Difficult conversations in health care: Cultivating relational learning to address the hidden curriculum

被引:133
作者
Browning, David M.
Meyer, Elaine C.
Truog, Robert D.
Solomon, Mildred Z.
机构
[1] Childrens Hosp Boston, Inst Prof & Eth Practice, Boston, MA 02215 USA
[2] Educ Dev Ctr Inc, Newton, MA USA
[3] Harvard Univ, Sch Med, Dept Psychiat, Boston, MA 02115 USA
[4] Harvard Univ, Sch Med, Dept Social Med & Anaesthesia, Boston, MA 02115 USA
关键词
D O I
10.1097/ACM.0b013e31812f77b9
中图分类号
G40 [教育学];
学科分类号
040101 ; 120403 ;
摘要
The authors describe the philosophy and pedagogical approach of an innovative educational program, grounded in principles of relational learning and designed to improve the preparedness of health care professionals for engaging in challenging conversations with patients and families. The Program to Enhance Relational and Communication Skills (PERCS) is a project of The Institute for Professionalism and Ethical Practice at Children's Hospital Boston, developed in collaboration with Education Development Center, Inc. The one-day workshop is interdisciplinary in its structure, includes practitioners with varying levels of professional experience, uses trained actors to portray patients and family members, and involves learners in improvised case scenarios. The program responds to several developments in contemporary health care: medical education reform, changing definitions of professional competence, and calls for greater attention to qualities of compassion, trust, and respect in practitioners' relationships with patients and families. The program's pedagogy responds to these developments by creating a safe climate for relational learning, by enacting emotionally challenging and ethically salient case scenarios, and by integrating patient and family perspectives in novel and substantive ways. By creating a curriculum and learning environment that explicitly embraces the moral experience of learners, the program's developers aim to exert a countercultural influence on the dehumanizing effects of the hidden curriculum.
引用
收藏
页码:905 / 913
页数:9
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