Medicine in Contemporary Society (MCS 4)
Course Goals
MCS 4 gives students an opportunity to expand their knowledge of ethical, social, cultural, and humanistic issues in medicine in a manner reflective of their own career choices and particular interests. MCS 4 focuses on mastery of knowledge and attitudes related especially to the following core competencies: professionalism and ethics, communication, self-awareness, social context of medical care, and health care systems.
Elective Courses Offered
The following electives are available for 2011-2012. or a course to be offered the minimum number of students is 5.
1. Compassionate Care and Hope in Clinical Practice
2. Patient Centered Decision Making
3. Clinical Ethics
4. What the Doctor Said: Literature, Arts, and Medicine
5. The History of the US Health Care System: Models, Reforms, Challenges
6. Medicine and the Law
7. Spirituality and Medicine
8. Altruism and Bioethics
9. Narrative Medicine
10. Ethics Writing Elective for MD with Recognition in Research
11. Peer Counseling Readings
12. Clinical Ethics: Neonatal Intensive Care
Course Title: Compassionate Care and Hope in Clinical Practice
Please Note: Two sections of this course will be taught at different times.
Dates Offered: Section 1. September 26 – October 9, 2011
Section 2. January 17 – January 29, 2012
Faculty: Stephen Post, PhD
Director, Center for Medical Humanities, Compassionate Care, & Bioethics
HSC Level 3, Rm 080
631-444-9797
Stephen.Post@stonybrook.edu
Description:
This course will introduce students to humanistic and scientific insights into both compassionate care and hope. Compassionate care makes otherwise technically competent professionals real healers. We want our students to look at patients and see more than biological puzzles. It’s the loss of care in this most basic sense that is currently being singled out across the United States as the most pressing concern not only of patients, but of physicians and other healthcare professionals. Related to compassionate care is physician respect for the dynamic of hope in patients. Harvard hematologist-oncologist Jerome Groopman, in his The Anatomy of Hope, writes that hope is “the elevated feeling we experience when we see – in the mind’s eye – a path to a better future” (p. xivi). Without endorsing the exaggerated popular literature on hope and healing, Groopman notes that belief and expectation, two aspects of hope, are fundamental to the placebo effect, and activate brain circuits that release endorphins (natural opiates) and dopamine (a feel good chemical). A careful assessment of the existing research compels Groopman to conclude, “Hope, I have come to believe, is as vital to our lives as the very oxygen that we breathe” (p. 208). Hope for patients is about the uncertain expectations around which they constitute their lives in time of serious diagnosis or illness. The skilled clinician must handle hope empathically, and be able to redirect patient hopes from one goal to another in order to circumvent despair. This is a course where the human side of medicine is elevated, examined, and revered.
Educational Objectives:
In addition to reviewing literature both scientific, clinical and humanistic, students will:
Requirements:
Students will be introduced to an engaging literature at the interface of science, humanism, and clinical care. They will be required to attend class sessions, to be actively involved in discussions, and to demonstrate an informed understanding of class assignments. Students will be asked to write a four-page paper on the themes of compassionate care and hope, demonstrating a working knowledge of the course readings. The class will meet six times over two weeks.
Reading materials:
Students will receive selected scientific and humanistic articles on compassionate care and hope. They will also be responsible for purchasing two books written be leading clinicians and researchers: Bernard Lown, MD, The Lost Art of Healing: Practicing Compassion in Medicine (1996); Jerome Groopman, MD, The Anatomy of Hope: How People Prevail in the Face of Illness (2004).
Evaluation:
Students will be graded on class participation (70%) and their paper (30%). Grading will follow the standard range (Honors, High Pass, Pass, Low pass, Fail) using the standard evaluation form.
Feedback:
The standard evaluation form includes a faculty feedback section. Students papers will be receive written
Number of Students: 5 - 20
course Title:Patient Centered Decision MakingDescription:
In many cases, the ‘best’ treatment option for a patient cannot be determined using only objective criteria, such as diagnostic test results, but also requires consideration of the patient’s own values and priorities. In these cases, patients assume a role—perhaps the primary one—in making decisions about their own healthcare. In order for these decisions to be properly informed, the patient must a) understand the treatment options available, including risks and side effects, weighed against the magnitude and likelihood of benefits, and b) form a judgment (that is, a preference) based on how the patient believes each treatment option will affect his or her quality of life. Many challenges present themselves here, from understanding sometime complex information about risks and benefits to accurately predicting how different outcomes will affect one’s quality of life. In this course, we will review what the cognitive psychological study of human decision making can tell us about these challenges--and how they might be overcome.
Educational Objectives:
Requirements:
Based on the week’s readings, students will submit one or two comments or questions via e-mail prior to each class, for use during the seminar discussion. Students will be asked to write two short essays on any topic of interest within the broadly defined area of patient-centered decision making (topics should be discussed with the instructor prior to preparing the essays).
Reading materials:
Readings will be derived from several sources including text books, empirical articles, commentaries and review articles. Three general topics will be explored: 1) how and when patient decisions about their medical care affect health and quality of life, 2) the basic psychology of decision making, and 3) how this psychology creates challenges (and perhaps opportunities) for physicians who want to help their patients make the best decisions possible when confronted with a complex array options and uncertain outcomes.
Evaluation:
The standard evaluation form includes a faculty feedback section. Student papers will receive written comments, and we will assess group dynamics and participation regularly. Students will be graded on class participation—including their submitted comments and questions (60%) and their papers (40%).
Number of Students: 5 - 20
Course Title: Clinical EthicsEducational Objectives
The purpose of this elective is to provide an opportunity to systematically review, reflect on and discuss ethical issues that have arisen in your clinical experience. The more particular objectives are as follows:
1. Describe a clinical situation that raises issues of ethics–personal and/or professional and articulate those issues.
2. Explain the difference between professional ethics and personal morality.
3. Differentiate between different approaches to medical ethics, for example principle based ethics, virtue ethics, and casuistry, and apply each to the situation you describe in objective #1.
4. Define consequentialism and deontology and demonstrate how they apply to moral decision making.
5. Articulate your own professional values.
6. Clarify methods of decision making that are used in resolving clinical ethical problems and indicate the strengths and weaknesses of each.
7. Assess your own strengths and weaknesses as a mediator, arbitrator and negotiator and describe a plan to mitigate the weaknesses.
8. Write a chart note describing how the case in objective #1 might be addressed by a clinical ethics consultant. [If an actual ethics consultation case occurs which you have an opportunity to observe, write the chart note that would appropriately capture the discussion and resolution.]
Evaluation
You will be assessed and graded according to the quality of your participation–quantity and quality–in discussions, the effectiveness of your evaluation of your own work and that of your colleagues, and the quality of your written work.
Reading Material
Readings will be drawn from Veatch RM, Haddad AM, English DC, Biomedical Ethics, Oxford University Press, 2009. The Introduction and Part 1 should be completed before our first class.
Once you have formulated what topics you would like to investigate, and PRIOR to starting the elective, e-mail Dean Williams Peter.Williams@stonybrook.edu or Dr. Newton Erkia.Newton@stonybrook.edu with the details.
Number of Students: 5–20
Course Title: What the Doctor Said: Literature, Arts, and Medicine
Dates Offered: January 30 – February 12, 2012
Faculty: Maria A. Basile, MD
Maria.Basile@stonybrook.edu
During this elective, we will explore the different ways that the Doctor-Patient relationship and the experience of illness are portrayed in literature, film, and the visual arts. By the completion of this elective, participants will articulate how the arts and humanities provide insight into the human condition, suffering, compassion, and physicians' responsibilities to patients, colleagues, and themselves. They will encounter examples of how the medical humanities offer historical and cultural contexts to the practice of medicine.
Method of Instruction
Screenings or live readings followed by seminar-style discussions.
Educational Objectives
By the completion of this elective, participant will be able to
1. Describe the value of positive relationships and recognize the power of intimate relationships.
2. Identify relationships and relationship factors that are important to him/her.
3. List the health benefits of meaningful relationships.
4. Recognize the difference between scientific and interpersonal ways of knowing. Recognize how social structures and social practices influence relationships.
5. Analyze the role of culture and power in mediating relationship quality, including that of the health care professional and patient .
