Beyond Medical Histories: Insight from Patient Stories mooc

Course: Beyond Medical Histories: Gaining Insight from Patient Stories
Length: 3 weeks, 2-3 hrs/wk
School/platform: Brown/edX
Instructor: Jay Baruch, MD
Quote:

Physicians and healthcare providers are – fundamentally – professional story-listeners, story-shapers, and story-responders. This shouldn’t come as a surprise; people have always related to each other and the world through the telling, listening, and interpreting of stories.

Expertise with stories is a low-tech skill that’s fundamental to connection, communication, curiosity, and problem-solving. It’s a clinical ability with multiple potential benefits, ranging from making us more mindful of our thinking to improving patient engagement. Aptitude with stories can both expand our tolerance for uncertainty and reduce risk.
We’ll focus on stories – challenging stories, in particular. We’ll discuss why healthcare providers must think more creatively, even in a field that prides itself on its grounding in scientific evidence.

Any course that starts with an Amy Hempel story has real promise.

I love medical stuff, and obviously I like stories, so this sounded like a win-win: using techniques from storytelling to better understand a patiet’s presentation. It’s primarily intended for medical practitioners, particularly those in training, but everyone was explicitly welcomed.

It’s a short course, three weeks (there is a Week 0, for purposes of getting used to the edX platform, but there’s no content). There’s very little solid content; it’s mostly open response to acted-out scenarios and discussions of the issues raised. Ostensibly the weeks had different foci, but I found it all to boil down to: keep an eye on your assumptions, notice when you’re being triggered by a difficult patient, and think about what isn’t being said as well as what is being said. The instructors were mostly emergency room physicians, a setting that often requires action when there isn’t a lot of time to gather a great deal of data.

Grading is purely self-reported: did you submit an answer to a survey question? Did you post on this topic? My main struggle with the course was remembering to click the checkboxes, since I normally don’t scroll down that far.

The acted-out scenarios in W1 and 2 were dramatic as conflicts arose between patients and staff, patients and their families, families and staff. I very much liked the Week 3 exercise, in which an abstract painting was the focus: what story do you see in the painting? Look at the negative space (I had trouble with this; I didn’t see any negative space). Map one of the patient scenarios to the painting in a way that makes sense to you.

My own assumptions, and background, got in the way at times. I have a rather uncomfortable relationship with healthcare for a lot of reasons. I was hoping to find some way to become more effective at conveying my concerns, but the course focused exclusively on the other side of the picture, on receiving a story.

My main thought was: I wonder how possible any of this approach is in the current healthcare system, which focuses on efficiency and cost-effectiveness. Insurance companies and accountants have reduced primary care physicians to something like data entry clerks, and socioeconomic factors more than medical factors impact patient decisions.

I would look at this more as an in-service training unit rather than a course. Still, it was interesting, and worth the time required.

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