Orienting Students to Patients and Professionalism

Students LemLem Getachew (in purple) and Sheila Roy (foreground) learned the most important thing about being a physician: It is about the patient.

On their very first morning as medical students, during new student orientation, members of the Class of 2012 heard first from a slim gray-haired woman, wrapped in a dull green hospital robe.

"My name is Meg," she told them. "I'm the face of ovarian cancer."

One by one, the "Faces of Patients" took the stage in the Health Sciences Learning Center's auditorium and told their stories. The students learned the statistics of smoking from Scott, the face of a smoker, and the difficult times faced by parents of special needs children from Elizabeth and her husband, Terry. Their daughter sat in a wheelchair nearby, vocalizing loudly.

"And that's Emma," she said.

The students heard from Michael, the face of HIV-AIDS, and Mary, the face of diabetes. After introducing themselves, the patients took off their robes to reveal their everyday clothes beneath, symbolically revealing the real people behind the diagnoses.

"The most important thing the students learned is that the patient comes first," says Patrick McBride, MD `80, MPH, SMPH associate dean for students. "This is a vital tenet of being a physician: it is about the patient."

"Faces of Patients" was a collaborative effort stemming from Patient, Doctor and Society (PDS), a four-semester course that begins by teaching new students how to communicate with patients.

"I wanted students to walk away from this experience remembering that there is a human being behind every diagnosis," says Jane Crone, NP, MEd, MS, a PDS course director and originator of the "Faces of Patients" program. Others who collaborated included Classroom and AV Services staff, and, most importantly, the patients themselves.

After meeting the patients, the students started medical school by creating a professional code unique to their class, and by cleaning parks as part of a community service activity. The expanded orientation week was part of major changes in store for this class. And the new orientation resulted from a collaboration between faculty, staff, students, patients and others.

"The new orientation week and the curriculum changes are all aimed at producing better doctors," says Christopher Stillwell, director of academic and career advising.

McBride was thrilled with the results of the new students' first activity for the week: writing their own professional code.

First, they heard about the history of medical codes, from the Hippocratic Oath to the Declaration of Geneva, from Susan Lederer, PhD, chair of the SMPH Department of Medical History and Bioethics.

And then the 166 students broke into small groups and discussed the things that they believe are important: honoring their patients, community, faculty, other healthcare professionals, each other and themselves. Each group elected a representative to hash out a draft that incorporated their ideals, and finally all the students voted on each of the five sections, using the audience response system in the school's lecture hall. The debate was passionate, but respectful.

For example, they argued about whether to include a commitment to global health issues but decided their commitment to "community" could be interpreted to include world health.

"Putting it down on paper is critical to getting them to think about these things and embed them into the culture," Stillwell says. "It's a way of making the unconscious conscious."

And it was a way to see where ideals conflict. For example, students grappled with how they would put their patients first, while still caring for themselves and leading a balanced life. It's a familiar struggle for most physicians, but not normally a topic for the first week of medical school.

A giant copy of the code now hangs on the wall in the student services center, signed by members of the class. Plans are to display it, and to update and revise it, as the students move along the path toward graduation.

Later in the orientation week, students bonded by painting a community center, helping build a Habitat for Humanity house and cleaning the park around the Goodman Pool.

Second-year students participated in many of the activities and regaled the incoming class with a hilarious welcome video that included a sketch titled "Med School Musical."

"Our primary goals are to teach students about collaboration, com-munication and collegiality," McBride says. "That is how medical practice and healthcare work best-when we work as a team to serve our patients. We wanted the new students to develop as a community to work together to solve the issues that they will face together as a class and as future healthcare professionals."