1. Jeffrey Sternlieb, PhD, Kristin Bresnan, MD, Shayla Graham-Brock, MD
Teaching Physicians How to Cope with Emotional Reactions to a Series of Patient Encounters
Jeffrey Sternlieb, PhD, Kristin Bresnan, MD, Shayla Graham-Brock, MD

2. Goals:
Learn and experience an approach to teaching self awareness and self reflection to residents and to physicians in practice;
Learn a method to integrate behavioral sciences into medical case oriented presentations;
Demonstrate Process
Consider the role and impact of the facilitator and residency culture.

3. Patient’s Perspective:

4. Physician’s Perspective

5. MegaClinic - an approach to teaching self awareness and self reflection.
Goals
Participants
Format
Presentation
Feedback
Discussion

6. MegaClinic - Goals
Understand that you and your patient caseload are an interactive system.
Recognize the risk of being the conduit through which patients affect one another and impact treatment.
Integrate “Tools of Turtle Craft” in our management of the impact of a full session’s caseload.
Identify and utilize office, nursing and medical staff as resources to manage patient care challenges.

7. MegaClinic - Participants
Residents
Faculty
Nursing Staff
Office Staff
Medical Students

8. MegaClinic - Format Presentation – narrative of session Feedback
Where is your head, heart, and gut?
Review of Schedule?
Chronological order of the session
Feedback
Pre-select resident, faculty, nurse and office staff member
Discussion

9. Demonstration

10. Kristin Bresnan, M.D.
1:10 p.m. – T. K., 39 yo F c/o back and rt hip pain, infection
1:30 p.m. – E.R., 45 yo F routine pap, c/o dizziness, family planning
1:50 p.m., J.T. 42 yo M f/u DM2, HTN, lipids, ED, chronic rt shoulder pain
2:10 p.m., N.P., 8 yo F, WCC (no show)
2:30 p.m. (blocked)

11. Kristin Bresnan, M.D.
2:50 p.m., R.P. 14 yo M f/u ER visit (left without being seen, brother had 4 pm football game)
3:10 p.m., J.O., 12 yo F school PE (bumped to KCR)
3:30 p.m., J.K., 23 yo F abd pain (no show)
3:50 p.m., L.K., 39 yo F f/u labs, thyroid
4:10 p.m., P.D., 45 yo F BP meds, gyn exam

12. Integrate Behavioral Sciences
Focus in on a series of medical visits.
Set goals and expectations.
Connect activity to curriculum.
Structured questions and guidelines.
Teach skills related to RCCM

13. Role of a facilitator Prepare presenting resident.
Maintain an emotionally safe space.
Protect the presenter from scrutiny.
Emphasize diverse styles.
Elicit empathy.
Normalize patient care experience.

14. The organization’s culture
Valuing self-reflection.
Built into curriculum.
Protected scheduled time.
Support for training.
IEP – reduced competitiveness.
Resident Selection