Patient centered care (PCC) is a term used in medical education that refers to a focus on a patient’s unique background and sets of needs during clinical interactions and in medical decision making. Despite the ubiquity of PCC and communication in medical education, recent surveys conducted by the American Academy of Family Medicine (AAFP) have shown that a strong disconnect still exists in the primary care setting between what the physician wants to discuss during a visit — results, diagnoses and labs, and what the patient wants to discuss — diet, sleep and mental wellness.
Authors attribute this to deficits in medical training, which emphasizes diagnostics, objective data and disease presentation rather than an accounting of personal, psychosocial and environmental factors. A potential method to mitigate this is bringing more health profession trainees into K-12 classrooms to serve the community as teachers.
Longitudinal community service presents health trainees with clear benefits including development of communication and interpersonal skills, understanding how to teach and insight into community level issues and personal well being. I recall my own days in an AmeriCorps-affiliated program called Jumpstart, an organization aiming to close the “word gap“ among young children entering primary school.
A major recent study demonstrated that increased conversational turns in the young child are associated with language center activation and increased cognitive development. The need for these conversations plays well into the hands of providers in training. In Jumpstart, some of the most important skills I learned involved communicating information to different audiences. For instance, during the day I would explain the physics of a kite to my partner children, utilizing grand hand gestures and ornate illustrations to show that kites capture the wind in certain directions in order to lift into the air.
Later in the day, I would briefly meet with my partner children’s parents, caretakers and classroom teachers explaining their progress or need for improvement and individualized attention in key English competencies including vocabulary, reading comprehension, writing and speech. Many of these conversations did not always bear the news that caretakers wanted to hear, but this helped me prepare for similar difficult conversations with patients and their loved ones.
During medical school, I am rekindling my devotions to teaching and personal growth in communication skills with a group of like-minded medical students by founding Companeros de Bienestar, a grassroots community partnership whose purpose is to bring health trainees into urban middle and high school classrooms to teach modules in sexual health, allyship and prevention of sexually transmitted diseases. While this project is still in development, the role of longitudinal service opportunities in medical school curriculum has been studied before. Through this service organization, we hope to embolden fellow health professions trainees to pursue personal growth in becoming patient educators.
Classroom teaching has the potential to become an integral part of the transition between the medical student and the physician educator. My personal anecdotes from the classroom, whether teaching predominantly Spanish-speaking preschoolers or modules in sexual health to adolescents, have unequivocally played a role in my transition from a student to a physician-in-training and patient educator. The conversations with young children, caretakers, teachers and even community stakeholders build a language of communication that easily transfers into the realm of medicine. The art of breaking down seemingly complex topics, like the physics of a kite to a four-year-old, can be drawn upon to explain findings in a computed tomography scan to a patient. Communicating to multiple audiences including patients, their families and members of the provider team is likewise a shared attribute. Having difficult conversations, including sharing reports that may not bear the desired news, is a priceless real-life training experience found on a daily basis in the medical setting.
Schools should make experiential classroom teaching an initiative to promote these service opportunities to pre-clerkship trainees as an additional layer of preparation for the clinical setting. Ultimately, every health professions trainee deserves to teach, and every patient deserves a well-versed provider.