A Review from Medical Science Educator from Dr. Steven Crooks

This month the IAMSE Publications Committee review is taken from the article titled Cultivating Patient-Physician Communication About Vaccination Through Vaccine Metaphors, published online in Medical Science Educator, (19 May 2020) by Amanda J. Chase, Mark A. Clark, Anna Rogalska & Melanie Musselman.

In a recent article in Medical Science Educator, Chase, Clark, Rogalska, and Musselman describe an innovative instructional intervention designed to teach medical students to use metaphor to improve patient-physician communication about vaccination—an important public health issue. I should note that the intervention isn’t necessarily limited to the topic of vaccination—it can easily be extended to a variety of topics that may be considered abstruse to those lacking a medical science background.

The intervention involved two separate 120-min activities. The first activity introduced the vaccination communication topic through a clinical case chronicling a conversation between a pediatrician and a vaccine-resistant mother of an unvaccinated child. Students studied the case in small groups (n=10) using discussion and role-play to explore ways to communicate with the patient. The second activity extended the first with a flipped classroom approach wherein each student composed their own written and/or graphical metaphor to “communicate a scientific conceptualization of vaccines” to a “relatively uneducated patient.” In preparing their metaphors, students were told to imagine the cultural and religious background of their hypothetical patient and to incorporate this information into the construction of their metaphor. The in-class portion of the activity involved students sharing their metaphors with the entire class intermixed with instructor-facilitated questions designed to stimulate connections between the students’ metaphors and the clinical scenario encountered earlier in the week in the small group sessions.

In my judgment, the authors have described a potent instructional intervention on a number of levels. The intervention merges two notoriously disparate—yet important—topics within the undergraduate medical curriculum: patient-physician communication (a core component of professionalism) and virology (a key area in medical science). This is a laudable achievement by itself as professionalism remains one of the most challenging—yet fundamental—areas of medical training to integrate into the main curriculum. Further, the intervention was implemented seamlessly within the biosciences in a way that highlighted empathy and communication as vital aspects of professionalism, not—as is often the case—as discrete intangible topics isolated from more important topics. The intervention also conveyed a very innovative, yet practical, rhetorical tool (i.e., metaphor) that medical students can use to improve their interactions with patients for the remainder of their careers.

I appreciate the authors sharing this intervention with the medical education community. From my perspective, we need more published reports of interventions documenting the application of our best theories/ideas (e.g., curriculum integration)—bringing them down from the realm of lofty ideals to the real-word of praxis. 

Steven Crooks, PhD, MHA
Professor of Medical Education
Western Michigan University Homer Stryker M.D. School of Medicine
Member, IAMSE Publications Committee