RP201 – Session 2: Perspective (Feb 2018)



Session Readings

 

Perspective


Background:

“The years teach us much the days never knew.” –Ralph Waldo Emerson

Welcome back! During RP101 (Contextual Thinking), we identified personal context as the interwoven fabric of one’s unique and diverse life experiences. This fabric can be thought of as a quilt to which we add pieces throughout our lives – some big, others small. The pieces we add include our experiences growing up; our perceptions of family, societal and cultural norms; and our experiences during our adult lives, including those during medical school. Just as each one of us has our own unique personal context, so too do we each have our own unique reactions to situations we encounter. These reactions are neither right nor wrong, they simply are. That said, the ability to be aware of such reactions, how they impact the way we think, and how they affect the way we act, is critical.

In RP201 (Thinking on Action), we are afforded the time to pause and reflect on our experiences during the clerkship year. Such reflection includes examining how our experiences have impacted our personal context, and thereby our perspective.  While our personal context evolves throughout our lives, for many physicians, the time between the beginning of clerkship and the end of residency is one in which changes in our personal context are the most dynamic, and the most easy to identify.

With this in mind, the first RP201 session is dedicated to reflecting on your experiences during clerkship year that significantly impacted your personal context and your perspective.  Examining these experiences and their impact is designed to help you:

  • Examine your reactions and actions over the past year in your role as a clerkship student
  • Identify specific ways in which your personal context and perspective has changed over the past year
  • Recognize that just as your personal context and perspective are dynamic, so are those of your patients
  • Recognize that given the fact that our patients’ perspectives are dynamic, applying monolithic labels to them puts us at risk of making errors when trying to diagnose, treat, and offer prognoses to our patients.

It is our hope that this session will offer you personal insight; enhance your compassion and ability to effectively care for others; and offer strategies for decreasing the risk of burnout and enhancing resilience.


Assignment – Reflective Essay – No specified format
Please submit papers in Sakai under the Assignments Tab; email in header; last name in file name

Review your reflective essays from RP101 (previously Human Context in Healthcare) pre-clerkship curriculum and reflect on patient encounters during your clerkship years. Identify clinical experiences in which your actual reactions and/or the implications of your reactions differed from those you had anticipated during the pre-clerkship period. In your essay:

  1. Identify and describe patient interactions during your clerkship rotations that (1) relate to topics discussed in RP101 and (2) in which your reactions and/or the implications of your reactions differed from what you had anticipated during pre-clerkship.  Set the stage so the reader can understand the context for these encounters. Be specific. As a reminder, sessions in RP101 included Illness&Disability, Dying&Death, Uncertainty, Obesity, Sexuality, and/or Mistakes.
  2. Describe in what ways this change in perspective did and did not surprise you. Have you experienced similar changes in perspective in the past? If so, how do you perceive this change in perspective to be similar and/or different from those you have experienced one you described?
  3. Examine the impact that your new perspective had on the way you interacted with/cared for this and other patients with whom you interacted during your clerkship year.
  4. Writing this paper will bring into sharp relief the reality that our personal context is dynamic, and that our own perspective can change (sometimes in subtle but important ways). This realization usually impacts the way we perceive others.  With this in mind, analyze how your change in perspective impacted the way you perceived your patient.  After this interaction, did you find that you were any more or less charitable and empathetic towards others?
  5. Last, in what ways has your reflecting on your change in perspective impacted your view of the value (or lack thereof) of introspection and self-awareness as a physician?

Objectives:

By the end of the small group session on “Perspective”, students will demonstrate the ability to:

  1. Review the reflective essays (RSIP papers) they wrote during the RP101/Human Context in Healthcare pre-clinical curriculum and reflect on patient encounters during their clerkship years.
  2. Identify situations in which their reactions and/or the implications of their reactions for patient care were dissimilar from anticipated.
  3. Examine personal experiences between the time they wrote their RP101/HCHC paper and the end of core clerkships that impacted their personal context and contributed to the change in perspective they identified in #2 above.
  4. Reflect on the implications of being aware that one’s perspective can change, including how this awareness might impact their approach to interactions with patients, their families, and other members of the medical healthcare team in the future.
downloadHow We See Ourselves, How We See Others by Emily Pronin Does our ability to know our own volition give us accurate insight into the volition of others? This article argues that the answer is a definitive "No".
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New York TimesWhen Doctors Become Patients by Eric D. Manheimer Few experiences have a greater impact on the perspective of healthcare providers than being in the patient role.
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YouTubeA First Person Narrative of the Challenges of Homelessness by Ronald Davis Do we respect our fellow human beings? This narrative by Ronald Davis, who has been homeless for the past 2 years, demonstrates that all too often the answer is no.
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New York TimesDoctor Priorities vs. Patient Priorities by Danielle Ofri Doctors and patients can have contrasting agendas, viewed through different lenses. The key is not trying to change someone else’s lens, but rather, appreciating the value of their perspective.
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Positive ExposureBeauty is in the Eye of the Beholder by Dr. Nancy Snyderman Photographer Rick Guidotti is a renowned fashion photographer who has worked in Milan, Paris and New York. Fifteen years ago, he saw the images of patients in medical textbooks and the experience changed his life.
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Session originally created by: Adam Saperstein | SOM/GSN, Uniformed Services University | Director, Reflective Practice | Family Medicine