Tag Archive for: therapeutic communication

As discussions about student mental health have resurfaced in the wake of the health crisis and amid reforms to graduate-level programs, our faculty teams have developed—in collaboration with students and service users—a one-of-a-kind educational concept. Temporarily titled “Interpersonal Skills and Therapeutic Communication,” this empathy-focused curriculum represents a true ethical and pedagogical innovation. To learn more, we spoke with the project’s leaders: Dr. Amandine Luquiens and Prof. Céline Bourgier, as well as Théo Lacoste, a student member of the steering committee.

 

The Origins of a Project Centered on Empathy

A need for evaluation arising from the R2C evaluation procedures

In 2018, the reform proposal for the second cycle of medical studies (R2C) was presented to the various academic leaders at the Faculty, prompting a response from Prof. Céline Bourgier. She noted that, under the R2C, student assessment would focus, among other things, on evaluating students’ interpersonal skills and empathy through the Certificate of Clinical Competence (C3). However, at that time, our curriculum did not include any courses entirely dedicated to developing this skill. 

Joined in 2019 by Dr. Amandine Luquiens, a psychiatrist specializing in addiction medicine at the Nîmes University Hospital, the two doctors will therefore team up to lead the project to develop an innovative teaching unit capable of meeting the requirements of R2C. Their first step is to assess the current level of empathy among medical students.

 

A striking finding: medical students’ empathy declines as they progress through their studies

Their initial findings are surprising. In fact, as they conducted their literature review, the two practitioners discovered that medical students tend to experience a decline in empathy throughout their studies. “This decline begins at the same time as hospital rotations. It appears that the gap between the ‘idealized view of the healthcare profession’ and the ‘reality of the healthcare profession’ is a triggering factor,” – explains Amandine Luquiens

Another observation: this decline is very strongly correlated with the burnout and depression that healthcare students may experience.

 

A structured educational program to halt this decline and ensure higher-quality care in the future

These findings have motivated the project leaders to create a new, innovative teaching unit (UE) with a twofold objective: 

  • To provide students with the tools and skills necessary to improve the quality of careby instilling in them a person-centered approach rather than focusing solely on symptoms or medical conditions
  • Preventing psychosocial risks—not only for patients, but also for students—future healthcare professionals.

These two complementary elements will therefore be developed jointly by a dedicated committee composed of faculty, students, and users.

 

An EU built collaboratively to foster skills related to empathy toward oneself and toward patients

Stages in the Development of the EU

Such an EU requires a period of development followed by a trial phase, which will be implemented within the Faculty in five major stages: 

  • STEP 1

    Establishment of a cross-functional steering committee

    Since this was a course developed collaboratively, the instructors were committed to creating a steering committee that included students so that the course would be tailored to their needs as much as possible. The committee is also supported by the Faculty’s Academic Council (then chaired by Prof. Denis Morin) and is composed of instructors from diverse backgrounds and specialties to ensure a comprehensive view of the project.

  • Assessment of the Current Situation and Expansion of the Steering Committee

    With the help of the academic administration staff, Amandine Luquiens and Céline Bourgier are compiling a list of the existing course units and courses within the program, focusing on the patient-physician relationship, the development of the care relationship, and interpersonal skills. This allows them to connect with the instructors teaching the existing courses and to include them on the steering committee for the new course unit.

    STEP 2

  • STEP 3

    Revision of existing courses, development of the UE

    The steering committee proposes a new structure for the existing courses over a five-year period. This involves reorganizing them into a more logical sequence, with a more gradual implementation that aligns with students’ entry into hospital internships. In addition to restructuring the existing curriculum, new courses are being proposed to round out the program, such as the therapeutic communication module, which is divided into three progressive levels and will incorporate the pre-existing theater workshop.

  • Incorporating the EU into the curriculum of a pilot class

    The 2021–22 DFGSM2 class is the pilot class and marks the launch of all EU courses over the 5-year program. In addition, a few modules are offered to DFGSM3 students to test the courses (Step 6). 

    STEP 4

  • STEP 5

    A cohort-based study of students to evaluate teaching

    To measure the impact of teaching on students, three cohorts are regularly evaluated based on criteria related to empathy, as well as well-being and their understanding of the therapeutic relationship. The DFGSM2 21-22 cohort will be compared to the DFGSM3 21-22 cohort, which will have benefited from a reduced course load, and to the DFASM1 21-22 cohort, which will not have been able to take the various EU modules.

 

An EU program designed to help students learn about emotion management

As Théo Lacoste, Student Vice-Dean for 21-22, points out, medical students are “perfectionists”: “They are selected because they are the best. And this selection process continues over the years. The need to be—or at least to appear—‘flawless’ at every level—whether professionally or emotionally—persists until it becomes an almost cultural component of our way of thinking.” 

However, it is precisely an process of acculturation on this subject that this course unit is intended to foster: Amandine Luquiens explains: “We are seeking to foster this awareness among students—and even within the Faculty as a whole. The Faculty takes care of its students, and students must take care of themselves. We will thus help them acquire tools that enable them both to protect themselves and to combat ‘emotional suppression’—a management strategy that doctors have been using for many years to address the patient-caregiver relationship.”

 PTo achieve this goal, the EU is structured around four major modules, all of which are mandatory: 

  • Introduction to Meditation Mindfulness
  • Exchange of Best Practices among peers: this module encourages open discussion and helps participants better understand professional communication within a healthcare team
  • Therapeutic Communication : a multi-year module featuring theoretical instruction on announcements, the integration of theater workshops, and simulation workshops.
  • Stigmatization in Healthcare : a module featuring user testimonials in which individuals share with students their personal experiences with situations they may have encountered during their care journey

 

In summary: an innovative initiative in more ways than one

Humanism is a core value of the Faculty. It is an integral part of its history, but it also serves as a guiding principle for its future, as evidenced by this program, which is innovative in more ways than one. Indeed, this is an ethical and pedagogical innovation

  • co-created with students, faculty, users, and administrative staff: a true example of cross-functional collaboration among the women and men of our community 
  • that focuses on a genuine social for health science students and that is addressed early enough in their academic program to address it proactively and long enough to address it in depth
  • which includes theoretical modules but also, and above all, highly practical modules, centered on a human-centered approach to the patient-caregiver relationship, particularly through simulation workshops
  • Skills Developer key skills centered on empathy and interpersonal skills: essential tools for a more humane approach to medicine
  • carrying a message for both students and their future patients

 

Opportunities for other degree programs

The introduction of this course unit into the medical curriculum inevitably raises questions about the other programs offered by the faculty (midwifery, paramedicine). “Medicine is relatively behind compared to other programs,” admits Dr. Luquiens. “Indeed, there are already course units in the other programs, but not in such a structured, phased manner. The idea, therefore, is that once this course unit has been refined, we will ‘spread’ it to the other programs, with the aim of taking a transdisciplinary approach to these skills.”