6. Describe differences between the nurse's and physician's role and how this affects relationships.
7. Encounter examples of functional and dysfunctional relationships between health care professionals and patients.
8. Describe fundamental components of a successful doctor-patient relationship.
9. Distinguish between pain and suffering.
10. Identify key features of suffering, including social and psychological isolation.
11. Apply 'witnessing' to the alleviation of suffering.
12. Specify what limits and facilitates compassion.
13. Explain the role of story-telling in the healing process.
14. Discuss the reasons physicians tell stories.
15. Engage in the process of empathizing with the disabled.
16. Recognize problems both physicians and patients face in dealing with chronic disease.
Materials
Video, Films, and other media clips will be screened in class. Links to pertinent artwork, literature, and other pertinent readings will be available online or provided in class.
Artists and writers whose works will inform our discussions may include, but are not limited to, Anne Sexton, David Gewanter, Donald Hall, W.H. Auden, William Carlos Williams, John Keats, Sylvia Plath, Jack Coulehan, Richard Bronson, Anton Chekov, Cortney Davis, Frida Khalo, Thomas Cole, Thomas Eakins, Francisco Goya, Alice Neel, Vincent Van Gogh, Rafael Campo, Robert Coles, Danielle Ofri, Pauline Chen, Atul Gawande.
Requirements
Attendance at screenings and discussion groups is mandatory. Journal-type reflections and short essays will be posted on a team blog with the opportunity for immediate and ongoing feedback from instructor and peers. Opportunities to meet privately with the instructor will be available, but not required.
Evaluation
Students will be graded both on class participation (50%) and their participation online (50%). Students will be graded on the standard range (Honors, High Pass, Pass, Low Pass, Fail) using the standard evaluation form.
Number of Students: 5–20
The objective of this course is to understand the origins of the contemporary health care system, particularly focusing on finance, insurance, and systems organization. We will explore issues in health care finance, the growth of hospitals, training of physicians and nurses, and repeated crises in funding and health care delivery. Public policy scholars talk about “windows” in which reform is possible, when the worsening or growing awareness of a problem intersects with a political situation that allows change and policy ideas that might improve it. We will explore current debates on health insurance and health care system reform in light of prior moments of reform and retrenchment in US health care in 1914, 1935, 1948, 1965, 1973, and 1993, as well as the history of other health care systems around the world.
Educational Objectives
1. Describe the financial payment systems for most US health care.
2. Differentiate between the history of the US health care system and those of other industrialized countries.
3. Analyze the strengths and weaknesses of current health care proposals in light of the success or failure of similar policy options in the past.
Requirements: Attendance is required. Students will be asked to write a 5-page paper on any question that interests them in health care organization or financing. These papers can include a history of a specific health care program or approach, an analysis of the historical origins of a current problem in health care organization, an analysis of a policy proposal currently being debated or other approaches. Emphases on changes over time or comparative approaches (between countries, states) are particularly encouraged. All students should discuss their paper topics with the professor by the end of the first week to ensure suitability and obtain suggestions for approach or research sources. The class will meet three times per week for two weeks, for a total of 12 hours. Reading in preparation for class is essential.
Evaluation: Students will be graded on class participation (70%) and their paper (30%). Students will be graded on the standard range (Honors, High Pass, Pass, Low Pass, Fail) using the standard evaluation form. All students are expected to attend each class session, read assigned material beforehand, and come prepared with at least one question or point for discussion. The student is evaluated based on attendance, preparation for class discussion and participation and the final paper. The grade of Honors will be awarded for a superior and well-researched paper, and contributions to class discussion that show particular insight into the subject matter and contribute to the education and understanding of other students. The grade of Pass reflects commitment and work that is appropriate for the level of training. The grade of Fail denotes deficits in attendance, performance and responsibility.
Reading Material
Excerpts from:
Feedback: The standard evaluation form includes a faculty feedback section. Student papers will receive written comments, and we will assess group dynamics and participation regularly.
Number of Students: 5–20
Course Title: Medicine and the Law
Dates Offered: February 27–March 11, 2011
Faculty: S. Van McCrary, JD, PhD, MPH
smccrary@notes.cc.sunysb.edu
Selected other faculty and staff at Stony Brook University Medical Center
Visiting faculty
Description:
Delivery and financing of health care is a large and rapidly expanding area of the law, which includes a variety of complex issues. This course will explore selected topics in health law. Sample topics include: powers of state and federal governments in matters affecting health care; the constitutional right of privacy; liability for negligence by health care providers and institutions; diagnostic errors, medication errors, and patient safety; risk management and root cause analyses; the legislative process; health care policy formulation; and, the law as portrayed in contemporary non-fiction literature. The format consists of ten 2-hour lecture/discussion sessions during the 2-week period (for a total of 20 hours in class), plus the reading assignment outside class.
