Teaching the psychosocial aspects of care in the clinical setting: practical recommendations. Acad Med 2005 Jan;80(1):8-20
Date
12/25/2004Pubmed ID
15618086DOI
10.1097/00001888-200501000-00006Scopus ID
2-s2.0-11344294293 (requires institutional sign-in at Scopus site) 57 CitationsAbstract
Communication skills and the psychosocial dimensions of patient care are increasingly taught in medical schools and generalist residency programs. Evidence suggests they are not reinforced or optimally implemented in clinical training. The authors present the product of an iterative process that was part of a national faculty development program and involved both experts and generalist teachers concerning teaching psychosocial medicine while precepting medical students and residents in clinical settings. Using scientific evidence, educational theory, and experience, the authors developed recommendations, presented them in workshops, and revised them based on input from other experts and teachers, who gave feedback and added suggestions. The results are practical, expert consensus recommendations for clinical preceptors on how to teach and reinforce learning in this area. General skills to use in preparing the trainee for improved psychosocial care are organized into the mnemonic "CAARE MORE": Connect personally with the trainee; Ask psychosocial questions and Assess the trainee's knowledge/attitudes/skills/behaviors; Role model desired attitudes/skills/behaviors; create a safe, supportive, enjoyable learning Environment; formulate specific Management strategies regarding psychosocial issues; Observe the trainee's affect and behavior; Reflect and provide feedback on doctor-patient and preceptor-trainee interactions; and provide Educational resources and best Evidence. The preceptor-trainee teaching skills that are recommended parallel good doctor-patient interaction skills. They can be used during both preceptor-trainee and preceptor-trainee-patient encounters. Important common psychosocial situations that need to be managed in patients include substance abuse, depression, anxiety, somatoform disorder, physical and sexual abuse, and posttraumatic stress disorder. For these problems, where high-level evidence exists, specific psychosocial questions for screening and case finding are provided.
Author List
Kern DE, Branch WT Jr, Jackson JL, Brady DW, Feldman MD, Levinson W, Lipkin M Jr, General Internal Medicine Generalist Educational Leadership GroupAuthor
Jeffrey L. Jackson MD Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Clinical MedicineEducation, Medical
Humanism
Humans
Mental Disorders
Physician-Patient Relations
Psychology, Social
