Abstract
The Patient Immersion Experience (PIE), part of the MD Program’s longitudinal Physicianship course, pairs medical students with individuals with chronic medical conditions to promote an understanding of the lived experience of illness. In October 2017, medical students AW and SC were matched with patient mentor MF, an autistic person[1] and artist. A year later, in the fall of 2018, MF invited his autistic friend AK to participate in collaborating in developing an “interpretive project”, a required capstone component of PIE organized by faculty-lead, PBM. Transcripts of online Google Doc conversations involving SC, AW, MF and AK, that took place over a 3-month period, were used to create a multimedia learning artifact that was exhibited as part of an annual Patient Appreciation Event organized at the end of the year. Rather than simply focusing on transmission of “information”, with SC and AW (as medical students) asking questions and AK and MF responding to it, a commitment was made to an ongoing mutual exchange of ideas. Four main topics were discussed: 1) the value of open communication with others, 2) how the process of informed consent differs for autistic people, 3) hope for a better future for healthcare, and 4) moving forward. These conversations point to the relationship-enhancing possibilities of open, back-and-forth dialogue as an antidote to monological approaches to medicine, providing insights into ways dialogue can enhance both a sense of agency and relational connections, generate new creative thinking, and promote a more holistic, person-centred approach to healthcare.
Highlights
In medical school we are taught to have scripted “monologic” interactions with our patients which do not provide space to truly get to know the patient
In October 2017, first year medical students Sierra and Alec were matched with Michael, an autistic volunteer patient mentor
The following edited summary has been excerpted from the open, dialogical conversations they engaged in using Google Docs from January to March 2019, which led to the multimedia project they created and exhibited as part of the MD Program’s Patient Appreciation Event in April 2019
Summary
In medical school we are taught to have scripted “monologic” interactions with our patients which do not provide space to truly get to know the patient. Alec learned about the difficulties Michael had communicating his healthcare needs, including his sensory differences which made routine procedures, such as dental work, excruciating During this period, Michael shared different artsbased projects he had created to communicate aspects of his experience of healthcare as an autistic person, including a photographic collage, videobased digital story, and card-based dialogue game. The interpretive project that they created, entitled “Building Dialogues between Medical Students and Autistic Patients,” included voice recordings of excerpts from their online conversations. It included a 3D virtual reality photosphere of one of Michael’s photographic collages, as well as a long text transcription of the dialogical inquiry. The following edited summary has been excerpted from the open, dialogical conversations they engaged in using Google Docs from January to March 2019, which led to the multimedia project they created and exhibited as part of the MD Program’s Patient Appreciation Event in April 2019
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