Thank you for your interest in learning more about the WeTALK method of teaching communication.
I will give you a taste of the literature which influenced the development of our WeTALK method for teaching. Actually, you have to go back to David Kolb's work first published in 1975 for one of the overarching influences about experiential learning theory. Our use, for example, of critical self assessment is a key component of Kolb’s theories of learning. A nice summary can be found here. Doctor’s lead chaotic and stressful lives and we needed a way to help our learners get into a mindset for learning. Our approach to the learning environment in the small groups is influenced by Professor Czikszentmihalyi's theory of "flow." Here is his TED talk on flow.
Tony Back et al, in 2007, described a week-long communication course built around simulation for oncologists. Tony and his group have myriad publications, including a book now, documenting the evidence behind their work. Tony has had the biggest influence on me personally and Amy and I have borrowed significantly from their methods. Our participatory theatre/improvisational theatre methods are influenced by the work of Augusto Boal and his use of the “fourth wall” which are described in the Howard and Jacobson papers. I include on the reference list some additional evidence about using theater for simulation to teach communication skills. Finally, for us this project is chiefly about our colleagues and helping you all to build resilience and skills for self-care so I include a piece from Charlie Hatem about renewal and Sandra Jarvis-Selinger about the idea of integrating identity/personhood into medical training. This is a not a complete reference list but will give the curious participant insight into the development of the WeTALK method that stretches across our influences in medicine, education, theater, and psychology.
Additional articles address the effect of this type of education on medical care. I have included a paper from Jane Weeks and two from Jennifer Mack showing that we often communicate poorly and better communication leads to better outcomes. But the question of whether or not communication training like ours leads to better outcomes is more difficult to assess. This type of educational intervention does not naturally lend itself to conducting an RCT and patient level data are difficult to accurately relate to the intervention. That has not stopped some from trying. Randy Curtis et al recently published a negative trial in JAMA reporting the results of their 5-year training curriculum done as an RCT.
For Amy and me this is very much an academic exercise. We intend to report our results and contribute to this story in a meaningful way.
Ultimately we want it to work for all of you so I'll be curious to know if you develop a new skill or two during the workshop and peer observation process.
Let me know if you would like more and thank you for your curiosity!
Back A, Arnold R, Tulsky J. Mastering Communication with Seriously Ill Patients: Balancing Honesty with Empathy and Hope: Cambridge University Press; 2009.
Back AL, Arnold RM, Baile WF, Fryer-Edwards KA, Alexander SC, Barley GE, et al. Efficacy of communication skills training for giving bad news and discussing transitions to palliative care. Arch Intern Med. 2007 Mar 12;167(5):453-60.
Baile WF, Buckman R, Lenzi R, Glober G, Beale EA, Kudelka AP. SPIKES-A six-step protocol for delivering bad news: application to the patient with cancer. Oncologist. 2000;5(4):302-11.
Csikszentmihalyi M. Flow : the psychology of optimal experience. New York: Harper Perennial; 2008.
Dow AW, Leong D, Anderson A, Wenzel RP. Using theater to teach clinical empathy: a pilot study. J Gen Intern Med. 2007 Aug;22(8):1114-8.
Hatem CJ. Renewal in the practice of medicine. Patient Educ Couns. 2006 Sep;62(3):299-301.
Howard LA. Speaking theatre/doing pedagogy: re‐visiting theatre of the oppressed. Communication Education. 2004 2004/07/01;53(3):217-33.
Jacobsen T, Baerheim A, Lepp MR, Schei E. Analysis of role-play in medical communication training using a theatrical device the fourth wall. BMC Med Educ. 2006;6:51.
Jarvis-Selinger S, Pratt DD, Regehr G. Competency is not enough: integrating identity formation into the medical education discourse. Acad Med. 2012 Sep;87(9):1185-90.
Mack JW, Cronin A, Keating NL, Taback N, Huskamp HA, Malin JL, et al. Associations between end-of-life discussion characteristics and care received near death: a prospective cohort study. J Clin Oncol. 2012 Dec 10;30(35):4387-95.
Mack JW, Weeks JC, Wright AA, Block SD, Prigerson HG. End-of-life discussions, goal attainment, and distress at the end of life: predictors and outcomes of receipt of care consistent with preferences. J Clin Oncol. 2010 Mar 1;28(7):1203-8.
Moore PM, Rivera Mercado S, Grez Artigues M, Lawrie TA. Communication skills training for healthcare professionals working with people who have cancer. Cochrane Database Syst Rev. 2013;3:Cd003751.
Watson K. Perspective: Serious play: teaching medical skills with improvisational theater techniques. Acad Med. 2011 Oct;86(10):1260-5.
Weeks JC, Catalano PJ, Cronin A, Finkelman MD, Mack JW, Keating NL, et al. Patients' expectations about effects of chemotherapy for advanced cancer. N Engl J Med. 2012 Oct 25;367(17):1616-25.