communication skills training Page Schmiedeknecht and Marissa Wilson com 571 spring 2015
Overview of Training
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Audience:
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Goal:
+ Newly hired physicians at an orientation for Saint Joseph Hospital
+ explain the four physician-patient models + Determine which one saint Joseph hospital recommends using that best embodies the ethics and beliefs of the organization
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Problems we are helping them overcome:
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Why is this skills training necessary:
+ communication issues + Physician- dominant decision-making + Treatment options
+ help physician- patient communication when decicing treatment + Provides an ethical guideline for physicians to follow + To understand patient autonomy
Rationale
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We believe that by providing the physician with tools and examples of which model to use, they will be able to form better relationships with patients and our organization will have better patient autonomy.
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Agenda
Appendix 1
+ overview + Rationale + Saint Joseph Hospital mission & core values + Importance of the physician - patient models + Patient autonomy + Importance of the Physician -patient relationship + The four models + Activity : Guest speaker video + Exercise: jeopardy Game + Design bonus
Our mission: ‘To Bring Wellness, Healing & Hope to All’
Our Identity:
Our Values:
Our purpose:
Integrity Doing the right things in the right way for the right reason.
We are a comprehensive health system strengthened by our Catholic, Jewish and academic heritages and inspired by our shared values. To bring wellness, healing and hope to all, including the underserved.
Our Future:
To transform the health care communities, care delivery and health care professions so that individuals and families can enjoy the best of health and wellbeing.
Reverence Respecting those we serve and those who serve.
Compassion Sharing in others’ joys and sorrows. Excellence Living up to the highest standards
Importance of the 4 models
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during the last two decades or so, there has been a struggle over the patient’s role in medical decision making that is often characterized as conflict between autonomy and health, between values of the patient and values of the physician. (Emanuel & Emanuel 1992a)
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the importance of the four models being discussed today is to improve patient autonomy and make the physician-patient relationship seem less-physician dominant.
Patient autonomy
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Patient autonomy is the right of patients to make decisions about their medical care without their physician or healthcare provider influencing their decision.
four different aspects of the four physician patient models: 01 02 03 04
goals of the physician-patient interaction physicians obligations role of patient values patient autonomy
Physician-patient relationship
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Patients no longer want to be told what to do in regards to their health. People want to be involved in decision-making and want to know what is going on with their treatment. Our goal is to make patients feel like they have a say in all medical decisions.
The four models Paternalistic Informative Interpretive Deliberative (See handout 2)
paternalisitc model Paternalistic
Patient Values
physician’s obligation
Objective and shared by physician and patient
Promoting the patient’s well-being independent of the patient’s current preferences
+ physician is in power + use in emergencies
patient autonomy Assenting to objective values
physician’s role Guardian
Informative model physician’s obligation
Patient Values
Providing relevant factual information and implementing patient’s selected intervention
Defined, fixed, and known to the patient
+ provide patient with as mush information as possible
patient autonomy
physician’s role
Choice of, and control over, medical care
Competent technical expert
Interpretive model physician’s obligation
Patient Values
Elucidating & interpreting relevant patient values as well as informing the patient & implementing the patient’s selected intervention
Inchoate and conflicting, requiring elucidation
+ physician provides info & helps patient choose option
patient autonomy Self-understanding relevant to medical care
physician’s role Counselor or adviser
Deliberative model physician’s obligation
Patient Values
Articulating & persuading the patient of the most admirable values as well as informing the patient & implementing the patient’s selected intervention
Open to development and revision through moral discussion
+ chosen model for saint joseph hospital + embodies patient autonomy
patient autonomy Moral self-development relevant to medical care
physician’s role Friend or teacher
Deliberative model = best model! physician’s obligation
Patient Values
Articulating & persuading the patient of the most admirable values as well as informing the patient & implementing the patient’s selected intervention
Open to development and revision through moral discussion
+ chosen model for saint joseph hospital + embodies patient autonomy
patient autonomy Moral self-development relevant to medical care
physician’s role Friend or teacher
Activity: Video Overview:
“
Why I Changed My Mind- From Natural Dying to Treat & Feed- for Certain Symptoms of Advanced Dementia
”
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Psychiatrist, Stanley A. Terman, PhD, MD, interviews Melissa Cook, who has Mild Cognitive Impairment which could potentially lead to Dementia Dr. Terman invented an Advance Care Planning tool called; “Natural Dying Living Will Cards” that help her determine what she wants as treatment if her condition were to worsen This is an example of using the deliberative model through psychiatrist and patient discussion because this was Melissa’s second time talking about her treatment so she was able to think about her values and morals more in depth and had time to reflect on them to fully understand what her best decision for herself would be if she developed Dementia
https://www.youtube.com/watch?v=qA0TQS1Pmwk
exercise: ‘It’s Play time!’ exercise: It’s Play Time! jeopardy
jeopardy
jeopardy
jeopardy
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jeopardy
jeopardy
jeopardy
jeopardy
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jeopardy
jeopardy
jeopardy
jeopardy
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Design bonus!
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Evidence-based design principles for healthcare & educational environments + Natural Sunlight + Windows and Glass to provide views + Gardens and presence of Nature ( Biophilic Design) + Utilizing Artwork and Branding + Privacy of Patients, Family members and Staff + Comfort + Color Psychology + Circulation Patterns + Wayfinding + Classroom layout design to enhance Learning
Chapel/reflection room + Natural Sunlight + Windows and Glass to provide views + Gardens and presence of Nature ( Biophilic Design) + Utilizing Branding
+ Comfort + Color Psychology + Circulation Patterns + Wayfinding
Training/classroom + Natural Sunlight + Windows and Glass to provide views + Gardens and presence of Nature ( Biophilic Design) + Utilizing Branding
+ Comfort + Color Psychology + Circulation Patterns + Wayfinding + Classroom layout design to enhance Learning
Consulting room + Natural Sunlight + Windows and Glass to provide views + Gardens and presence of Nature ( Biophilic Design) + Utilizing Artwork and Branding + Privacy of Patients, Family members and Staff
+ Comfort + Color Psychology + Circulation Patterns + Wayfinding + Technology
COM571 / Spring 2015
Page Schmiedeknecht & Marissa Wilson
Thank You!