Reaching out for deeper connection

Helly Goez

Building relationships the core of superior medical care

By Sasha Roeder Mah

Jack Zhang was in his second year in the MD program when the Faculty of Medicine & Dentistry hosted its first ever LGBTQ "human library- type experience" a half-day of intimate conversation designed to foster understanding of the unique challenges LGBTQ patients experience in encounters with the health-care system. "The experience was a valuable opportunity for me to learn about vulnerability, humility, sympathy and empathy," he recalls. "These are foundations to being a good physician, in my opinion, and can only be learned from candid interactions in a safe environment."

About 160 MD students-the readers-and 20 community volunteers-the books-took part in the session, the first of its kind in Canada. Many of the volunteers intend to return to make this an annual event, says Helly Goez, co-ordinator of the four-year physicianship course.

Goez collaborated with MD student Derek Fehr, '19 MD, and community representatives to design the sessions as part of six hours of new LGBTQ curriculum.

"I found it very rewarding to see participants' currently held beliefs and perceptions be challenged," says volunteer Lowell Acorda. "It's important that marginalized voices are represented and heeded … in having more informed, and even affirming, health-care professionals, we can improve the quality of health care provided to those within the LGBTQ community as well as create confidence in our health-care system."

Social engagement like this has been a movement in medical education since 1995, when the World Health Organization urged medical schools to orient their education and research to meeting the needs of the communities they serve.

Explains Jill Konkin, Associate Dean, Community Engagement, "our priorities are to be determined in partnership with the community." And that means getting out from behind textbooks and into dialogue with the people being served.

Getting to know you

Another part of the four-year physicianship course, the Patient Immersion Experience (PIE) pairs students over the span of two years with people living with chronic illness. They go to doctor appointments together and spend social time together as well, allowing the students an in-depth look into the everyday battles these patients face.

Tracey Hillier, Associate Dean, MD program, says: "The idea is to come at this encounter from the lens of the patient. Students get to hear from the patient about their lived experience with the health-care system and hear from their families." In 2018, more than 160 students took part in the program, a joint effort between the faculty's MD and Arts & Humanities in Health & Medicine programs.

Experiences like the PIE allow future doctors to cultivate sensitivity to patients as human beings. Memorizing facts and studying textbooks are crucial aspects of becoming a competent physician, says Goez, but "we are touching people in their lowest moments in their lives, where there is so much insecurity and fear." Compassion must be a part of those interactions. "The relationships built in this program will help make more empathetic physicians," Hillier says.

Healing historical wounds

The inaugural Indigenous Academic Day at the Alexis Nakoda Sioux Nation in 2016 was eye-opening for both medical residents and patients. "Prior to this session many residents had not been to a First Nations reserve," says Cara Bablitz, '07 Bsc, '11 MD, who organized the event after working with the Indigenous Health Program to deliver primary care at the Alexis Nakota Sioux Nation, about an hour northwest of Edmonton. Her father, a Métis physician, has been a source of inspiration for her work to reduce health inequities.

"The impact that our medical schools can have in our Indigenous communities in Alberta can be enormous," says Alika Lafontaine, U of A lecturer and anesthesiologist, member of the board of governors for First Nations University of Canada and collaborative team leader for Indigenous Health Alliance.

A second Indigenous Health Academic event took place at Poundmaker's Lodge in August 2018, where elders shared meaningful conversations with first- and second- year residents at the site of a former residential school. It was a powerful opportunity to learn from Indigenous community members about the culture, health issues and barriers to health care they face.

"We were exposed to solemn topics such as the history of Indigenous peoples in Canada, and prejudice and barriers Indigenous patients face in our health-care system. This knowledge was not presented to us with a spirit of condemnation, but a spirit that welcomed partnership and reconciliation, a true cultural immersion experience," says Danika Leung, second-year resident and part of the planning committee for the Academic Day.

"A majority of the residents' encounters with Indigenous peoples prior to this day were in a medical setting, which could create a skewed picture of who Indigenous people are," says Bablitz, clinical lecturer in the Department of Family Medicine. "This day allows resident physicians to see the resilience and strength of our people at a site that is working towards Indigenous healing and wellness."