At the Weill Cornell College of Medicine, new doctors-in-training are learning communication and teamwork skills right alongside their medical skills. Cornell has integrated simulated practice and role-plays into their medical education and training. Students learn to effectively use human factor skills when communicating with patients because numerous studies have shown that the better physicians can create rapport with patients, the more effectively the patient will follow their medical advice.
In the learning center where simulations occur, a central observation area is outfitted so that faculty can observe students practicing with the actor-patients; there are one-way mirrors and the technology to support wireless headsets so that instructors can change the audio channels to observe several rooms simultaneously. Rooms are also outfitted with AV equipment and microphones so that every interaction is recorded. This creates a longitudinal database so that students and professors can track their progress and ensure that practice has a positive outcome on student performance in medical school and beyond. This is an important point - practice sessions are taped for study and learning.
Football coaches have long analyzed game tape, but taping practice is actually more important. Part of building a culture of practice is videotaping practice; it sends the message that improvement through practice matters.
Cornell uses the lens of practice and feedback for all aspects of their program.
After each training session the actor-patient breaks out of the role and, using a detailed checklist, gives the medical student three pieces of very explicit feedback. Following feedback from the actor-patient, each student debriefs with faculty for more performance feedback. Finally, the students go through the very painful process of watching their own video tape. (I know this is painful because this is the exact process we followed when learning how to present new material when I was an instructor at TOPGUN. Fellow instructors played the role of students in a classroom listening to our presentation, and after getting their feedback we received feedback from our instructor on the new material, and finally, we had to watch a video tape of the whole presentation.)
What these new medical students are learning is priceless for success in the new world of health care:
Medical skill is not enough. Every clinician must know how to be an expert communicator and how to operate as part of a highly functional team.
Practicing together and exchanging feedback builds isolated individuals into an expert collaborative team.
If you don't know how to create the "culture of practice" around teamwork and communication in your organization, LifeWings can help. It's what we do, and we know it matters if you want to create a sustainable culture of safety.
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