M1 Sequence Overview
Family Centered Experience
Sequence Directors

Arno Kumagai, M.D.
Assistant Professor of Internal Medicine
E-mail: akumagai@umich.edu
Phone: 734-936-5035
Fax: 734-766-6684

Secretary: Sacha Hamady
Email: sacha@umich.edu
Office: 5550 MSRBII
Sequence Dates
Longitudinal across all four years
Sequence Mission Statement & Intended Learning Outcomes

The overall mission of the Family Centered Experience is to help physicians-in-training to understand the importance of viewing illness and health care from the patient's perspective, i.e., to view illness and its treatment in psychosocial and cultural contexts and to explore the impact of illness on an individual's sense of self, beliefs, family, and environment. In this setting, the course emphasizes the development of effective skills in empathic listening and communication, reflective, critical thought, and teaching and interactions in small group settings.


I. KNOWLEDGE OUTCOMES:

By the end of the course, students should have:

Knowledge #1
(Impact of Illness) A basic understanding of the impact of illness on the patient's sense of identity and meaning systems, as well as his/her daily activities, relationships with others and plans for the future.A basic understanding that illness has effects on both the patient and the family, not only from clinically, but also on psychological, emotional, financial, and social levels.

Knowledge #2
(Health Beliefs) An appreciation that health beliefs and behaviors vary widely among individuals, and are shaped by one's history, i.e., personal, family, and cultural, and socioeconomic background.Knowledge #3
(Impact of Age)A basic understanding of the impact that a patient's age and stage in life may have on his/her experience of an illness or medical condition.

Knowledge #4
(Environmental Influence) An appreciation of how a patient's home and work environments (social interactions, lifestyle, socioeconomic status, type of work, support systems, etc.) affect his or her health and ability to care for him or herself.

Knowledge #5
(Family Influence) A basic understanding of the influence that families and support systems may have on a patient's health behaviors and response to illness.

Knowledge #6
(Health resources) A basic understanding of the various social resources that are available to patients/families on personal (e.g., support systems), community (e.g., churches, mutual aid associations, etc.) and private or governmental levels (e.g., insurance, unemployment services, assistance for elderly family members, food stamps), as well as the factors that determine patient options and choices.

Knowledge #7
(Community resources) A basic understanding of various social resources that are available to patients/families on personal (e.g., support systems), community (e.g., churches, mutual aid associations, etc.) and governmental levels (e.g., unemployment services, assistance for elderly family members, food stamps), as well as the factors that determine patient options and choices.

Knowledge #8
(Chronic conditions) A basic understanding of the importance of continuity of care and the ongoing physician-patient interactions in managing chronic health problems for which no cure is available

Knowledge #9
(Communication) An ability to identify factors that assist in, or prevent, the development of an effective relationship between patients and their families, and their physician(s). Elements in this relationship include:

1. Trust
2. Rapport
3. Non-judgmental approaches
4. Respect for self-determination
5. Non-verbal communication
6. Confidentiality
7. Ability to discuss difficult or sensitive issues (e.g., sex, substance abuse)

Knowledge #10
(Cultural influences)A basic understanding of the ways in which the culture of patients affects their perceptions of, and responses to, health, illness, and health care.

Knowledge #11
(Health Care Discrepancies) A basic understanding of the factors that give rise to discrepancies in health care based on socioeconomic, racial and gender-related levels as well as the consequence of those discrepancies.

Knowledge #12
(Health decisions) An appreciation and understanding of how health care decisions are made; i.e., What was the process? Was a particular decision arrived at collaboratively between the patient and his/her physician? Were family members involved?

Knowledge #13
(Navigating health system services) Students should have a basic understanding of how patients access care and navigate around a variety of services in the context of receiving health care (e.g., scheduling appointments, transportation, justifying or making up for missed work or school for clinic appointments, specific requirements of clinic visits, e.g., fasting/diet issues).

Knowledge #14
(Alternative therapies) A basic understanding of conventional Western and complementary/alternative therapies for health maintenance and for treatment of diseases and medical conditions, and how a patient's beliefs influence his/her therapeutic choices and decisions.Knowledge #15
(Basic Science Connection)An understanding of how basic science information relates to patients and their illnesses, linking the theory with the practice of medicine. 

 II. SKILLS OUTCOMES

By the end of the course, students should be able to:

Skills #1
(Synthesize) Synthesize information gathered from interviews with the patient and family, the course readings, and the small group discussions into discussion questions, written themes, and presentations that reflect deep-level understanding.

Skills #2
(Apply) Apply relevant learning across the sequences and experiences in the first year within the framework of the Family Centered Experience. 


III. PROFESSIONAL ATTITUDES, BEHAVIORS, AND CHARACTERISTICS OUTCOMES

Professional Attitudes, Behaviors, and Characteristics #1
(Compassion) Compassion toward the patient and family, i.e., understand the patient with the illness rather than the disease in the patient.

Professional Attitudes, Behaviors, and Characteristics #2
(Respect for Diversity)An understanding and respect for the diversity of patient’s and family’s personal and health belief systems, perspectives, and reactions to illness, family structures, values, and how they affect health care decisions.An ability to suspend personal judgments and biases and communicate effectively and empathetically in situations in which there may be conflicts between the health and personal belief systems of the patient and family and their own.

Professional Attitudes, Behaviors, and Characteristics #3
(Confidentiality)
Appropriate confidentiality related to patient and family information.

Professional Attitudes, Behaviors, and Characteristics #4
(Responsibility and Commitment)Accountability and commitment to this experience, and to the patients and families, in the context of concurrent curriculum responsibilities.
Resources
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