Original Publication
Open Access

Caring for Challenging Patients Workshop

Published: February 13, 2014 | 10.15766/mep_2374-8265.9701

Included in this publication:

  • Evaluation Instrument-CCPW.doc
  • Facilitator Guide-CCPW Family Planning.doc
  • Facilitator Guide-CCPW Jail Health Service.doc
  • How to Facilitate a CPPW (Optional Slides for Self-Learning).pptx
  • Instructor's Guide-CCPW.docx
  • Learner Handout-CCPW Family Planning.doc
  • Learner Handout-CCPW Jail Health Service.doc

To view all publication components, extract (i.e., unzip) them from the downloaded .zip file.


Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.

Abstract

The Caring for Challenging Patients Workshop consists of two components: In the first section, students are asked to describe specific patient interactions in which they felt “their buttons pushed” by patients. They are asked to focus on patient scenarios in which the patients’ behaviors made them feel anger, frustration, or annoyance, feelings that students are not often encouraged to discuss. After a discussion, the group reviews strategies for managing those reactions so they do not interfere with the patient-physician relationship. These strategies include describing and exploring their feelings (self-awareness), exploring why the patient might be behaving in a particular way (empathy), understanding that the patient is having a hard time (compassion), accepting that s/he is in their care, and exploring how they can care for him/her professionally while caring for themselves. In the second section, specific cases are reviewed that often cause students and physicians to react with strong feelings. While the included materials have been adapted to focus on either family planning-specific cases or cases in a jail setting, this workshop can be modified to include other subject areas. Since 2008 the workshop has been integrated into the UCSF third-year student ob-gyn core clerkship to teach self-awareness, empathy, and compassion, with the ultimate goal of improving professionalism. The Caring for Challenging Patients curriculum has also been used to train clinicians, nursing and medical students, residents, fellows and faculty in a variety of global settings.

This curriculum has been used to train clinicians, nursing and medical students, residents, fellows, and faculty in a variety of global settings. Over 40 faculty in the US have been trained to facilitate the workshop. Since 2008 the workshop has been integrated into the UCSF third-year student ob-gyn core clerkship to teach self-awareness, empathy, and compassion, with the ultimate goal of improving professionalism. During that time the students have consistently given it positive reviews in routine course evaluation. In addition, early in the development of the workshop a qualitative evaluation was done through interviews of 16 students. The students reported that the workshop met the intended objectives; they especially valued the opportunity for reflection and to strategize about ways to find empathy for patients. (Manuscript in preparation) This workshop was created for use in family planning training for medical students and residents; however, the framework can be modified for use in a wide range of settings.

Nursing Values Clarification – The Kenneth J. Ryan Residency Training Program in Abortion and Family Planning has modified this session for nurses to discuss feelings about abortions.
Longitudinal integrated clerkship – The Caring for Challenging Patients Workshop has also been modified for integration into a longitudinal, integrated clerkship based at San Francisco General Hospital, an urban hospital affiliated with UCSF. Students participated in groups of 10-15 in three sessions of the workshop, held monthly over the course of their 6 month clerkship.
Jail rotation – Dr. Carolyn Sufrin has modified the cases for use in a rotation for ob-gyn residents at the San Francisco County Jail to address their judgmental feelings about incarcerated women. Her module is included in the materials.

Educational Objectives

  1. To provide an opportunity for learners to reflect on their own feelings and values about challenging patients and discuss patient interactions that might make them feel uncomfortable.
  2. To use this awareness to identify strategies for maintaining a therapeutic relationship with patients who make decisions about health care with which the provider may disagree.
  3. To understand the potential for a judgmental reaction or tone to interfere with the patient- doctor relationship.
  4. To develop strategies for preventing this interference.

Author Information

  • Jody Steinauer, MD, MAS: University of California, San Francisco, School of Medicine
  • Carolyn Sufrin: University of California, San Francisco, School of Medicine
  • Mitchel Hawkins: University of California, San Francisco, School of Medicine
  • Felisa Preskill: University of California, San Francisco, School of Medicine
  • Katheryn Koenemann: University of California, San Francisco, School of Medicine
  • Christine Dehlendorf: University of California, San Francisco, School of Medicine

Disclosures
None to report.

Funding/Support
None to report.



Citation

Steinauer J, Sufrin C, Hawkins M, Preskill F, Koenemann K, Dehlendorf C. Caring for challenging patients workshop. MedEdPORTAL. 2014;10:9701. https://doi.org/10.15766/mep_2374-8265.9701