1. The Legacy Teachers Program at Mizzou University of Missouri-Columbia Betsy Garrett, MD, MSPH Caroline Kerber, MD

2. Background

3. Confluence of Events  MU2020 Communications Committee Planning Meeting  Faculty attended Relationship Centered Care Institute at IU  Significant emphasis on reflection through student portfolios  Goal to increase activities that emphasized patient- centeredness in clinical years

4. Legacy Teachers  Initiated in 2006 for third year students  Asked to submit essay on a patient who had taught them lessons they felt would make them a better physician  4 submissions that first year (2 about pediatric pts and their families, two about adults- one of whom had since died)  Luncheon held to recognize students and honor Legacy Teachers and their guests

5. 2007  9 essays submitted  Most essays have come from Family Medicine experience in part due to the required paper

6. 2008  9 submissions again  **required experience for second year students  Mid-April- students incredibly distracted by Step I  Surveys done

7. Survey of Luncheon Participants 1. Has this event had any effect on your thinking about how patients and doctors relate? 2. Has this program given you any new insights about providing patient-centered care? 3. Suggestions for improvement?

8. Survey Results M2 Students: N=69 (88%) 1. Has this event had any effect on your thinking about how patients and doctors relate? Yes: 45 (65%) No: 22 (32%) (2 clarified it corroborated prior feelings, thus no net effect) No answer: 2 (3%)

9. M2 Comments  “I think I want to reflect more on how I relate to patients in the next few years.”  “Patients can be very influential in shaping future physicians.”  “It is much more personal than I thought.”

10. Survey Results M2 Students: N=69 (88%) 2. Has this program given you any new insights about providing patient-centered care? Yes: 43 (63%) No: 23 (33%) No answer: 3 (4%)

11. Suggestions from Students  48% had at least one suggestion “It was a beautiful event.” “It was a beautiful event.” “It rocked.” “It rocked.” “Open it to the first year students. Given the time constraints and stress we are under at this time, it is very difficult to appreciate the meaning of this event.” “Open it to the first year students. Given the time constraints and stress we are under at this time, it is very difficult to appreciate the meaning of this event.” “Don’t make this required. It doesn’t have the same meaning when you are forced to go.” “Don’t make this required. It doesn’t have the same meaning when you are forced to go.”

12. 2009!  Expanded to artwork and poetry  23 students (24% of third year class) participated  Established Legacy Teacher Endowment Fund April, 2009

13. A truly feel good event, but..?  Powerful experiences shared in essays  Great exercise in reflection  Clear line of sight with our patient-centered care mission  Students recognize the impact of patients as teachers, and are able to thank them  Faculty share importance of continuing to listen and learn from patients

14. Logistics  Open to third year students  Deadline in February  Students receive help with editing  Have not turned away any submissions to this point  Luncheon in April  M3s and their guests, M2s, staff and faculty  Hardest part is follow- up and invitations to the patients and their guests  Not all Legacy Teachers are invited

15.  Patients and their families are stunned to learn of the impact they have made on a young physician  Families are so grateful to know that their loved one lives on in a young physician’s career  It allows all of us to say thank you for the many gifts we receive from patients

16. Future Plans- Many!  Publish a collection of quotations from students and faculty, poetry, and artwork- share with learners  Create an enduring memento for the Legacy Teachers  Continue the Luncheon and celebration  Bigger and better