Authors: Isaac Alty; Luis Guilherme Cardoso; Michael Kochis, EdM; Ashwini Joshi

Editor: Wesley Chou, Andrew Foley, MPH, and Joyce Zhou​

Reviewers: Kate Treadway, MD; Katie Greenzang, MD, EdM; Andrea Wershof Schwartz, MD, MPH; Jocelyn Streid, MPP; Aliya Feroe; Catherine Mankiw

Introduction

As physicians, we must master not only the science of medicine but also the art. Module 4 discusses how the pandemic is a tremendous psychological trauma for all of society: While not everyone will become infected with SARS-CoV-19, in the setting of a pandemic, everyone is a patient. The art of medicine involves bringing that recognition to our encounters with friends and family, as well as to patients in a direct clinical setting. Furthermore, physical distancing measures impose new realities on what interactions can look like. Adapting to these changes presents the perfect opportunity to review the communication skills that will serve us well in this uncertain time.

Additionally, there is a renewed sense of urgency surrounding conversations on advance care planning (ACP), given the disproportionate burden of COVID-19 on the elderly and those with serious illness. While medical students may not necessarily spearhead these challenging conversations, they can play a critical role in prompting busy care teams to discuss ACP with patients. Thus, familiarizing themselves with what ACP entails and frameworks for approaching it are certainly relevant to every medical student’s education.

We’ve now discussed Brian and Diane in the context of their medical and mental health risk and why our community benefits from all of us practicing physical distancing. But knowing the facts is only a small part of effective engagement. In this module, we pivot to developing concrete tools that can help us communicate effectively with individuals like Brian and Diane.

Think of the people in your own life who may be struggling in similar ways to Brian and Diane. What makes communicating with them challenging, and how may you try to understand or support them differently?

Learning Objectives

At the end of this module, medical students should be able to:

• Compare and contrast 2 different responses individuals may have to the pandemic

• Revisit 3 key conceptual frameworks for communication skills

• Recognize the tool that would be most appropriate for a given situation

• Rehearse potentially difficult situations with patients pertaining to bad news, misinformation, and advanced care planning.

Core Materials

• Stone, Patton, and Heen, “Difficult Conversations,” Introduction and Chapter 1.

• VitalTalk, COVID-ready communication skills.

• Recommended Activity: Tamerius and Campt, “Your Angry Uncle Wants to Talk About Politics. What Do You Do?” New York Times Opinion.

• Infographic: COVID-19: What you need to know: a 1-page guide​

• Twitter: @FutureMDvsCOVID​

• Instagram: futuremdvscovid​

• Facebook: Future MD VS COVID​