Communication and Relationship in Medicine 4th Year
A.Y. 2023/2024
Learning objectives
The purpose of the course is: i) to provide essential knowledge about behavioral skills in the human relations and in particular as far as the doctor-patient-family relations, also in the context of health education; ii) to provide knowledge of protocols and basic skills and attitudes as far as difficult conversation in medicine (e.g., giving bad news).
Expected learning outcomes
Students are able:
a) to recognize and use communicative and relational skills in the doctor patient family communication and
b) to describe complexity factors related to the physician's inner life.
a) to recognize and use communicative and relational skills in the doctor patient family communication and
b) to describe complexity factors related to the physician's inner life.
Lesson period: First semester
Assessment methods: Esame
Assessment result: voto verbalizzato in trentesimi
Single course
This course cannot be attended as a single course. Please check our list of single courses to find the ones available for enrolment.
Course syllabus and organization
Single session
Responsible
Course syllabus
- Bad news communication;
- Error communication;
- Death;
- Consent and donation;
- The inner life and the well-being of physicians;
- Distance communication;
- Practice on bad news and error communication.
- Error communication;
- Death;
- Consent and donation;
- The inner life and the well-being of physicians;
- Distance communication;
- Practice on bad news and error communication.
Prerequisites for admission
No prior knowledge is required.
Teaching methods
Each CFU consists of frontal and innovative teaching hours. Innovative teaching activities consists of detailed study of topics, included in the program and agreed with students.
Frontal didactic hours will be devoted to frontal teaching, supplementary activities (view and discussion of visits videos and role playing) and exercises in preparation for the final exam.
Frontal didactic hours will be devoted to frontal teaching, supplementary activities (view and discussion of visits videos and role playing) and exercises in preparation for the final exam.
Teaching Resources
Books:
· Moja E.A., Vegni E. La visita medica centrata sul paziente, Raffaello Cortina Editore, 2000
· Buckman R. La comunicazione della diagnosi in caso di malattia grave, Raffaello Cortina Editore, 2002.
· Kubler-Ross E. La morte e il morire, Edizioni La Cittadella, 1976.
· Truog RD, Browning DM, Johnson JA, Gallagher TH. Errori medici. La comunicazione con il paziente e i familiari. Raffaello Cortina Editore, 2013.
Reviews and chapters:
Patient-centered medicine model:
· Visser, L. N., Tollenaar, M. S., de Haes, H. C., & Smets, E. M. (2017). The value of physicians' affect-oriented communication for patients' recall of information. Patient education and counseling, 100(11), 2116-2120.
· Fuertes, J. N., Toporovsky, A., Reyes, M., & Osborne, J. B. (2017). The physician-patient working alliance: Theory, research, and future possibilities. Patient education and counseling, 100(4), 610-615.
· Kelley, J. M., Kraft-Todd, G., Schapira, L., Kossowsky, J., & Riess, H. (2014). The influence of the patient-clinician relationship on healthcare outcomes: a systematic review and meta-analysis of randomized controlled trials. PloS one, 9(4), e94207.
· Eton, D. T., Ridgeway, J. L., Linzer, M., Boehm, D. H., Rogers, E. A., Yost, K. J., ... & Sauver, J. L. (2017). healthcare provider relational quality is associated with better self-management and less treatment burden in people with multiple chronic conditions. Patient preference and adherence, 11, 1635.
· Rutten, L. J. F., Hesse, B. W., Sauver, J. L. S., Wilson, P., Chawla, N., Hartigan, D. B., ... & Arora, N. K. (2016). Health self-efficacy among populations with multiple chronic conditions: the value of patient-centered communication. Advances in therapy, 33(8), 1440-1451.
· Mattarozzi, K., Sfrisi, F., Caniglia, F., De Palma, A., & Martoni, M. (2017). What patients' complaints and praise tell the health practitioner: implications for health care quality. A qualitative research study. International Journal for Quality in Health Care, 29(1), 83-89.
· Schaad, B., Bourquin, C., Bornet, F., Currat, T., Saraga, M., Panese, F., & Stiefel, F. (2015). Dissatisfaction of hospital patients, their relatives, and friends: Analysis of accounts collected in a complaints center. Patient education and counseling, 98(6), 771-776.
·
Styles in medicine:
· Emanuel E.J., Emanuel L.L. Four models of the physician-patient relationship. JAMA 1992; 22/29 (267): 2221-2226.
· Del Negro, S. M. L., Borghi, L., Ferrari, D., & Vegni, E. (2017). Comunicare l'indicibile: proposte dalla medicina centrata sul paziente al paternalismo palliativo. Recenti Progressi in Medicina, 108(12), 508-510.
Values in medicine:
· Jansen LA. Between beneficence and justice: the ethics of stewardship in medicine. J Med Philos. 2013 Feb;38(1):50-63. doi: 10.1093/jmp/jhs058. Epub 2013 Jan
· Thompson, I. E. (1979). The nature of confidentiality. Journal of medical ethics, 5(2), 57-64.
