C�unicati� AS A FOUNDATION Teaching good ways to deliver bad news
for Care STORY BY MARK SOMMER
M
PHOTOS BY DOUGLAS LEVERE
edical educators understand that if they focus too heavily on the science of medicine, they risk overlooking the art of medicine, an art perhaps best exemplified by good physician-patient communication.
In recent decades, this understanding has grown out of difficult lessons that caused medical professionals to step back and acknowledge that high technology, while a tremendous boon, also served to undermine their relationships with patients. This in turn affected adherence to treatment plans and patient satisfaction, contributing to an increase in malpractice suits. Recognizing these trends, the Accreditation Council for Graduate Medical Education mandated in 2007 that residents be formally taught communication skills. At about this same time, medical professionals also began acknowledging a responsibility to communicate more effectively when talking with patients about life-altering or terminal diagnoses and issues related to informed consent. The Jacobs School of Medicine and Biomedical Sciences anticipated these trends when it established the Standardized Patient Program in its Clinical Competency Center in the early 1990s. The program
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grew out of concerns that third- and fourth-year students were not being adequately trained in communication skills. Since that time, the program has been expanded to include first- and second-year students, as well as residents. Other courses, established in the late 1990s, focused on teaching students how to compassionately and effectively deliver difficult news to patients. These groundbreaking programs continue to thrive today and are being expanded by a new generation of faculty devoted to sustaining excellence in this aspect of medical education in the Jacobs School.
Early exposure to lifelong skills First-year medical students in the Clinical Practice of Medicine 1 course are introduced to a six-step protocol for how best to present distressing information in a caring and organized manner to patients and their families. Known by the acronym SPIKES, the protocol was developed in the early 2000s by British oncologist
