Doctors pretend to be ‘George Clooney’

When you think about doctors and
acting, the first thing that comes to
mind might be the plethora of medical
TV shows, but researchers at VCU have
recently discovered it’s actually doctors
who could stand to learn something
from actors.

After reading a New York Times article
about doctors’ lack of bedside manner,
theatre department chair David Leong
decided to contact his medical colleagues
at VCU to investigate a way to measure
and possibly teach doctors better bedside
manners. Leong recognized that the skills
doctors seemed to be lacking were those
key to acting.

This eventually led doctors and theater
professors to conduct a series of studies.
The studies found that with all those
years of medical training, there was
one thing doctors haven’t been learning
– communication skills.

The initial study, “Using Theater to
Teach Clinical Empathy: A Pilot Study,”
was published in the August issue of the
Journal of General Internal Medicine.
Alan Dow, co-author of the study, associate
director of residency training and
assistant professor of internal medicine
at the VCU Medical Center, is concerned
that these skills are either being taught
poorly or not at all.

“Medical educators have, in a sense,
forgotten how to teach it. What a lot of
medical research has borne out is that
we are not doing a good job of training
doctors to be good communicators,”
Dow said.

Aaron Anderson, study co-author
and professor of voice and movement at
the theatre department, said the study
wasn’t about teaching doctors how to be
actors, but about teaching them “clinical
empathy” – how to talk to their patients
and express that they care.

“Communication is one of the core
competencies that has been identified
as key to the practice of medicine, but
there aren’t necessarily any tools within
the medical profession about how best
to break those down and measure them,
teach them,” Anderson said. “In theater,
it’s the thing that we teach. We have a
structured and proven curriculum for
teaching and measuring those skills.”

Dow said the communication and focus
skills key to acting are also an essential part
of providing quality patient care.

“For doctors, it’s when you’re talking
with someone, being able to cut out
all the distractions of everything else
that’s going on in a doctor’s life – the
sick patient in the next room, the pager
that’s going off – and being able just to
focus on that patient and really be in
the moment with that patient in that
conversation,” Dow said.

The first part of the study was spent
measuring the patient communication
skills of 33 doctors before and after they’d
had a theater class. The doctors’ skills
were measured using standard theater
evaluations used on students. Anderson
said the evaluation measures 35 different
specific skills grouped into four major
areas: physical presence, vocal presence,
emotional presence and time awareness.

“We measured their communication
with real patients in a clinic. Across all
the dimensions that we compared, the
groups improved,” Dow said.

A second study concentrated on
what makes a doctor good in the eyes
of patients. When it comes to how
patients rate their doctors, medical IQ
isn’t necessarily the first thing on their
minds.

The study asked patients to give
detailed descriptions of their interactions
with what they considered good and
bad doctors.

“He (Anderson) asked patients to
describe a good doctor and used that,
those things that those patients said,
to pull out how patients define a good
doctor and a bad doctor,” Dow said.

The results were surprisingly much
more about doctors’ bedside manner
than their actual medical skill and the
outcome of the patient’s illness.

“And of those (descriptions), almost
97 percent of them were about communication
and presence. Very few were
about technical skills,” Dow said.

Additional authors of the study
were Leong and Richard Wenzel, chair
of the VCU Department of Internal
Medicine.