to communicate with the media, with philanthropists and fundraisers, the general public and even policymakers, according to the Association of American Medical Colleges (AAMC).
All of that is a curriculum requirement at the Fort Worth school.
“Both for this dean position and actually for the way they’re developing the curriculum, the areas they’re integrating in communication and narrative medicine is quite unique and it’s actually really exciting,” says Dr. Alison Whelan, Chief Medical Education Officer with the AAMC.
Whelan says the communication focus at the new medical school is part of a growing trend.
“More and more schools are beginning to [teach] reflective narrative as part of professional development and self-directed learning,” Whelan says. “But not all schools do.”
Dr. Samir Nangia welcomes the change. The kidney specialist is one of nine doctors learning to coach new medical students. Coaching's another important element of this school’s communications curriculum. It won’t just help teach students professionally, like managing patient concerns, but also, Nangia says, it may help them personally, too.
“I didn’t have anyone in my family who was a physician,” Nangia says. “So, when I went through medical school, I felt disconnected. I didn’t know what to expect. And when I was in there, I went through a lot of scary times. I was barely passing my classes. I had a lot of anxiety.”
Addressing mental health
Dr. Stacey Vanvliet, a pediatrician, and another coach-in-training, wishes she had a coach when she was in medical school.
“You don’t realize necessarily that you need it…while you’re in the midst of med school,” Vanvliet says. “You can feel some of these things, like stress and anxiety, starting to build.”
Vanvliet says having a coach to bounce ideas off of could help alleviate some stress and help students plan their future.
“When I talk with students now I ask them, ‘What’s your life look like in 10 years?’ I was asked as a med student: ‘Do you want to be a clinic doctor or do you want to be in the OR?’ That’s what matters,” Vanvliet says. “But that’s not just what matters.”
What matters more and more these days is a doctor’s mental health, says Samir Nangia. Physicians lead all U.S. professions in suicide — one each day — according to a recent study.
“By doing this, making it mandatory for students to work with a coach,” Nangia says. “You see some of those students, it may not be affecting their grades, but internally it’s affecting them. So, if we can catch it early, we can prevent anxiety, stress and even worse outcomes, like suicide.”
Whelan with the Association of American Medical Colleges says she and others will be watching.
“I really want to see if outcomes are different,” Whelan says. “And if they are, then I think it’s likely other schools would begin to adapt some of what they’re doing as well.”
School leaders here are already convinced this school’s communications focus represents the future of medical education.