Educational Objectives
At the conclusion of this course, students will be able to:
1. Discuss substantive law in some areas relevant to medical practice and health policy
2. Recall aspects of legal terminology
3. Recognize how the law deals with biomedical and health information
4. Identify and interpret legal issues in health care
5. Know how health care institutions analyze and seek to prevent adverse events
6. Evaluate when health care providers need to consult legal counsel
Evaluation
The course is graded on a Pass/Fail basis.
To receive a passing grade, students will:
1. Attend, and arrive punctually at, every class meeting
2. Participate regularly in class discussions
3. Read the required text and demonstrate comprehension of its implications
Students who miss one or more classes (except for documented illness or family emergency) will be required to prepare a written paper. The paper will be a 10-page report on legal research conducted by the student, using primary sources, about a current issue in health law.
Required Reading
A Civil Action by Jonathan Harr. Vintage Press, 1996.
Feedback: Verbal feedback will be provided during class discussions
Assessment: The standard assessment form will be used for this course.
Number of Students: 15 (maximum)
Course Title: Spirituality and Medicine
Dates Offered: March 12– March 25, 2012
Faculty: Michael Vetrano, PhD
Michael.Vetrano@stonybrook.edu
This is an intensive course on spirituality in the clinical setting. This elective provides an opportunity for students to work closely with chaplains, hospice personnel, and palliative care specialists, ministering to the spiritual needs of patients. Through clinical experience and theological reflection, the students and their mentors will grapple with issues of suffering, human dignity, mortality, and the role that health care professionals can play in the spiritual journey of the patient. This course will also encourage a careful assessment of the physician's own spirituality as an asset in the clinical setting.
Educational Objectives
At the conclusion of this course you will have the ability to:
1. Define, for yourself, a beneficial spiritual approach to medicine which will include attitudes, spiritual practices, and resources.
2. Integrate spiritual attitudes such as trust, forgiveness, gratitude, mindfulness into your medical practice.
3. Speak with patients' intelligently and compassionately regarding spiritual concerns.
4. Refer patients properly to chaplains and other spiritual counselors.
5. Include spiritual conversation in the process of giving bad news and/or discussing death and dying issues.
Evaluation: U the standard evaluation form, students will be graded on the standard range (Honors, High Pass, Pass, Low Pass, Fail) based on the following:
1. Attendance at all sessions is mandatory.
2. Being prepared for class vis-a-vis readings and articles is mandatory.
3. Participation in discussion
4. The class will define a collaborative project and working on this together is required.
5. Patient skills will be assessed via a descriptive verbatim for at least one current or past patient encounter.
Reading Material
Students will also be required to select, read, and report on articles in particular areas of their own interest related to the collaborative project above.
Feedback: All papers, projects, and reflections will receive written comments.
Number of Students: 5-20
Course Title: Altruism and Bioethics
Dates Offered: April 9 –April 22, 2012
Faculty: Stephanie L. Brown, PhD.
Stephanie.Brown@stonybrook.edu
Description:
This elective, to be offered annually, provides an opportunity to consider the role of altruism in the medical context including health, medicine, and health care. Altruism refers to any action that benefits another at a cost to the self, and may or may not include the genuine concern for the well-being and security of another. We will cover the neurobiology of altruism, the interplay between the stress response and altruism, the evolutionary origins of altruism, and the health effects of altruism. We will discuss the question of whether altruistic motivation can or should guide altruistic behavior in a medical setting (i.e., compassionate care), as well as the costs and benefits to compassionate care in a medical context. We will also consider the implications for the physician-patient relationship, medical decision-making, diagnosis, and clinical trials.
