1. UNIVERSITY OF MICHIGAN MEDICAL SCHOOL 3 rd Annual Patient and Family-Centered Care Conference University of Michigan Health System November 30, 2011

2. The “15-Second Conversation” “What is empathy?” If a central ingredient of patient- and family- centered care is empathic healthcare providers, then we should ask:

3. UNIVERSITY OF MICHIGAN MEDICAL SCHOOL Arno K. Kumagai, M.D., Director Eric P. Skye, M.D. Assistant Director

4. The Family Centered Experience N. Schon, The Dialogue, 1964 The foundation of the FCE: listening to the stories that patients tell.

5. The Family Centered Experience SEPTEMBEROCT-NOV.JANUARYAPRIL Home Visit 1Home Visit 2Home Visit 3The Clinic Visit Home Visits with Volunteers Illness: Impact on Self & Family Patients & Physicians Views of Doctoring Breaking Bad News Home Visit 4Home Visit 5Home Visit 6 Stigma “Family’s Choice” Lessons Learned SEPTEMBEROCT-NOV.FEBRUARY M1 M2

6. Discussion as Exploration E. Kyeyune The Conversation, 1963 Learners bring their own “cultural surround” (Kegan) to the interactions.

7. N. Schon, The Dialogue, 1964 What are the students learning? A.K. Kumagai, P.T. Ross, and E.A. Murphy Adv Health Sci Edu 14:315-26, 2008 Diabetes Stories: Use of Illness Narratives to Teach Patient-Centered Diabetes Care

8. What are the students learning? Stories have emotional power: “I think that you can read about the disease and understand the cause of the disease, but you don’t really get the full effect about just finding out about [it] from the beginning…when you go to the hospital and figure out why you’re feeling the way you are and the shock of what to expect… At home, when they talked about when she first found out she had diabetes and how she sat in bed and cried, you can’t get that from a book. You can’t get the full effect of what it’s like.” -- Third-year Medical Student

9. What are the students learning? “More and more of medicine is becoming the chronic sorts of thing…and in that aspect I think the FCE changed that for all of us and made it more personal with the families.” -- Second-year Medical Student, UMMS The Dialogue, 1964

10. The FCE Interpretive Project During Winter Term of the M1 year. Students work in teams of 2-3 (representing 2-3 different volunteer families). Task: To develop a project that best represents the lived experience of illness from the patient’s perspective. Students are encouraged use any medium to express their understanding of this experience.

11. A Portrait of Illness Sean Kelly Salma Noorulla and Kevin Mundy Cover Art Academic Medicine May 2009

12. FCE Interpretive Project: “Lullaby” Caitlin Collins, Ben Kaplan-Singer & Heiko Yang Presented at the International Academy for Communications in Healthcare meeting, Miami, FL October 2009 http://www.youtube.com/watch?v=Lbj129Cxwes

13. Family Centered Experience: Goals Auguste Rodin Unfinished Work Can one “learn” empathy and compassion?

14. Arno K. Kumagai, M.D., Director akumagai@umich.edu Eric P. Skye, M.D., Assistant Director eskye@umich.edu Heather Wagenschutz, M.A., Program Administrator hmwags@umich.edu Office tel 734 615-4886 Family Centered Experience Website: www.med.umich.edu/lrc/fce/index.html

15. Selected References Kumagai AK, Murphy EA, Ross PT. Diabetes Stories: Use of illness narratives to foster patient-centered care. Advances in Health Sciences Education. 2008;14:315-326. Kumagai AK, White CB, Schigelone A. The Family Centered Experience: Using patient narratives, student reflections, and discussions to teach about illness and care. ABSAME Journal. 2005;11(2):73-78. Kumagai AK. A conceptual framework for use of illness narratives in medical education Academic Medicine. 2008;83(7):653-658. Kelly S, Noorulla S, Mundy K, Skye E, Perlman RL. Teaching and learning moments: Portrait of a Chronic Illness: artists' statement. Academic Medicine. Apr 2009;84(4):485. Li L, Carulli A, Nayak-Young S, Barnosky A, Kumagai AK. Artist' Statement: The Face of Illness. Academic Medicine. 2011;86(6):723. Abella IB, Vladescu I, Turgeon DK, Kumagai AK. Imagination, art, and learning: a web of support. Academic Medicine. Mar 2009;84(3):353.