· Roeland, E., Cain, J., Onderdonk, C., Kerr, K., Mitchell, W., & Thornberry, K. (2014). When open-ended questions don't work: the role of palliative paternalism in difficult medical decisions. Journal of palliative medicine, 17(4), 415-420. (consigliato).
· Truog, R. D, et al. Microethics: the ethics of everyday clinical practice. Hastings Center Report. 2015; 45(1), 11-17.
· Lamiani G, Meyer EC, Rider EA, Browning DM, Vegni E, Mauri E, Moja EA, Truog RD. Assumptions and blind spots in patient-centredness: action research between American and Italian health care professionals. Med Educ. 2008 Jul;42(7):712-20. doi: 10.1111/j.1365-2923.2008.03038.x. PMID: 18588650.
The triadic relationship:
· Iapichino E., Vegni E. "Il terzo incomodo. Complicanze comunicativo-relazionali nella visita medica tiradica". La parola e la cura, Autunno 2007; 28-32.
· Laidsaar-Powell RC, Butow PN, Bu S, Charles C, Gafni A, Lam WW, Jansen J, McCaffery KJ, Shepherd HL, Tattersall MH, Juraskova I. Physician-patient-companion communication and decision-making: a systematic review of triadic medical consultations. Patient Educ Couns. 2013 Apr;91(1):3-13. doi: 10.1016/j.pec.2012.11.007. Epub 2013 Jan 17.
· Iapichino E., Vegni E., Cavacciuti F., Moja EA. "La visita in medicina generale: l'incontro medico-paziente e l'incontro medico-paziente-accompagnatore. Uno studio descrittivo". Recenti Progressi in Medicina 2007; 98(3): 160-165. (consigliato).
The chronic patient's motivation:
· Emmons KM, Motivational Interviewing in health care settings. Am J Prev Med 2001; 20 (1): 67-74.
· Gruninger UJ, Patient education: an example of one to one communication. Journal of Human Hypertension 1995; 9: 15-25.
Patient education:
· Bodenheimer T, Lorig K, Holman H, Grumbach K. Patient self-managment of chronic disease in primary care. JAMA 2002; 288 (19): 2469-2475.
· Lipkin M, Patient education and counseling in the context of modern patient physician-family communication. Patient Education and Counseling 1996; 27: S-11.
Patient adherence:
· Osterberg L, Blaschke T. Adherence to medication. New England Journal of Medicine 2005; 353(5): 487-97.
· McDonald HP, Garg AX, Haynes RB. Interventions to enahnce patient adherence to medication prescriptions. JAMA 2002; 288 (22): 2868-2879.
· Vrijens B, De Geest S, Hughes DA, Przemyslaw K, Demonceau J, Ruppar T, Dobbels F, Fargher E, Morrison V, Lewek P, Matyjaszczyk M, Mshelia C, Clyne W, Aronson JK, Urquhart J; ABC Project Team. A new taxonomy for describing and defining adherence to medications. Br J Clin Pharmacol. 2012 May;73(5):691-705
· Moja E.A., Vegni E. La visita medica centrata sul paziente, Raffaello Cortina Editore, 2000
· Buckman R. La comunicazione della diagnosi in caso di malattia grave, Raffaello Cortina Editore, 2002.
· Kubler-Ross E. La morte e il morire, Edizioni La Cittadella, 1976.
· Truog RD, Browning DM, Johnson JA, Gallagher TH. Errori medici. La comunicazione con il paziente e i familiari. Raffaello Cortina Editore, 2013.
Reviews and chapters:
Patient-centered medicine model:
· Visser, L. N., Tollenaar, M. S., de Haes, H. C., & Smets, E. M. (2017). The value of physicians' affect-oriented communication for patients' recall of information. Patient education and counseling, 100(11), 2116-2120.
· Fuertes, J. N., Toporovsky, A., Reyes, M., & Osborne, J. B. (2017). The physician-patient working alliance: Theory, research, and future possibilities. Patient education and counseling, 100(4), 610-615.
· Kelley, J. M., Kraft-Todd, G., Schapira, L., Kossowsky, J., & Riess, H. (2014). The influence of the patient-clinician relationship on healthcare outcomes: a systematic review and meta-analysis of randomized controlled trials. PloS one, 9(4), e94207.
· Eton, D. T., Ridgeway, J. L., Linzer, M., Boehm, D. H., Rogers, E. A., Yost, K. J., ... & Sauver, J. L. (2017). healthcare provider relational quality is associated with better self-management and less treatment burden in people with multiple chronic conditions. Patient preference and adherence, 11, 1635.
· Rutten, L. J. F., Hesse, B. W., Sauver, J. L. S., Wilson, P., Chawla, N., Hartigan, D. B., ... & Arora, N. K. (2016). Health self-efficacy among populations with multiple chronic conditions: the value of patient-centered communication. Advances in therapy, 33(8), 1440-1451.
· Mattarozzi, K., Sfrisi, F., Caniglia, F., De Palma, A., & Martoni, M. (2017). What patients' complaints and praise tell the health practitioner: implications for health care quality. A qualitative research study. International Journal for Quality in Health Care, 29(1), 83-89.
