Publications by authors named "P Weissmann"

9 Publications

Communicating value to patients-a high-value care communication skills curriculum.

Postgrad Med 2021 Mar 22;133(2):231-236. Epub 2020 Aug 22.

Department of Medicine, University of Minnesota, Minneapolis, MN, USA.

Introduction: With rising health care costs in the United States, trainees will be increasingly challenged in discussing testing stewardship with patients.

Objective: We piloted a high-value care (HVC) communication skills curriculum utilizing the Four Habits Model for communication. We hoped residents would 1) learn to apply the Four Habits communication model to HVC discussions with standardized patients (SP) and 2) improve value-based communication skills through training in a high-intensity curriculum with feedback from trained faculty facilitators and peers.

Methods: Thirty interns at the University of Minnesota were randomized to a standard HVC communication SP encounter (n = 15) or a high-intensity HVC communication skills curriculum (n = 15). The high-intensity curriculum included video and audio-recorded SP encounters followed by facilitated small group discussions/feedback. Experiences were reported in a post-intervention survey; communication skills were assessed with the CARE empathy scale.

Results: 70% (21/30) of interns (57% high intensity, 43% standard) responded to the survey. In total, 88% of high intensity v. 44% of standard interns agreed/strongly agreed that the curriculum was valuable for their communication skills. High-intensity interns were more likely to report that feedback was valuable with subsequent incorporation of feedback into future patient encounters. High-intensity participants also reported higher levels of interest in future HVC curricula (55% vs 22%).

Conclusion: There was no difference in overall performance on the CARE empathy scale. Our HVC high-intensity skills curriculum was well received by interns and provided opportunities to practice structured conversations and debrief around testing stewardship.
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March 2021

A good clinician and a caring person: longitudinal faculty development and the enhancement of the human dimensions of care.

Acad Med 2009 Jan;84(1):117-25

Division of General Internal Medicine, 49 Jesse Hill Jr. Drive, Suite 446, Atlanta, GA 30303, USA.

Purpose: To successfully design and implement longitudinal faculty development programs at five medical schools, and to determine whether faculty participants were perceived to be more effective humanistic teachers.

Method: Promising teachers were chosen from volunteers to participate in groups at each of the medical schools. Between September 2004 and September 2006, the facilitators jointly designed and implemented a curriculum for enhancing humanistic teaching using previously defined learning goals that combined experiential learning of skills with reflective exploration of values. Twenty-nine participants who completed 18 months of faculty development at the five medical schools were compared with 47 controls drawn from the same schools in the final six months of the two-year project. For comparison, the authors developed a 10-item questionnaire, the Humanistic Teaching Practices Effectiveness Questionnaire (HTPE), to be filled out by medical students and residents taught by participants or control faculty. Items were designed to measure previously identified themes and domains of humanism. Control faculty were similar to participants by gender, specialty, and years of experience.

Results: Thirty-four (75%) of the original 45 enrollees completed the programs at the five schools. Faculty participants outperformed their peer controls on all 10 items of the HTPE questionnaire. Results were statistically significant (P < .05) and sufficiently robust (8%-13% differences) to suggest practical importance.

Conclusions: A longitudinal faculty development process that combines experiential learning of skills and reflective exploration of values in the setting of a supportive group process was successfully accomplished and had a positive impact on participants' humanistic teaching.
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January 2009

Caring attitudes in medical education: perceptions of deans and curriculum leaders.

J Gen Intern Med 2007 Nov 5;22(11):1514-22. Epub 2007 Sep 5.

Harvard Medical School, Boston, MA, USA.

Background: Systems of undergraduate medical education and patient care can create barriers to fostering caring attitudes.

Objective: The aim of this study is to survey associate deans and curriculum leaders about teaching and assessment of caring attitudes in their medical schools.

Participants: The participants of this study include 134 leaders of medical education in the USA and Canada.

Methods: We developed a survey with 26 quantitative questions and 1 open-ended question. In September to October 2005, the Association of American Medical Colleges distributed it electronically to curricular leaders. We used descriptive statistics to analyze quantitative data, and the constant comparison technique for qualitative analysis.

Results: We received 73 responses from 134 medical schools. Most respondents believed that their schools strongly emphasized caring attitudes. At the same time, 35% thought caring attitudes were emphasized less than scientific knowledge. Frequently used methods to teach caring attitudes included small-group discussion and didactics in the preclinical years, role modeling and mentoring in the clinical years, and skills training with feedback throughout all years. Barriers to fostering caring attitudes included time and productivity pressures and lack of faculty development. Respondents with supportive learning environments were more likely to screen applicants' caring attitudes, encourage collaborative learning, give humanism awards to faculty, and provide faculty development that emphasized teaching of caring attitudes.

Conclusions: The majority of educational leaders value caring attitudes, but overall, educational systems inconsistently foster them. Schools may facilitate caring learning environments by providing faculty development and support, by assessing students and applicants for caring attitudes, and by encouraging collaboration.
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November 2007

Teaching Advanced Interviewing Skills to Residents: A Curriculum for Institutions with Limited Resources.

Med Educ Online 2006 Dec;11(1):4584

a University of Minnesota Medical School Department of Medicine P7 Hennepin County Medical Center Minneapolis , MN USA.

Residency program directors currently face new requirements from the Accreditation Council for Graduate Medical Education (ACGME), including the mandate to demonstrate their residents' proficiency in communication skills. Such skills can be improved through an educational intervention, but few residencies specifically offer formal instruction in communication. Furthermore, the only formal instruction in communication skills described thus far for internal medicine residents requires hundreds of hours per month of faculty and resident time. This paper describes a time-efficient seminar series in communication skills for first-year internal medicine residents, which has been received well by faculty and learners as evidenced by post-seminar surveys and focus groups.
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December 2006

Role modeling humanistic behavior: learning bedside manner from the experts.

Acad Med 2006 Jul;81(7):661-7

Department of Medicine, Hennepin County Medical Center, University of Minnesota Medical School--Twin Cities, Minneapolis, Minnesota 55415, USA.

Purpose: Humanistic care is regarded as important by patients and professional accrediting agencies, but little is known about how attitudes and behaviors in this domain are taught in clinical settings. To answer this question, the authors studied how excellent clinical teachers impart the behaviors and attitudes consistent with humanistic care to their learners.

Method: Using an observational, qualitative methodology, the authors studied 12 clinical faculty identified by the medical residents enrolled from 2003 to 2004 as excellent teachers of humanistic care on the inpatient medical services at four medical universities in the United States (University of Minnesota Medical School, Emory University, University of Rochester School of Medicine, and Baylor College of Medicine). Observations were conducted by the authors using standardized field notes. After each encounter, the authors debriefed patients, learners (residents and medical students), and the teaching physicians in semistructured interviews.

Results: Clinical teachers taught primarily by role modeling. Although they were highly aware of their significance as role models, they did not typically address the human dimensions of care overtly. Despite the common themes of role modeling identified, each clinical teacher exhibited unique teaching strategies. These clinical teachers identified self-reflection as the primary method by which they developed and refined their teaching strategies.

Conclusions: Role modeling is the primary method by which excellent clinical teachers try to teach medical residents humanistic aspects of medical care. Although clinical teachers develop unique teaching styles and strategies, common themes are shared and could be used for the future development of clinical faculty.
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July 2006