By Mary Boyle

Looking for a way to bring real patients to students in pre-clinical years?

Each year we ask our specialists to invite a few patients in to match a topic we are studying— Peripheral Vascular, Rheumatology, and Dermatology.  They kindly arrive at our lecture or small group sessions to show us the sequelae of their disease.  We have tried a variety of methods— for Rheumatology, our patient places her hand beneath a digital overhead projector and it is magnified many times with clarity in the lecture hall, but then, more importantly, together we walk to each small group so students can be up close to see and examine her delicate hands and speak to her about her life. For Dermatology and PV, students move in small groups to see two to three patients individually and hear their stories.

This year, we took on a bigger project.  We worked closely with our hepatologist during our abdominal block.  Through her generosity of time, we were able to move 163 students through the paracentesis clinic.  The workshop took place over several sessions on several days.  She met with a small group of students at the beginning of the session to discuss some of the findings and the significance of those findings.  Then five students at a time gathered around one patient’s bedside in the procedure room.  The patient’s permission was obtained ahead of time. Students met the patient, saw physical findings, then stayed a few more minutes to watch the paracentesis.  Each student group spent about twenty minutes at the bedside.  These sessions were scheduled numerous times over a month.

Each time it is the personal story of how a patient’s life is affected that engages the student.  They meet one patient up close and, I believe, they then go back to study with greater interest and remember with greater ease.  It is an opportunity to improve their understanding of patients, and by doing so, increase their communication skills.  These sessions open their eyes early to patients’ experiences and the student grows in their professional identity formation as a nonjudgmental listener and healer.

This endeavor takes a bit of time to coordinate.  It demands flexibility to work with patient cancellations.  But oh, what a difference in interest and ability to make connections with what could otherwise be tedious material to master.

Extend the invitation, patients will actually come and allow you to gather around them.  It is our privilege, our chance to learn well.

Mary C. Boyle, MD, is clinical associate professor of emergency medicine and medical education at the Loyola University Chicago Stritch School of Medicine. She is the course director for the second year patient-centered medicine course.