MMI Question -Opinion

[FinalShowtime]

Hey!

 

Quick question for the MMI:

 

Say you have to cope with a situation in which someone is sad/depressive/crying at some point in a scenario. Is it better to:

 

a) Pause and wait a bit before trying to comfort the actor

Start immediately to start to comfort the actor

 

And is it better to be ambitious or more conservative in terms of when you are trying to help someone:

 

Ex: You have to announce person A that he/she has cancer. Do you go and be like: Trust me I will do everything in my power to help you out or do you go like ''you are in a bad situation but it could be worst blablabla...''?

[Applemanv3]

Hey!

 

Quick question for the MMI:

 

Say you have to cope with a situation in which someone is sad/depressive/crying at some point in a scenario. Is it better to:

 

a) Pause and wait a bit before trying to comfort the actor

Start immediately to start to comfort the actor

 

And is it better to be ambitious or more conservative in terms of when you are trying to help someone:

 

Ex: You have to announce person A that he/she has cancer. Do you go and be like: Trust me I will do everything in my power to help you out or do you go like ''you are in a bad situation but it could be worst blablabla...''?

Something we learned in our interprofessional collaboration classes was the PEARLS model of communication. Partner, Empathize, Apologize, Respect, Legitimize, and Support.

 

In the scenario above, you would:

1. Take a deep breath ma'am/sir. I'm here to help! (Partner)

2. I know (or I can understand) how difficult this must be for you. (Empathize)

3. I'm so sorry you have to go through this. (Apologize)

4. I'm only here to help, so you can feel free to share as much or as little as you want. I will see what I can do to assist you. (Respect)

5. Ma'am/Sir, anyone in your position would be right to feel upset/hurt/angry. This is only natural. (Legitimize)

6. How can I be of any assistance? (Support)

 

"The AAPP suggests the

mnemonic PEARLS for this relationship-building aspect

of the medical interview: Partnership, acknowledges that

the physician and the patient are in this together; Empathy,

expresses understanding to the patient; Apology, acknowledges

that the physician is sorry the patient had to wait,

that a laboratory test had to be repeated, etc; Respect,

acknowledges the patient’s suffering, difficulties, etc; Legitimization,

acknowledges that many patients are angry,

frustrated, depressed, etc; Support, acknowledges that the

physician will not abandon the patient."

http://www.mayoclinicproceedings.com/content/78/2/211.full.pdf+html

[FinalShowtime]

This was an awesome quick response. Thank you for sharing. If I get interviewed, I will follow this model .

 

Something we learned in our interprofessional collaboration classes was the PEARLS model of communication. Partner, Empathize, Apologize, Respect, Legitimize, and Support.

 

In the scenario above, you would:

1. Take a deep breath ma'am/sir. I'm here to help! (Partner)

2. I know (or I can understand) how difficult this must be for you. (Empathize)

3. I'm so sorry you have to go through this. (Apologize)

4. I'm only here to help, so you can feel free to share as much or as little as you want. I will see what I can do to assist you. (Respect)

5. Ma'am/Sir, anyone in your position would be right to feel upset/hurt/angry. This is only natural. (Legitimize)

6. How can I be of any assistance? (Support)

 

"The AAPP suggests the

mnemonic PEARLS for this relationship-building aspect

of the medical interview: Partnership, acknowledges that

the physician and the patient are in this together; Empathy,

expresses understanding to the patient; Apology, acknowledges

that the physician is sorry the patient had to wait,

that a laboratory test had to be repeated, etc; Respect,

acknowledges the patient’s suffering, difficulties, etc; Legitimization,

acknowledges that many patients are angry,

frustrated, depressed, etc; Support, acknowledges that the

physician will not abandon the patient."

http://www.mayoclinicproceedings.com/content/78/2/211.full.pdf+html

[igeorgex]

when following models of communication, just keep in mind that you don't want to sound robotic also.. patients can tell if empathy is being faked and if you're not sincere it could really backfire on you. adapt a model to your own comfort and style and let the conversation flow naturally. like, if they are sharing their situation with you, you don't want to just keep on legitimizing or offering your support without expanding on what they're talking about.

 

remember, in an MMI nobody is expecting you to be a master of communications. you will have many, many opportunities to practice that within any professional program best of luck!

[EoE]

I would say introduce yourself and then let them lead the conversation.

 

I try to be as ambitious as possible (but still realistic) since I don't have to follow up on my promises (I would follow up in real life of course, but this is MMI). For example if pretending to be a doctor: "I will do absolutely everything I can to help you." "Call the office anytime or just drop by if you think you need to be seen, I will make the time to see you."

 

One quick tip is to mirror the patient-actor's feelings. If they are sad, treat the situation as sad. If they make light of the situation, it is okay for you to smile and laugh, although you will want to keep it toned down. Sympathizing in this way fosters trust and a connection with the person.

 

I feel kind of dirty for having tricks to sympathize with people...

[psychoswim]

I don't think I'd really start thinking about MMIs almost a year in advance.. I only talked a bit about it with a friend finishing premed the week before, less stress that way. Also, I'd just suggest going with your instinct at the time, doing what you would normally be tempted to do or would want to do, because "cheating" your reaction shows.

[Applemanv3]

I agree with the other comments made here. You do not want to overthink or sound robotic.

 

However, having a solid grasp on the more widely accepted communication models can only help if you apply them with common sense and a sense of genuine caring.

 

I have been on the judging side of MMIs 2 years in a row and so trust me, it will make a difference if you are able to hit particular traits or approaches.

[funnyboy6]

when following models of communication, just keep in mind that you don't want to sound robotic also.. patients can tell if empathy is being faked and if you're not sincere it could really backfire on you. adapt a model to your own comfort and style and let the conversation flow naturally. like, if they are sharing their situation with you, you don't want to just keep on legitimizing or offering your support without expanding on what they're talking about.

 

remember, in an MMI nobody is expecting you to be a master of communications. you will have many, many opportunities to practice that within any professional program best of luck!

 

I guess the whole difficulty/challenge of being a good communicator is you want to be empathetic and support the person, but you have to balance it with the intellectual/professional duties of a physician (eg, talking about next steps)

[hking03]

I would like to add something to the "empathize" part. If the person in the scenario has cancer (or anything similar), I wouldn't say "I understand how you feel" unless I had cancer at some point in my life (in my opinion, you can't truly understand how they feel if you didn't go through something similar). I would go with something like "It must be difficult for you" etc. Worked for me.

 

good point. this is something that was brought up in my training as a supervisor at a call centre. people don't want you to talk about how you know how it feels. unless you've been there you've got to avoid that kind of talk.