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Communication 202: A Deeper Understanding of GI Illness Through a Patient Centered Approach 
This innovative video learning tool teaches the sophistication and complexity of the medical interview. Within the context of a clinical visit, the program demonstrates educational techniques to improve communication skills, patient centered care, psychosocial assessment, shared decision making, and methods to optimize the patient-provider relationship. Although the symptoms relate to disorders of gut-brain interaction (functional GI disorders), the information provided within the interview applies to patients with most any medical diagnosis. Thus, the medical symptoms serve only as a template to explore in greater depth the patient’s understanding, associated psychological features, patient concerns and behaviors and at a deeper level the psychosocial derivatives of the illness that drives the clinical presentation. Using this knowledge, the clinician is able to utilize more advanced methods to optimize patient care.

About this program:
The program consists of 6 clinical vignettes involving a patient’s visit to the doctor. Each clinical vignette has four components to guide the reader in their learning:

1. An ineffective interview where the physician makes errors in communication style leading to a dysfunctional level of communication. The visit does not provide meaningful clinical information and is associated with mutual dissatisfaction on the part of the patient and doctor.

2. A patient centered facilitative interview that discloses more meaningful information and leads to the discovery of important underlying clinical information that also identifies important psychosocial derivatives. This engages the patient in the treatment and produces patient and doctor satisfaction.

3. An interview with the patient in character who discusses his or her perceptions of the previous two interviews. The discussion includes how it felt to experience the visits, and what he or she liked and didn’t like about the physician’s communication style.

4. Finally, we provide a detailed step by step analysis of the interview including the key verbal and nonverbal messages. The narrator reviews what comments or behaviors worked and didn’t work with regards to engaging with the patient, and establishing an effective patient provider relationship.

We hope that this program is enjoyable, informative and most important will help you in your clinical practice.

This innovative video program looks at six clinical vignettes that begin as common clinical presentations but then require effective skills to fully understand and manage important issues:
  • Case Vignette 1: A 17-year-old adolescent attending an exclusive girl’s school is referred after an episode of hematemesis. She was diagnosed by endoscopy to have a (Mallory-Weiss) tear.
  • Case Vignette 2: A 37-year-old hospital pharmacist with a long-standing history of abdominal pain and diarrhea has had multiple hospitalizations with IV narcotic treatment. Multiple diagnostic studies have been negative. She is requesting hospitalization for diagnosis, treatment and cure.
  • Case Vignette 3: A 42-year-old man has a diagnosis of Crohn’s Ileocolitis which is being treated with mesalamine. His concern is that of rectal pain and diarrhea that has worsened over the past several weeks.
  • Case Vignette 4: A 23-year-old woman presents with abdominal pain, infrequent hard stools and straining and blood on the toilet tissue with defecation. She requests that the doctor not do a rectal exam.
  • Case Vignette 5: A 33-year-old lawyer reports abdominal pain, fatigue, and nausea for two years. She describes the pain as “aching…like an emptiness.” The symptoms are worse at bedtime and prevent sleeping. The evaluation has been negative. The symptoms interfere with work and social activities.
  • Case Vignette 6: A 64-year-old executive prides himself on his good health and successful career. He presents with a 6-month history of epigastric burning made worse with eating that is only partially relieved by acid blocking medication. The visit was initiated for continued difficulties in carrying out work, and on several occasions, he had to leave business meetings because of the pain.
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Results of Survey of Gastroenterologists
The Communication 202 program was studied and reviewed by 20 gastroenterologists and GI fellows who completed the following survey: