Transcript doc.com an interactive learning resource for healthcare

The story of doc.com:
development of on-line tools
for the teaching and learning of
medical communication skills
by Christof Daetwyler MD
Drexel University College of Medicine, Philadelphia, PA
Christof J Daetwyler MD <[email protected]>, Technology in Medical Education
and Medical Skills Teaching and Assessment – Drexel University College of Medicine
Background
Effective physician-patient communication is the sinequa-non of effective patient care.
A physician's communication skills determine the nature
and quality of diagnostic information elicited from
patients and the quality of the physician's counseling.
Communication determines the patient's trust in the
physician, which is strongly linked to patient
adherence and satisfaction.
However, studies suggest that many physicians do not
practice effective physician-patient communication.
Christof J Daetwyler MD <[email protected]>, Technology in Medical Education
and Medical Skills Teaching and Assessment – Drexel University College of Medicine
Dennis had a dream
Dennis Novack MD, Assoc. Dean for Medical
Education at DUCom and one of the founding
members of AAPP* had a dream: developing a set
of online-teaching modules that would role-model
best practice of medical communication skills.
*The American Academy on Communication in
Healthcare AACH is the institution who started
training physicians in the U.S. to do patientcentered interviewing, a technique developed by
George Engel and his disciples.
Christof J Daetwyler MD <[email protected]>, Technology in Medical Education
and Medical Skills Teaching and Assessment – Drexel University College of Medicine
We gave him a headache
When Dennis became aware of the program "Headache
interactive"* at a “Slice of Life” meeting about
computers in medical education, he realized it’s
potential to help in the learning of communication
skill. In a short demo I will show how it combines
role-modeling of best practice with an opportunity to
pick the brain of the specialist, revealing “hidden
layers” of stories and experience.
*"Headache Interactive" developed by Marco
Mumenthaler and Christof Daetwyler received the
European Academic Software Award in 2000.
Christof J Daetwyler MD <[email protected]>, Technology in Medical Education
and Medical Skills Teaching and Assessment – Drexel University College of Medicine
About Learning Paradigms
After my graduation from Medical School in 1993 I started
my career as developer of educational media at the
Department for Educational Media at the University of
Berne in 1994. At this time, Multi-Media was hip and
became the “word of the year 1995” in Germany. The
catch-words were self-guided, self-paced and so on.
Around 1998 the focus shifted to Problem Based Learning
and to “pure” constructivistic concepts - away from any
cognitive influence. In Berne, the facilitators initially
were forbidden to know anything about the topic..
Christof J Daetwyler MD <[email protected]>, Technology in Medical Education
and Medical Skills Teaching and Assessment – Drexel University College of Medicine
About PBL Paradigms
Teaching how to fish(!)
Christof J Daetwyler MD <[email protected]>, Technology in Medical Education
and Medical Skills Teaching and Assessment – Drexel University College of Medicine
About Learning (for what?)
The “pure” PBL paradigm in Berne was re-considered, and now also
content experts are facilitators (or mentors?) . I guess that one of
reasons this happened is that only happy teachers are good teachers
- and good teachers care for their students, and that is what really
counts. Showing experts demonstrating best practice and allowing
learners to watch them has become acceptable again.
Burt Landau, a very experienced teacher, told me once that
“I think that the students try harder for a teacher they like.”
I understand now that learning means to add meaningfully information
to pre-existing knowledge - and who could better do this than a
caring teacher who know the students? So I shifted my focus to the
development of tools who emphasize on the process of learning,
assisting the teachers and the learners..
Christof J Daetwyler MD <[email protected]>, Technology in Medical Education
and Medical Skills Teaching and Assessment – Drexel University College of Medicine
What we had in place
• High stakes exams test for proficiency in communication
skills were put in place - need for educational tools
• 200,000.-grant from the Arthur Vining Davis Foundations
• The “Annotated Videos” technology
• DUCOM’s Standardized Patients Program
• AAPP’s renowned Experts on Communication Skills
• My Expertise as developer, team-leader and project
manager (Joe’s Interactive Media Lab @ Dartmouth)
Christof J Daetwyler MD <[email protected]>, Technology in Medical Education
and Medical Skills Teaching and Assessment – Drexel University College of Medicine
Our task: Address 40 different topics
using text and annotated videos
(Academic Medicine, Vol. 79, No. 6 / June 2004 pp 495 - 507)
CORE CONCEPTS
•
Overview
•
Integrating self-reflection and self-awareness
•
Therapeutic Aspects of Medical Encounters
•
Balance, Self Care
ESSENTIAL ELEMENTS
•
Structure and content of the interview
•
Builds a
•
Opens the discussion
•
Gathers information
•
Understands the patient’s perspective
•
Shares information
•
Reaches agreement
•
Provides closure
ADVANCED ELEMENTS
•
Responding to strong emotions
•
Non-verbal and Paraverbal Aspects of Communication
•
Cultural Issues in the Interview
•
Promoting Behavior Change and Adherence
•
Informed Decision-Making
•
Exploring sexual issues
•
Exploring Spirituality & Religious Beliefs
COMMUNICATING IN SPECIFIC SITUATIONS
•
Family Interview
•
The Pediatric Interview
•
The Adolescent Interview
•
The Geriatric Interview
•
Smoking Cessation
•
Diet/ Exercise
•
Anxiety/Panic Disorder
•
Depression
•
Domestic Violence
•
Alcoholism Diagnosis and Counseling
•
Drug Abuse Diagnosis and Counseling
•
Medically Unexplained Symptoms and Somatization
•
Advanced Directives
•
Giving Bad News
•
Terminal care
•
Discussing Medical Error
•
Terminating the Doctor/Patient Relationship
COMMUNICATING WITH COLLEAGUES
•
The oral presentation
•
Communication within Health Care Teams
•
Talking with Impaired Colleagues
•
Principles of Teaching Medical Students and Residents
Christof J Daetwyler MD <[email protected]>, Technology in Medical Education
and Medical Skills Teaching and Assessment – Drexel University College of Medicine
To tape the videos, we needed
a studio - and we found one..
Christof J Daetwyler MD <[email protected]>, Technology in Medical Education
and Medical Skills Teaching and Assessment – Drexel University College of Medicine
The first shoot (module 6)
Christof J Daetwyler MD <[email protected]>, Technology in Medical Education
and Medical Skills Teaching and Assessment – Drexel University College of Medicine
Show how it works (hopefully)
http://webcampus.drexelmed.edu/doccom/materials
Offers a demo of doc.com featuring 3 complete modules
•01 Overview with Geoff Gordon
•06 Building the relationship with Julian Bird
•13 Dealing with strong emotions with Barry Egener
Besides it allows for a 15 days trial-subscription
to all existing modules! Look there for Calvin Chou’s
module about “Cultural Issues” for example.
Christof J Daetwyler MD <[email protected]>, Technology in Medical Education
and Medical Skills Teaching and Assessment – Drexel University College of Medicine
THANK YOU!
Christof J Daetwyler MD <[email protected]>, Technology in Medical Education
and Medical Skills Teaching and Assessment – Drexel University College of Medicine