Palliative and Supportive Care

Review Articles

Recognition, reflection, and role models: Critical elements in education about care in medicine

Anna L. Janssena1 c1, Roderick D. MacLeoda2a3 and Simon T. Walkera4

a1 Faculty Education Unit, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand

a2 District Palliative Care Medical Director, Waitemata District Health Board, Auckland, New Zealand

a3 Department of General and Primary Health Care, University of Auckland, Auckland, New Zealand

a4 Bio-Ethics Centre, Dunedin School of Medicine, University of Otago, Otago, New Zealand

ABSTRACT

Objective: Medical education can be described as a socialization process that has a tendency to produce doctors who struggle to convey to patients that they care. Yet, for people who are suffering, to enjoy the quality of life they are entitled to, it is important that they feel cared for as people, rather than simply attended to as patients.

Method: This article addresses how we teach medical students the art of caring for the person rather than simply treating the disease—a question particularly relevant to end-of-life care where, in addition to the physical needs, attention to the psychosocial, emotional, and spiritual needs of the patient is paramount. Following an overview of what it is to care and why it is important that patients feel cared for, we investigate how we learn to care and develop caring human relationships, describing the development and display of empathy in adulthood and the developmental impact of human interaction.

Results: We outline evidence of situational barriers to effective education about care in medicine including role models, ward culture, and the socialization process.

Significance of results: We then propose a model for medical education based on patient contact, reflection, self-care, role model development, and feedback that will see students learn the art of human care as well as the science of disease management.

(Received May 01 2007)

(Accepted August 17 2007)

Correspondence:

c1 Address correspondence and reprint requests to: Anna Janssen, Faculty Education Unit, Faculty of Medical and Health Sciences, University of Auckland, 151 Park Road, Grafton, PO Box 92019, Auckland, New Zealand. E-mail: a.janssen@auckland.ac.nz