Acessibilidade / Reportar erro

Addressing the Clinical Relationship and Communicating Difficult News with the Aid of the Arts and Living Stories

ABSTRACT

Introduction

Clinical Relationship (CR) is a more comprehensive term than doctor-patient relationship and is currently used to describe the health team’s contact with the patient and their families, as well as the team’s interaction with each other. To establish satisfactory interpersonal relationships, it is important to bring together communication and empathy skills that play a key role in building the CR. However, such topics are given little attention during medical training, with a more focused study on diseases and treatments. Rigid protocols and guidelines have accounted for a large proportion of undergraduate medical curricula, leaving less time for discussion of more abstract subjects related to the humanities and the subjectivity of patients, a view that is part of people’s reality.

Objectives

To provide spaces and theoretical references for the discussion of topics less addressed in the medical curriculum and to encourage the importance of communication and empathy in health/disease processes.

Methods

In view of the importance of providing medical students with humanizing experiences, we have proposed theoretical-practical workshops and conducted a qualitative research in order to evaluate the students’ views on learning about CR themes. In total, 33 second-year medical students participated in the project, by voluntary adhesion in response to an invitation distributed via electronic mail. Six theoretical-practical workshops were offered and executed in small groups and addressing topics such as: empathy, mourning, palliative care, end of life and communication of difficult news. The data collection methods were two focus groups conducted at the end of the six meetings encounters and participant observation, the notes from which were taken in a field diary.

Results

Content analysis (Bardin, 2011) was the method chosen to study the results, following transcription and analysis of the speech of the groups. At the end of the analysis, four main categories (and five subcategories) emerged, of which two are highlighted in this article: “Art, cinema and literature evoke feelings: seeking humanism” and “Difficult news in the view of patients – the living experiences”. To this end, we used active methodologies such as small group work, use of videos and excerpts from films, music, reports, reading texts and conversation wheels.

Conclusion

The participants’ statements showed satisfaction with the proposed theme and methodologies. We therefore evaluated the use of such techniques to sensitize students, leading them to reflect on the importance of empathy and communication in the work of physicians and health staff, developing interpersonal skills.

Medical Education; Empathy; Humanism

Associação Brasileira de Educação Médica SCN - QD 02 - BL D - Torre A - Salas 1021 e 1023 | Asa Norte, Brasília | DF | CEP: 70712-903, Tel: (61) 3024-9978 / 3024-8013, Fax: +55 21 2260-6662 - Brasília - DF - Brazil
E-mail: rbem.abem@gmail.com