Combined exploration of personal awareness and skills learning The Medical Interview Teachers Association (MITA), a British group whose mission is similar to that of AACH, developed this model, whose working assumption is that personal awareness issues are best addressed in the context of daily work, rather than at specified times in a curriculum. As an example, imagine that during a discussion of an interview, the interviewer comments on the frustration s/he feels when coping with patients who somatize. This “integrated” group might decide to not only discuss and/or role play useful skills for helping with patients who somatize, but also choose to reflect on the source of the interviewer’s frustration and how to cope with such feelings. Since emotions frequently arise when working with patients and learners, there are plentiful opportunities to explore this domain throughout the week. This group has the flexibility to divide into whatever configurations and for whatever length of time it determines will properly balance the skills learning goals of the participants with the personal awareness goals.AACH integrated groups are composed of 6-7 course participants, a faculty facilitator, and up to 2 co-facilitators.
Each participant in this group will be asked to be prepared to share (spoken informally, read from pieces s/he has written previously, or written in the moment) 2-3 vignettes that may include the following domains:
- Stories of Celebration (Tell about an experience with a patient or a learner when you felt creative, connected, or felt you made an important and helpful impact)
- My Most Meaningful Patient or Learner1 (Tell about an experience with a patient or a learner that was meaningful to you. Explain why this experience made an impact, and what you learned.)
- Critical Incident Report2 (Tell about an experience with a patient or a learner in which there was conflict, or the outcome was not what you hoped for. What did you learn that you have carried forward in your practice or teaching?)
Participants will explore the extent to which narratives resonate with their own experience, and explore themes of professionalism illuminated by the stories.AACH Narrative groups are composed of 4-5 course participants, one facilitator, and one or two co-facilitators.
Modeled after the work of Michael Balint - Michael and Enid Balint developed this approach to personal awareness in Great Britain in the 1950’s. Participants in case-based groups discuss particular clinical cases, enabling participants to become more sensitive to and understanding of their patients' experience and use this understanding for enhanced effectiveness.The AACH has adapted this case-based approach to include teacher-learner relationships and to facilitate more exploration of the health provider's/teacher’s personal reactions. Participants bring into the group case-based dilemmas, and the group decides which cases will be presented at each session. Participants respond to presentations by offering perspective and empathic support. AACH Case-Based groups are composed of 4-5 course participants, a facilitator, and up to 2 co-facilitators.
Groups for Intact Teams are designed for intact teams of 5 people or more registering together. These groups focus on enhancing skills and personal awareness among individual members of an intact team and developing habits and strategies to maximize intact team function
An application of the “case-based groups” outlined above, participants in leadership case-based groups will discuss particular management and leadership issues, enabling participants to become more sensitive to and understanding of their direct reports’ experiences, and to use this understanding for enhanced effectiveness. This case-based approach will facilitate more exploration of leaders’ personal reactions. Participants will bring into the group case-based dilemmas, and the group will decide which cases will be presented at each session. Participants respond to presentations by offering perspective and empathic support.AACH leadership case-based groups are composed of 7-8 course participants, up to 2 facilitators, and up to 2 co-facilitators.
Adapted improvisational theater principles and skills can help us improve our communication skills with patients and colleagues to enhance teamwork in medicine. During our time at ENRICH, we will combine reflective discussion with improvisation exercises to cultivate mindfulness, kindhearted curiosity and connected presence— qualities that result in more effective and fulfilling interactions with patients and colleagues.