Episode 20: Bioarchaeology

# AnthroAlert

## Episode 19: Emergency Department

Originally aired 6 October 2017 on bullsradio.org

In this episode, we explore how an anthropological perspective can be a part of the emergency department.

Our guests, Dr. Roberta Baer and Dr. Jason Wilson , will present on their project where they design a course for pre-med students to better understand the patient experience. We will better define the role of anthropology and social science epistemologies in medical school training .

Roberta Baer is Professor of Anthropology and specializes in medical and nutritional anthropology.

Jason Wilson, is, Research Director, Division of Emergency Medicine for USF Health. Dr. Wilson has an MA in anthropology from the University of Michigan, and took a Medical Anthropology class at USF with Dr. Baer. Dr. Wilson earned his BA in Anthropology from USF in 2000.

The class was entitled, “Research Experience in Patient Provider Interaction.” This class was team taught by the Dr. Baer, and Dr. Jason Wilson, an attending physician at the Tampa General Hospital Emergency Department, who also has a MA in Anthropology. Our explicit goal in this class was to train pre-medical students to have a better understanding and valuation of the patient perspective in the physician-patient encounter. These issues are at the core of the subfield of applied medical anthropology.

While these perspectives date to over 40 years ago, medical school curriculums have not widely adopted these concepts. As such, we sought to incorporate this perspective into the coursework of students before they began medical school. We conducted the course in the context of a Level 1 Trauma Center, which functions not only to deal with traumatic injuries, but also as a health safety net for patients without health insurance. Class activities included reviews of current literature regarding the culture of the Emergency Room, the intersection of medicine and culture, and methods of qualitative research. While students were required to shadow physicians, they were also required to shadow patients, which we have learned is a key activity in developing an understanding of the patient experience. The class used what they learned to put together a leaflet for patients about common misunderstandings of how the Emergency Room works, and then evaluated the perceptions of the leaflet. Reflection activities about their experiences were also required.

Students noted the value of learning about the patient perspective. One stated,

> “This class has made me realize that the art of compassionate care and social interaction ...should be combined with the necessary sciences...and curative methods to provide the most appropriate care to patients.”

Another observed,

> “However, physicians often forget just how ... [it] feels to be a patient under stress and pain and waiting hours to see you.”

Yet another noted,

>“I learned most importantly not to lose sight of how much of an impact you can have as a physician on a patient’s life, both for the good and the bad. For the doctor, curing the disease is the goal, while for the patient it isn’t just the biological side that matters to their health. It’s how their disease will affect their daily life and whether they can afford to be sick.”

The class activities also pushed the students into learning more about themselves. One said,

> “Never could I have imagined what this class would teach me about medicine and about myself... Unlike other classes where reading material is assigned... and discussed, the reading and discussion were different and more enlightening in this class because I was able to see and apply what articles, films, and lectures taught me related to my experiences in the ER. Despite dreading the 4 hour patient shadowing assignment since syllabus day, looking back, it was probably my favorite assignment of the class... Mainly the patients taught me that their health wasn’t something separate from their lives. Their health was something that affected them every day and really influenced the person they had come to be, and how the interactions they would have in the ER would impact their coming days and weeks.”

Another noted,

> “The course pushed me to thinking outside of the box and into new perspectives...While putting together all of the research the class has done this semester has been hectic, it has also been one of the most satisfying experiences of my life...After taking this course I was shocked to find out that there are no anthropology courses taught during medical school. The lessons I learned ...are essential to my career as a physician... I can comfortably enter a patient’s room and talk confidently with them even in times of distress. I can also better understand their perspective and needs as a patient. Learning these lessons will make me a better medi...