Supported by a Grant from the Donald W. Reynolds Foundation

Clinical Care from the Patient Perspective (CCPP) Experience

Lisa M. Gibbs, MD

Supported by a grant from the Donald W. Reynolds Foundation

Clinical Care from the Patient Perspective (CCPP) Experience

Notes to Instructors:

Introduction:

The CCPP is a learning exercise for medical students designed to promote awareness of the patient’s experience during an ambulatory patient visit. The medical student will step out of the physician-learner role and view the interaction from the patient’s perspective. The rationale behind this exercise is to develop an understanding of patients’ stated and unstated needs during a given encounter. This experience is designed to cultivate empathy in learners by assuming an advocacy role for the patient. The objectives are as follows:

1. To provide a reflective exercise in patient-physician communication, health literacy and medical decision making.
2. To engender empathy for patients.
3. To appreciate the role of the Medical Assistant as a part of the medical team, noting that the Assistant has valuable information to share as a result of the ‘rooming process.’
4. Since learners observe their attending’s patient visits, learners will appreciate that even experienced clinicians have a variety of clinical outcomes.

Notes for Instructors and Students

Methods:

1. Each learner will pair with the Medical Assistant who is working with their physician attending. The learner will follow the MA once to observe process and techniques of preparing patients for the visit.
2. The physician will then identify an appropriate patient for the learner to assume the MA/advocate role. Once identified, the student should be aware of the patient in the waiting area.
3. When a room is ready and the medical assistant is available to observe, the learner will greet the patient, obtain the vital signs, escort them to the room and elicit their chief complaint.
4. While the learner waits for the provider with the patient, he/she will then discuss the questions below with their patient.
5. Once the physician or provider enters, they will assume an observer role, knowing what the patient’s needs are, and taking note of the patient-physician interaction. After the visit has concluded, the student will continue to observe the discharge process, noting areas where patients need additional assistance in making appointments, and following up on physician instructions.

Assignment Questions:

1. What was your patient’s general demeanor and comfort level in the reception area? (Communication)

1. Patient’s hesitancies and hopes for their visit are apparent even before the formal encounter with their physician. Did they start to express this as you obtained their vital signs and roomed them? (Communication)

1. What was the wait like for them? Did it eventually help or hinder the patient-physician encounter? (Empathy)

1. What were your patient’s hopes for the visit? (Note that it may be completely different from their chief complaint. Physicians learn to balance their own agenda for patient care with the patients’ needs. ) (Empathy)

1. Was the medical subject matter discussed in a way that your patient understood the content? (Health Literacy)

1. If treatment decisions were made, how would you describe the decision making process? (Medical decision-making) Were the decisions shared between the physician and patient or unilateral decisions? Was this process helpful for your patient?

1. After the visit: Were your patient’s questions answered? Were some left unanswered? Why? If un-answered, was your patient frustrated? (Communication)

1. Did your patient/family understand the discharge process-how to make an appointment and act upon referrals? (Health Literacy)

1. After experiencing this patient-physician interaction from the patient’s perspective, please discuss what you learned.

Please prepare a written summary of your answers to the above questions and be prepared to discuss them during the Wrap-Up session at the conclusion of your Geriatric Medicine rotation.

Clinical Care from the Patient Perspective (CCPP) Experience Presentation

Notes: