Doctors and scientists labor under a curse, actor and science communicator Alan Alda told a capacity crowd at the Medical School on Friday. And only by actively fighting that curse will they truly and effectively connect with patients and the public.
The curse, he said, is the curse of knowledge.
“If you understand something so deeply that you forget what it’s like not to understand it, you’re under the curse of knowledge,” Alda said.
For a doctor, failing to fight this curse may mean a patient doesn’t fully understand his or her treatment — or may not trust the doctor enough to follow a prescription. For a scientist, it could mean failing to help the public understand important information, or to help policymakers fully understand the issues they are trying to regulate or legislate.
But by using effective communication techniques — one of our species’ defining traits — those in technical fields can overcome the curse, he said.
“If we’re talking about one of our greatest achievements — science — why wouldn’t we do it with our other great strength, communication?” he asked the audience of U-M physicians, medical students, scientists and other clinicians.
Many in the Ford Auditorium and two overflow locations know Alda as an actor, writer and director from his work on the big and little screens. From the iconic Hawkeye Pierce in “M*A*S*H” to host of two public television science series, he has brought stories of medicine and science to life for millions worldwide.
But his latest role focuses on teaching effective communication to people in scientific fields, together with the staff of the Alan Alda Center for Communicating Science at Stony Brook University in New York.
That’s what brought him to U-M, where Medical School leaders have engaged the center to help third-year medical students learn techniques that will serve them from their first interactions with patients and throughout their medical careers.
The pilot workshop, held over the weekend, featured interactive sessions focused on crafting a story and using improvisational techniques to inspire effective communication. All were designed to help students and select faculty exercise their communication muscles in new ways.
“This was a stellar event for our medical students and faculty, and we’re looking forward to teaching all 170 of our incoming third-year medical students theses skills in May,” said Dr. David Fessell, a U-M radiologist involved in medical student education.
Alda and the center’s staff work with medical schools and scientific institutions around the country. In partnership with the Stony Brook University School of Journalism they have also developed a course required for every Stony Brook medical student.
According to Dr. Rajesh Mangrulkar, associate dean for medical student education, the techniques shared by the Alda Center staff and Alda’s inspirational remarks sparked an increased level of energy and motivation among the participating medical students and faculty.
“They helped us better understand how communication is an essential element of medical care,” Mangrulkar said. “They brought skills and techniques from a very different profession, acting, and gave us some practical steps to help improve our own communication abilities as doctors,” he said.
Alda’s talk Friday gave a taste of what the Alda Center sessions offer, sprinkled with his trademark wit and charm. He recalled episodes from his own experiences interacting with doctors and scientists — both those who communicated well and those who could have benefited from an Alda Center workshop.
He likened the process of communicating effectively to what he called the three stages of falling in love: attraction, infatuation and finally, if one is lucky, commitment.
“The public is on a blind date with science, and to some extent with their doctors,” he said. “They’re thinking, ‘Can I trust this person, do they have an agenda, do they care, are they thinking only about themselves?’ We want to move from a blind date to a close relationship.”
The first step, he said, is to recognize how to approach an interaction with a patient or public audience in a way that makes attraction possible — through body language and other non-verbal cues.
Having a stiff demeanor, not making eye contact, sitting back or turning one’s back all result in “a little excommunication,” before the scientist or doctor even has a chance to try to communicate with words, he said.
After attraction comes infatuation – where emotion and memory prevail. Using emotion as part of communication, it becomes easier for the patient or audience member to relate with the doctor or the scientist, he said. It may also help cement memories of what’s been communicated in the listeners’ brains, he noted, citing recent neuroscience research.
Getting to the final stage of communicating effectively with a layperson — commitment — must include active, two-way listening, he said. Listening with the eyes and ears, and remembering to consider what the other person might be thinking about what you’ve said, will help both parties tune in to the topic at hand.
Also essential to success in communicating, he said, is to know your audience’s level of understanding and introduce technical information in a way that starts simply, and gradually adds more detail.
Alda’s emphasis on communicating well with patients was echoed by Dr. Walter Dishell, a Medical School alumnus who trained Alda on medical techniques during “M*A*S*H.” Dishell, a Los Angeles-based otolaryngologist who has worked to bring medical authenticity to other Hollywood productions, also spoke to medical students on Friday.
“If you can’t talk to your patients and explain to them what’s going on, and make them feel as if you’re part of what’s going on, and committed to them, it doesn’t work, and you’ll have unhappy and insecure patients,” Dishell said. “The one thing you can give your patient if you’re a doctor is confidence in you and your ability to treat them.”
Victoria Neff
It is certainly non-trivial to keep track of what you know that most people do not know!
I suspect that giving patients the impression you care what becomes of them may also be critically important to their outcomes.
Thanking them for coming to see you, giving them Duchenne smiles (http://en.wikipedia.org/wiki/Smile#Duchenne_smile), giving them a friendly pat on the arm as they leave…..
Perhaps Alan also suggested these non-verbal ways to do that emotional communicating.
Kara Gavin
Yes, he did! Not so much about physical contact, but definitely eye contact, posture and more.
Barbara Eulenberg
Actually, most medical schools and other health professions programs teach interpersonal and communication skills to students by using “standardized patients” (SPs) – men and women of all ages who are trained to portray real “patients” in a clinical setting. The SPs then evaluate the students history taking and physical examination skills, as well as communication skills and offer them verbal feedback. Standardized Patient Education has been around since the 60s. Almost every university that has health professions programs has a Standardized Patient Program. At our university, Rosalind Franklin University of Medicine and Science in North Chicago, Illinois, I am the director of this program. I run a “simulation clinic” that has 14 patient examination rooms. The SPs (most of whom are actors) portray the patient cases realistically. The students know they are not real patients, but treat them as such. Each exam room has cameras and microphones so that we can record the students’ encounters with the patients. Faculty and students can then watch these recordings later on to see how their students are doing when it comes to clinical performance. It’s an extremely effective way to teach and evaluate students who will soon be seeing real patients in clinics and hospitals.