Medical School Gets Grant to Teach Students to Be More Caring, Sensitive Physicians

BUFFALO, N.Y. -- Can medical students learn to become sensitive, caring physicians, in the same way they can be taught to become skilled technicians and expert diagnosticians?

The University at Buffalo’s School of Medicine and Biomedical Sciences thinks the answer is “yes.”

Tackling one of the most common complaints about physicians head on, the UB medical school is developing a model program to train prospective doctors how to empathize and communicate with their patients. Results will be used as a model by other medical schools throughout New York State.

The project received the 1997 Mannix Award for innovation in medical education from the Medical Society of the State of New York and will be funded by a $50,000 grant from the Medical Liability Mutual Insurance Co.

“For several decades the science and technology of medicine and medical care has been the primary focus of medical education,” said Frank Schimpfhauser, Ph.D., assistant dean for educational evaluation and research in the UB medical school and principal investigator on the project.

“This has left little time to pay attention to the interpersonal skills physicians need to communicate effectively with patients, and to develop a mutually-trusting relationship. Perhaps the most common criticism of modern medicine is that physicians either do not take the time, or don’t have the ability, to discuss issues that concern patients in language that is understandable and sensitive to their anxieties.”

The project will employ standardized cases and patients to present medical students and resident physicians with typical situations they may face in their practices. Standardized patients are persons trained to portray patients in a consistent fashion. They record data on student performance and provide feedback to trainees in a systematic way, based on faculty-developed criteria, to assure that minimal competencies are met.

Schimpfhauser, who coordinates UB’s standardized patient program, said that while most medical schools use standardized patients to teach students how to take a medical history or to demonstrate their skills at conducting a physical examination, few use them to train prospective physicians how to listen, empathize and communicate.

Scenarios they will face include substance abuse, teen-age pregnancy, domestic violence, sexually transmitted disease, obesity and nutrition, presenting bad news (such as a terminal-illness diagnosis), “do-not-resuscitate” orders, HIV risk and informed consent. Students will be videotaped and their performance critiqued. Those who don’t measure up will be required to practice weak skills and participate in positive role-modeling. Communication skills eventually will become part of UB’s annual competency exams.

The project will be implemented at UB by next spring, and will culminate in a state-wide conference next summer to demonstrate the standardized cases to other medical schools and provide copies of cases for their use.

UB has extensive experience with standardized cases and patients. The Macy Foundation funded a two-year project in 1993 involving UB, Albany Medical College and the Upstate Health Science Center at Syracuse to introduce the concept to their faculty members. In 1995, UB was named one of two national standardized patient research sites by the National Board of Medical Examiners. These sites will test and evaluate cases for possible inclusion in the 1999 national board exams.

Co-investigators on the project are Harry Sultz, D.D.S, M.P.H., UB professor of social and preventive medicine; Lisa Benson, M.D., UB clinical assistant professor of medicine; James Hassett, M.D., UB professor of surgery and director of the surgical residency program; Timothy Gabryel, M.D., UB clinical assistant professor of medicine and director of the internal medicine residency program at Millard Fillmore Hospital; Stanley Spurgeon, M.D., clinical assistant professor of emergency medicine and consultant to the UB Standardized Patient Program, and Karen Zinnerstrom, Ph.D., trainer/evaluator of the standardized patient program.