· Schaad, B., Bourquin, C., Bornet, F., Currat, T., Saraga, M., Panese, F., & Stiefel, F. (2015). Dissatisfaction of hospital patients, their relatives, and friends: Analysis of accounts collected in a complaints center. Patient education and counseling, 98(6), 771-776.
·
Styles in medicine:
· Emanuel E.J., Emanuel L.L. Four models of the physician-patient relationship. JAMA 1992; 22/29 (267): 2221-2226.
· Del Negro, S. M. L., Borghi, L., Ferrari, D., & Vegni, E. (2017). Comunicare l'indicibile: proposte dalla medicina centrata sul paziente al paternalismo palliativo. Recenti Progressi in Medicina, 108(12), 508-510.
Values in medicine:
· Jansen LA. Between beneficence and justice: the ethics of stewardship in medicine. J Med Philos. 2013 Feb;38(1):50-63. doi: 10.1093/jmp/jhs058. Epub 2013 Jan
· Thompson, I. E. (1979). The nature of confidentiality. Journal of medical ethics, 5(2), 57-64.
· Roeland, E., Cain, J., Onderdonk, C., Kerr, K., Mitchell, W., & Thornberry, K. (2014). When open-ended questions don't work: the role of palliative paternalism in difficult medical decisions. Journal of palliative medicine, 17(4), 415-420. (consigliato).
· Truog, R. D, et al. Microethics: the ethics of everyday clinical practice. Hastings Center Report. 2015; 45(1), 11-17.
· Lamiani G, Meyer EC, Rider EA, Browning DM, Vegni E, Mauri E, Moja EA, Truog RD. Assumptions and blind spots in patient-centredness: action research between American and Italian health care professionals. Med Educ. 2008 Jul;42(7):712-20. doi: 10.1111/j.1365-2923.2008.03038.x. PMID: 18588650.
The triadic relationship:
· Iapichino E., Vegni E. "Il terzo incomodo. Complicanze comunicativo-relazionali nella visita medica tiradica". La parola e la cura, Autunno 2007; 28-32.
· Laidsaar-Powell RC, Butow PN, Bu S, Charles C, Gafni A, Lam WW, Jansen J, McCaffery KJ, Shepherd HL, Tattersall MH, Juraskova I. Physician-patient-companion communication and decision-making: a systematic review of triadic medical consultations. Patient Educ Couns. 2013 Apr;91(1):3-13. doi: 10.1016/j.pec.2012.11.007. Epub 2013 Jan 17.
· Iapichino E., Vegni E., Cavacciuti F., Moja EA. "La visita in medicina generale: l'incontro medico-paziente e l'incontro medico-paziente-accompagnatore. Uno studio descrittivo". Recenti Progressi in Medicina 2007; 98(3): 160-165. (consigliato).
The chronic patient's motivation:
· Emmons KM, Motivational Interviewing in health care settings. Am J Prev Med 2001; 20 (1): 67-74.
· Gruninger UJ, Patient education: an example of one to one communication. Journal of Human Hypertension 1995; 9: 15-25.
Patient education:
· Bodenheimer T, Lorig K, Holman H, Grumbach K. Patient self-managment of chronic disease in primary care. JAMA 2002; 288 (19): 2469-2475.
· Lipkin M, Patient education and counseling in the context of modern patient physician-family communication. Patient Education and Counseling 1996; 27: S-11.
Patient adherence:
· Osterberg L, Blaschke T. Adherence to medication. New England Journal of Medicine 2005; 353(5): 487-97.
· McDonald HP, Garg AX, Haynes RB. Interventions to enahnce patient adherence to medication prescriptions. JAMA 2002; 288 (22): 2868-2879.
· Vrijens B, De Geest S, Hughes DA, Przemyslaw K, Demonceau J, Ruppar T, Dobbels F, Fargher E, Morrison V, Lewek P, Matyjaszczyk M, Mshelia C, Clyne W, Aronson JK, Urquhart J; ABC Project Team. A new taxonomy for describing and defining adherence to medications. Br J Clin Pharmacol. 2012 May;73(5):691-705
Assessment methods and Criteria
Just one exam will be held in the 4th year.
A written exam composed of 4 parts: 1) multiple-choice questions; 2) open-ended question on a theoretical topic; 3) exercise on the transcript of doctor-patient dialogue; 4) writing of a doctor-patient dialogue according to the patient-centered model. Results will be communicated through the online platform
A written exam composed of 4 parts: 1) multiple-choice questions; 2) open-ended question on a theoretical topic; 3) exercise on the transcript of doctor-patient dialogue; 4) writing of a doctor-patient dialogue according to the patient-centered model. Results will be communicated through the online platform
M-PSI/08 - CLINICAL PSYCHOLOGY - University credits: 2
Informal teaching: 16 hours
Lessons: 8 hours
: 4 hours
Lessons: 8 hours
: 4 hours
Professor:
Vegni Elena Anna Maria
Educational website(s)
Professor(s)