Medical students can get so consumed by their chosen
field, Sarah Clever says, that they can literally forget
themselves. A student, for example, might lose sight of
what led her to become a doctor in the first place, or fail
to address his own physical and emotional needs.
To confront this issue, Clever, an assistant professor
in General Internal Medicine at the
School of Medicine, has offered to second-year students
the Healer's Art, a five-session course intended to help
them better understand their humanity and innate capacity
as healers. Specifically, they learn tools of stress
reduction, offer group support to colleagues and experience
firsthand the power of listening — all skills they
can use in their professional career.
"Through the exercises, the students will find
acceptance for taking time for their own healing, and share
moments of loss and pain. We hope that what students learn
from this is just how important listening can be," she
said. "When students get on the wards, it's reinforced on
them just how much they don't know, or that they don't know
anything, yet. But we want them to know that it's not true
and that just by listening to somebody they can help them
feel better."
The course, which was designed by nationally known
educator and mind/body health pioneer Rachel Naomi Remen,
has been used in more than 30 medical schools during the
past decade, but it has never been subject to rigorous
evaluation. So Clever and a colleague, Gail Geller,
designed a research project to determine the outcomes.
The study was funded in part by a grant from the
Osler Center for Clinical Excellence at Johns Hopkins,
an initiative that seeks to train physicians in the basic
elements of a sound doctor-patient relationship —
like how to listen. Since its inception in 2002, the Osler
Center has been dedicated to training a new generation of
doctors who, in addition to applying sound clinical skills,
can communicate effectively with patients and their
families.
William Osler, Johns Hopkins' first physician in
chief, set the gold standard in general medical practice
and himself championed a humanistic approach to health care
that valued the patient's insights and history. His 1892
authoritative textbook, The Principles and Practice of
Medicine, emphasized ways to reach out to patients.
David Kern, director of the Osler Center and an
associate professor in the Department of Medicine, said
that the center's mission is to promote and develop all
learning activities, like the Healer's Art, that further
the Osler-inspired doctor-patient interaction.
"Bringing better care to the bedside is what this
center is all about," Kern said.
The Osler Center endorses what it calls the "modern
old-fashioned doctor model," a physician who can combine
caring and empathy with the latest medical advancements.
Currently, the bulk of the center's activities
involves providing grants for educational projects and then
helping communicate the research to a national audience.
The programs that come out of the center help train
doctors at all levels on patient-related issues. For
example, one program has been developed to teach all Johns
Hopkins medical students to blend communications skills,
clinical reasoning and joint decision making in treating
patients. In another center-funded project, internal
medicine residents take a one-month in-depth course on
communication skills and the psychosocial problems their
patients are likely to encounter.
Last year, the center funded six projects, including
one on enhancing a resident's communication skills in HIV
prevention.
On Jan. 31, the Osler Center hosted an event that
presented outcomes from three of the funded programs,
including Clever's, which was titled "The Healer's Art: A
Curriculum to Help Medical Students Identify, Strengthen
and Cultivate the Human Dimensions of the Practice of
Medicine."
To date, the Healer's Art has been offered here twice.
While more sessions and a greater sample size are needed to
determine any real conclusions as to the effectiveness of
the training, Clever feels confident the experience will
bear fruit. She says the Osler Center is a tremendous
resource for Johns Hopkins faculty.
"The grant we received was vital," she said. "We had
no other way we could perform this level of research, or
provide the course in the first place."
Medical education has traditionally been extremely
underfunded in the United States, Kern says, as most of the
money given to medical schools goes toward research and
clinical practice. He hopes education funding will now
start to catch up.
"We don't give new treatments to patients without
fully researching the efficacy of these treatments, but we
give new information to doctors without looking into how
best to communicate it," he says. "In our work here, we are
trying to take what we already know and improve educational
and training techniques."
Kern said that in the near future the center plans to
host a seminar that highlights best practices. He also
wants to be able to offer more grant funding, but
additional donations are needed. The center currently
receives the bulk of its funding through private
philanthropic gifts, primarily grateful patients.
John Flynn, the center's associate director, said that
the world recognizes Hopkins' stature in medical research
and clinical care. It ranks first in federal research
dollars, and for 15 straight years the hospital has topped
U.S. News & World Report's annual rankings of
America's Best Hospitals. While the School of Medicine is
currently in the lead pack of medical schools, Flynn said
the Osler Center's work will be part of the many
educational efforts that are occurring right now to take
the school even further to the forefront.
To learn more about the Osler Center and its
educational grants, go to
www.hopkinsbayview.org/oslercenter/index.html.
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