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Release: Immediate

UI College of Medicine stresses humanism to its students

IOWA CITY, Iowa -- The University of Iowa College of Medicine has been changing the way medical students think about their studies, their patients and themselves.

Learning to mend broken bones or recognize symptoms of illness have always been part of the medical school curriculum. Medical education often focuses on teaching students to diagnose and treat illness but students also must learn to consider their patients, whose needs may extend beyond physical relief from ailments.

Attuned to these concerns, the college broadened the scope of its curriculum and fostered new programs to highlight the importance of a humanistic approach to medical practice. Changes to the medical curriculum, which began in the 1995-96 academic year, included Foundations of Clinical Practice, a course for the students' first two years of medical school. The course helps students go beyond developing analytical skills to become responsible, caring and compassionate physicians. Topics include biomedical ethics, problem-based learning, behavioral medicine, human sexuality, patient communication skills and continuity of care.

In partnership with the Arnold P. Gold Foundation, the college implemented a White Coat Ceremony three years ago for first-year medical students to emphasize caring in health care, and to stress the significance of the doctor-patient relationship. The hope is that students will regard patient care as more than just a matter of technical skill.

For the past two years the college has held an Orientation to Clinical Courses and Skills program in June. This was designed to introduce third-year medical students to their clinical studies, which involve less time in the classroom and more time learning in patient care settings. Throughout the week, organizers, including a committee of student volunteers, introduced humanistic topics related to what students will face in their final two years. With support from the Gold Foundation, this year's program included a Clinical Beginnings ceremony and luncheon at the end of the weeklong program, which formally recognized the medical class of 2000.

Third-year medical student Anji Newell was one of the members of the planning committee for this year's program. She volunteered because of the significance of the transition in her own medical education and the overall message of the program itself. "I think it is important to recognize various milestones on our journey to become competent, caring physicians," Newell said. "I welcomed the opportunity to be involved in a project that acknowledges the commitment of medical professionals to provide humanistic, holistic, patient-centered care."

End-of-life issues was one of the topics the committee chose to cover during the orientation week this year. Kirk Payne, M.D., UI associate in internal medicine and biomedical ethics, developed the palliative care aspect of the program, titled Death and the Dying Patient. Hospice nurses, social workers, physicians and patients gathered to share their experiences with students. In one instance, author Evan Handler spoke about his experiences as a leukemia patient, which are chronicled in his book "Time on Fire." Handler provided a patient's perspective on the physician's impact on care, and how patients perceive the care they are given.

Another presentation, The View from the Other Side of the Examination Table, offered viewpoints from doctors who have been patients. Jerold C. Woodhead, M.D., UI associate professor of pediatrics and faculty advisor for the orientation program, said the presentation helped students because "the doctor who has been sick himself or herself can more effectively say, 'Hey, this really had an impact on me' or 'This changed the way I viewed my medical practice.'"

The Project Art program at the UI Hospitals and Clinics also contributed to the week's events with the presentation, The Artist as Witness to Illness and Recovery. Project Art director Mark Towner spoke about patients who are able to cope with illness and express their feelings through artistic expression. Project Art "added another dimension to our students' ability to see how patients perceive their illnesses and the people involved in their health care," Woodhead said.

The issues raised during the orientation week continue as an important aspect of education throughout the academic year. Students are responsible for ongoing assignments that reflect the seminars, lectures and small group activities that make up the orientation week.

At the Clinical Beginnings ceremony and luncheon, students and faculty recognized those who serve as role models for incorporating humanism into medical practice. The class of 2000 honored George V. Lawry, M.D., UI associate professor of internal medicine, for his teaching contributions. Six medical residents at the UIHC were chosen for honors by the class of 1999. Bonnie Ranson, M.D.; Daniel Ellsbury, M.D.; David Coppola, M.D.; Adil Husain, M.D.; Mary Tjarks, M.D.; and Sarah Cada. M.D., were recognized as advocates of humanism in medicine.

For Ellsbury, the award affirmed his own work and his attitudes toward medical practice in general. "I felt honored to receive this award," he said. "As a parent of a child with multiple disabilities, I've seen things from the receiving end of medicine. I have always hoped to be the kind of physician that I would have wanted for my son, and have endeavored through teaching to pass these insights on to students. This award gives me confirmation that I have, to some degree, accomplished these goals."

Ellsbury praised the orientation program as a guide for students making the difficult third-year transition from the classroom to the clinic. "Bad habits learned at this stage can quickly become permanent. This program is an excellent way to guide students through this difficult transition and direct them on the path to being a good doctor," he said.

The Arnold P. Gold Foundation is a non-profit organization dedicated to finding creative and innovative ways of encouraging compassion in medical practice and research. The UI was one of only five medical colleges across the country chosen by the foundation to develop a program celebrating the beginning of students' clinical years.