Home visits help build empathy in students

Photo above: First-year medicalstudents Lim Li Yan (left) and Lee Shi Hui visiting Madam Lung Wai Lin at home.They learn how Madam Lung, who has rheumatoid arthritis, deals with the obstacles of daily living. SINGAPORE - For the past 11 months, first- year medical students Lim Li Yan and Lee Shi Hui have been paying regular visits to a chronically ill patient.

They did so as part of the longitudinal patient experience, a voluntary programme which started in January that involves medical undergraduates befriending a patient with a chronic illness.

During these visits, the 20- year-olds learnt how Madam Lung Wai Lin, 57, deals with life's daily obstacles as a person with rheumatoid arthritis.

The National University of Singapore (NUS) students found out that the housewife's painful joints prevent her from doing simple chores, such as wringing a piece of wet cloth. A trip with her to the hospital opened their eyes to the long wait to see the doctor.

Key among this initiative's objectives is to expose medical students to the realities that patients face outside hospital.

Two freshmen are paired with two mentors - a senior at school and a clinical mentor who is also the patient's primary physician.

They first meet formally in the hospital.

The whole team is also present at the first home visit.

From then on, the students are on their own. But they continue to meet the doctor-mentor before and after each visit for updates.

They are required to visit the patient at least four times for an hour each time, and are not allowed to give medical advice as they are not yet qualified doctors.

They have to understand how the patient lives outside the hospital, and are encouraged to think about how to "add value" to the patients.

This could be in the form of doing the dishes for the patient, or just taking out the trash, said Associate Professor Joshua Levi Jacobs of the Yong Loo Lin School of Medicine.

"One of the goals of the programme is to connect them with a real human being.

That this person will serve as an anchor to remind them always that the patient at 'Bed 5' is that grandma they visited at home," said the assistant dean of education.

Studies have shown that the majority of medical students lose empathy during their course because they distance themselves from patients as a defence mechanism.

The pattern is also more pronounced towards vulnerable groups such as the elderly.

This initiative is part of the school's concerted efforts to instil more empathy in students, and to expose them to geriatric care to meet Singapore's health- care needs.

For instance, a compulsory two-week geriatrics foundation course was introduced in 2010 as part of the curriculum for all second-year students.

In one workshop, students are made to wear translucent glasses and stuff cotton balls in their ears to simulate cataracts and loss of hearing.

Assistant Professor Reshma Merchant, from the school's department of medicine, said a review of the new curriculum showed that students had improved and had more positive attitudes.

The longitudinal patient experience programme, which took in 60 students this year, will be expanded, said Prof Jacobs.


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