Educational Objectives:
In addition to reviewing literature and engaging in seminar discussion on these items, we will be mindful of other more general objectives:
Requirements:
Students will prepare two thoughtful questions before each class, based on the assigned readings. These two questions should be typed and at a length no greater than 50 words a question. The students “ticket” into each class session will be these questions, to be handed in at the door, each of which will be used at some point in seminar discussion. Attendance is required. Students will be asked to write a 4-page paper on any question that interests them with regard to medical altruism and compassion. Students will be graded based on class participation (70%) and their paper (30%). The class will meet three times per week for two weeks, for a total of 12 hours. Students will need to do considerable reading in preparation for classes.
Evaluation:
Students will be graded on class participation (70%) and their paper (30%). Students will be graded on the standard range (Honors, High Pass, Pass, Low Pass, Fail) using the standard evaluation form.
Readings Material: A reading packet consisting of articles and book chapters will be provided, and we will read studies conducted by pioneers in behavioral neuroendocrinology, psychophysiology, and epidemiology including Michael Numan, Sue Carter, Barbara Fredrickson, Carolyn Swartz, Jim House, Stephanie Preston, and Neal Krause.
Feedback: The standard evaluation form includes a faculty feedback section. Student papers will receive written comments, and we will assess group dynamics and participation regularly.
Number of Students: 5-20
Course Title: Narrative Medicine
Dates Offered: April 30 –May 13, 2012
Faculty: Jack Coulehan, MD; Maria Basile, MD
John.Coulehan@stonybrook.edu
Educational Objectives: Upon completion of this course, the student will
1. Demonstrate an understanding of the skills required for narrative competence in medicine Explain the relationship of narrative competence to clinical empathy, self-awareness, physician-patient communication, and reflective practice.
2. Describe, compare, contrast, and provide examples of "narrative professionalism" and "rule-based professionalism."
3. Utilize personal narratives (written by oneself and others) to explore positive (caring, compassion, altruism, collegiality, affiliation, and self-knowledge) and negative (detachment, alienation, arrogance, depression, and burnout) dimensions of medical practice.
4. Be conversant with strategies useful in maintaining a reflective approach to practice during residency training.
5. Describe the community and public health dimensions of medical professionalism by reference to narratives of living, historical, and fictional role models.
Pre-course Journal. Students who enroll in Narrative Medicine will be expected to keep a reflective journal for some period during the earlier part of their 4th year. The journal should contain at least 20 entries and focus on:
a. Personal response to clinical situations;
b. Stories or vignettes about patients, families, and other health care professionals;
c. Reflections on personal change during your undergraduate medical education.
More specific instructions for the reflective journal will be e-mailed to all registrants in August 2009.
Readings
1. Campo, Rafael. "Just like a Prayer" and "Imagining Unmanaging Health Care," The Poetry of Healing, New York, W. W. Norton and Company, 1997, pp. 24-49 and 175-196
2. Charon, Rita. "Narrative and Medicine." New England Journal of Medicine 2004; 350(9):862-4.
3. Coles, Robert. "Stories and Theories," The Call of Stories, Boston, Houghton Mifflin Company, 1989, pp. 1-30
4. Coulehan, Jack. "Written Role Models in Medical Education," Med Humanities. 2007; 33 (2): 106-109
5. Hatem D, Ferrara E. "Becoming a Doctor: Fostering humane caregivers through creative writing. "Patient Educ Couns. 2001;45(1):13-22.
6. Hilfiker, David. "War Stories," Not All of Us Are Saints, New York, Macmillan, 2004, pp. 42-59.
7. Meier D.E., Back A.L., Morrison R.S. "The inner life of physicians and care of the seriously ill." JAMA. 2001; 286: 3007-3014.
8. Novack DH, Suchman AL, Clark W, Epstein RM, Najberg E, Kaplan MD Calibrating the physician. Personal awareness and effective patient care. JAMA. 1997; 278: 502-509.
9. Ofri, Danielle. ÒDrawing blood,Ó ÒThe professor of denial,Ó and ÒTime of death: 3:27 AM,Ó Singular Intimacies. Becoming a Doctor at Bellevue. New York, Beacon Press, 2003, pp. 5-16, 89-100, and 130-137.
10. Selzer, Richard. ÒImelda,Ó ÒBrute,Ó ÒToenails,Ó and ÒMercy,Ó Letters to a Young Doctor, New York, Touchstone Books, 1982, pp. 21-36, 59-63, 64-69, and 70-74.
