LAUSR

A challenge faced by medical educators is how best to prepare future physicians to communicate effectively across the diverse settings and situations in which patient-physician interactions occur. The conceptualization of communication as a set of skills or tasks allows for standardization to ensure a basic level of competence. With more complex clinical encounters (e.g., communicating uncertainty, exploring sensitive issues such as trauma, managing patients who are distressed), an appreciation of context and flexibility may facilitate effective communication [2, 3]. Questions may thus need to be tailored or the clinician may need to respond to an interaction that did not go as planned. Moreover, obtaining a patient’s history of present illness through systematic questioning is also often seen as a means to an end to make a diagnosis. However, when there is uncertainty or ambiguity in a patient’s presentation, eliciting a patient’s subjective experiencemay be as important as diagnosis to address suffering or distress [4, 5], highlighting the therapeutic function of patient-physician communication. MEET (Making Every Encounter Therapeutic) was established as an elective pre-clerkship course in the University of Toronto MD Program to offer enhanced opportunities for pre-clerkship medical students to practice and develop therapeutic communication skills. MEET is conceptualized as a transitional experience between preclerkship and clerkship in that medical students interview patients who are pre-selected for the elective from a physician’s clinical practice. This experience is in contrast to many undergraduate communication skills courses that utilize standardized patients in small group classroom settings. The goal of MEET is to foster therapeutic (i.e., healing) conversations through listening and responding to a patient’s illness narrative. In this educational case report, we offer a description of the MEET curriculum and a qualitative analysis of medical students’ reflections of participating in the course.