11. Williams, William Carlos. "Old Doc Rivers," The Doctor Stories, New York, New Directions, 1984, pp. 13-41.
Course Format: This elective will consist of 8 two hour seminar sessions ( 4 each week) organized around topics in narrative medicine and reflective practice. Sessions will include presentation and discussion of material from participant journals and also discussion of course readings relevant to the topic. Attendance is required.
Students will submit their journals by e-mail at, or prior to, the beginning of the elective. With the students' permission, I will copy and distribute selections from journals for consideration during various seminars. Note: Participants must agree to strict confidentiality regarding our seminar discussions.
In addition to the journal, each student will write a "narrative reflection" during the two week period. This short (2 double-spaced pages) reflection should be based on his or her personal response to a story or opinion raised in class. Ideally, the reflection will capture a sudden insight or "ah ha!" experience.
This elective addresses the following core competencies: (a) effective written and oral communication; (b) professionalism, ethics, and personal values; (c) self-awareness, self-care, and personal growth, and (d) social and community contexts of healthcare.
Evaluation. Using the standard evaluation form, the instructor will assess student performance based on (a) attendance and participation in seminars [a make-up assignment permitted for 1 or 2 missed seminars]; (b) a completed journal, as described above; and (c) a 2-page written narrative reflection. Students will be graded according to the standard system (Low Pass, Pass, High Pass, Honors).
Number of Students: 5–20
Course Title: Ethics Writing Elective for MD with Recognition in Research
Dates Offered:April 30– May 13, 2012
Faculty:Stephen G. Post, Ph.D.
Director, Center for Medical Humanities, Compassionate Care, & Bioethics
HSC Level 3, Rm 080
631-444-9797
Stephen.Post@StonyBrook.edu
This course is open only to those students who are pursuing the MD with Recognition in Research. These students are engaged in extensive scientific research on a wide variety of topics. Some subset of students may wish to expand their topic area with a focus on its humanistic or ethical aspects. For example, a student studying the science of autism may wish to extend their work into questions of healthcare justice as it pertains to this population; a student studying stem cell differentiation may wish to extend their work into broader ethical questions around the use of stem cells and IRB regulatory policies; a student investigating the neurology of Alzheimer disease may wish to examine cultural differences in the moral respect afforded persons with increasingly severe dementia; a student researching the BRAC1 gene may wish to interview women with regard to the benefits and burdens of knowing their susceptibility genotype.
Students are expected to petition Stephen.Post@stonybrook.edu directly if they wish to enroll in this elective. By November 1 of Year 4, each interested student should have emailed Dr. Post with a two or three page topic area proposal, including the problem to be studied, and at least several representative bibliographical items. Finished 12-14 page papers (double spaced with endnotes) should be forward to Dr. Post by one week before the start of the course, at the latest.
Starting April 11, students will convene for two-hour sessions, with ample time devoted to each paper including extensive feedback from peers and instructor. The number of sessions will depend on the number of students, but we will have to meet at least several times regardless should student interest be limited in any given year.
Students will be expected to revise their papers independently, but we will not expect this to be accomplished during the elective period, not will the final grade depend on this.
Educational Objectives:
In addition to developing and writing their papers, students will be engaged in seminar discussion and feedback. We will be mindful of other more general objectives:
Requirements:
Students will present their papers against the background of a brief introduction to their scientific projects. Students will invite response based on their identification of conceptual limitations in their papers, and more generally. Students will be responsible for revising their papers after the elective concludes, but this will not be part of the course assessment nor need this final manuscript be handed in. Hopefully, some students will be able to publish their work. It is important that all students read all papers and be prepared to respond to each paper in some depth. Attendance is required. The class will meet three times per week for two weeks, although this may be reduced depending on enrollment.
Evaluation:
Students will be graded on class participation (50%) and their paper (50%). Students will graded on the standard range (Honors, High Pass, Pass, Low Pass, Fail) using the standard evaluation form.
Readings Material:
Papers from all students will be made available.
Number of Students:
No more than 20 students will be allowed to enroll.
Feedback:
The standard evaluation form includes a faculty feedback section. Student papers will receive written comments, and we will assess group dynamics and participation regularly.
Course Title: Peer Counseling Readings
Dates Offered: May 8 – May 12, 2012
Faculty: Edward Feldman, DSW (Edward.Feldman@stonybrook.edu) &
Stephen G. Post, Ph.D.(Stephen.Post@stonybrook.edu)
Director, Center for Medical Humanities, Compassionate Care, & Bioethics
Description
This special course is designed for medical students who initially volunteer as Peer Counselors in Years One or Two, and who have been engaged in ongoing monthly training in empathic skills and counseling under the guidance of Dr. Feldman. This a unique and specially created longitudinal course, culminating in an MCS4 “capstone” format that allows students to present cases and to reflect on compassionate care in the context of their counseling experiences. Students will be introduced to some readings on the humanistic and scientific insights into compassionate care, and draw from their experiences as counselors to reflect on what it means to be a caring physician. Students will be challenged to articulate the techniques of compassionate care that they have developed as peer counselors, and to reflect on the connections between empathy and successful clinical outcomes that can be applied to patient interactions in their future professional lives. The course will be co-taught by Drs. Feldman and Post.
Educational Objectives
Students will:
1. Articulate techniques of successful empathic care as they have developed these over their years as peer counselors;
2. Extrapolate from experience and readings to the therapeutic importance of engaging the patient as person;
3. Appreciate the art as well as the science of medicine, and the nature of a healing or optimally therapeutic physician-patient relationship;
4. Students will be encouraged to think through the nature of being a good doctor, and even partner in health, at a deeper and more holistic level.
Requirements
Students will be presenting their cases from peer counseling, respectful of anonymity and confidentiality. They will interweave their counseling experiences with several articles at the interface of science, humanism, and clinical care. They will be required to attend class sessions, to be actively involved in discussions, and to present cases as they have reflected on these as peer counselors. Students will be asked to write a five-page paper on the theme of compassionate care as grounded in their experiences.
Special Scheduling Considerations
The peer counselors have met many times as a group with Dr. Feldman. This MCS4 course is a capstone opportunity. We will meet three times (to be determined), for two-hour sessions.
Evaluation
Students will be graded on class participation (70%) and their paper (30%). Grading will follow the standard range (Honors, High Pass, Pass, Low pass, Fail) using the standard evaluation form.
Reading Material
Students will receive selected scientific and humanistic articles on compassionate care.
Feedback
The standard evaluation form includes a faculty feedback section. Students papers will be receive written feedback.
Number of Students
5–20
Educational Objectives:
At the conclusion of this course, students will be able to:
1. Recall and describe how distinctive medical and social issues in neonatal critical care contribute to complexity of ethical cases in children
2. Distinguish ethical assessments between pediatric and adult cases
3. Formulate plans of care for pediatric cases that maintain ethical standards
4. Recognize that family decision making authority and legal constraints may limit physicians' ability to solve some ethical problems in pediatric critical care
Evaluation:
1. Attendance at all assigned rounds and course conferences is mandatory.
2. Participation in discussion at all NICU conferences
3. A weekly Friday conference with Dr. McCrary for case presentation and discussion
4. Two 3-page case reports addressing either a case the students have observed in the NICU or a relevant neonatal ethics issue of interest to the individual student, and including independent research on pertinent articles (due each Friday)
* Important Note:
All students should check in with Dr. McCrary at the NICU nurses' station (on 8 South) each morning during the course (M-F) at 9:15 to discuss planning for that day and future days.
Required Reading:
Jonsen AR, Siegler M, Winslade WJ. Clinical Ethics: A Practical Approach to Ethical Decisions in Clinical Medicine (6th ed). New York: McGraw-Hill, 2006.
Number of Students:
4 in NICU (maximum)
Feedback:
Verbal feedback will be provided during weekly faculty conferences. All case reports will receive written comments.
Assessment:
The standard assessment form will be used for this course.
MCS 4 Exceptions:
Students actively pursuing an MD with Recognition in the Humanities will receive MCS 4 credit for elective time spent working on their project. Any student who has made a prior arrangement (i.e. during the 3rd year) with an MCS faculty member to receive credit for a project to be undertaken in the 4th year should contact that faculty member to review his or her proposal. These will be considered on a case-by-case basis.
Palliative Medicine Elective
MCS 4 credit will be granted to students who participate in the Palliative Medicine elective
(Medicine: Palliative Care with Survivorship & Supportive Care Team)
There is no need to contact the MCS office to take this elective.