Approaches to reflection on your topic area

You may want to write about:

-       What you learnt

-       Your thoughts on compassion

-       Reflections on these themes through what you have witnessed on wards and in clinics

-       Your experience of collaborating, preparing your presentation, presenting, dialogue afterwards

-       Reflection on any creative enquiry text you produced or co-produced

What you learnt?

Compassion is a difficult topic, and only after researching further, I realised that it can be quite easy to get compassion fatigue or feeling burnt out. GPs can meet so many different patients with varying health problems, which can become overwhelming. GPs are human, with their own personal and work stresses, and all these together can affect the level of effective compassion that they can provide. This project has also highlighted to me that, in the future, for me to be able to provide the best care as a doctor, I must be able to respect my own feelings, and need to find methods through which I can express how I feel, be it through talking to someone or by writing my feelings down on paper.

One recurring theme was mental health issues due to things like isolation, grief or ill health. For many people the GP was one of the only forms of human contact that they would experience for a long time and therefore it is so important that as doctors we acknowledge this and try to listen and show as much compassion to patients as possible without judging or disregarding their concerns

One of the things that I found very interesting when looking into the GMC outcomes for graduates document was the fact that self-compassion was something that had been mentioned a plethora of times.

The research into compassionate care was definitely an eye-opening experience. I think, as many people do, I had underestimated just how much of an impact compassion has on how patients experience healthcare.

Overall, I believe the entire process of producing this presentation has given me a greater insight into the meaning of compassion in medicine. I think that before this, I had overlooked and underestimated the role of compassion and how in fact, it forms the primary motivator in providing care. 

The important part to remember here is that the person in front of you is a fellow human being that in this moment has the need of reassurance and consolidation from you.

I was keen to include a slide on ways to improve compassionate practice. I believe that this prompted us to think about where we have seen compassionate practice slip, and consequently allow us to suggest ways to improve this. I have found that including this slide has allowed me to question how I would define compassion (outside of its formal definitions) and thus, has enabled me to have a deeper understanding of the concept.

What have you witnessed in clinics and on wards?

Although patients may understand the difficulty clinicians face, there is often a disconnect between the clinical agenda doctors have and the agenda patients hold. I feel that communicating with compassion and empathy are key to bridging such gaps.

I was also able to reflect during this time about the reasons why compassionate care might be difficult to achieve sometimes. I think there are a lot of factors that go into poor compassionate care and sometimes it is completely outside of the control of the doctors and the patient...situations are outside of the control of the doctor and the patient, but the result of these situations could be frustration for both the people involved.

Listening in during telephone consultations have helped me gain a deeper understanding for how clinicians can show empathy through their tone of voice.

Your thoughts on compassion?

One thing that interested me during my research was looking not only at how compassionate practice affects patients but also how it involves being compassionate to colleagues and also to yourself.

Compassionate practice also involves showing compassion to your colleagues as they are your teammates and often they equally need to be shown compassion in order to feel valued and to do their stressful job as effectively as they possibly can.

‘The good physician treats the disease; the great physician treats the patient who has the disease’ - William Osler. I think this sums up well how much better it is for the doctor to treat the patient holistically and as a person rather than as a series of symptoms and a disease that needs to be treated. I think this all comes under the compassionate practice umbrella.

This made me think about all the ways that we often don’t show compassion to ourselves - when we overwork ourselves and take on more than we can handle for example. It is very important to create a general atmosphere of compassion in the workplace, that we show ourselves the same compassion that it is so important to show others.

Why is it that the compassion we feel for our patient’s suffering is rarely if ever directed at ourselves?... Self-compassion could very well be one of the tools we can use to protect ourselves and those that we provide care for. Our hope is that through such discussion, we are able to slowly but surely help breakdown the stigma and prejudice associated with mental health. To provide better care for those in need, we must first take care of ourselves.

However, too much compassion can lead to burn out and desperation for doctors, as they can take on too much of the emotional load from patients. It is important to find a way to balance the need to be a compassionate practitioner, and the need to look out for your well-being.

I think as a medical student  I am lucky in that I’m not on a tight schedule when speaking with patients- I don’t have a list of patients that I need to have seen by the end of the day. When talking to a patient, the time I have to listen and connect with them, is as long as I want. It’s much easier to show your compassion when you have all this time because you can listen to your patient without interrupting them

The doctor and patient relationship is based on trust, mutual respect and compassion. This is why many patients feel comfortable disclosing very personal information with their doctor and it is very important that this information is treated with confidentiality and empathy. We, as medical student in this GP placement, have come across many cases of patients that apart from the apparent symptoms they came to visit their GP for, they were also going through either a difficult period in their lives or had to face some bad news, for example, cancer. The important part to remember here is that the person in front of you is a fellow human being that in this moment has the need of reassurance and consolidation from you. Dealing with such situations can be tricky and I feel that you become better in handing them as you go along and although sometimes you don’t really know what is appropriate to say in such cases, I feel that the best thing you can do is pay attention to the non-verbal cues and decide on spot the best reaction. 

Your experience of collaborating, preparing your presentation, presenting, dialogue afterwards

I also enjoyed collaborating with a partner on the project as it allowed us to bounce ideas off of each other and teamwork is an important skill to develop in all walks of life

I feel that discussing with colleagues during the continuity exercise and sharing clinical encounters helped me further my ability to collaborate with colleagues. I feel that this experience also helped me broaden my perspective in the importance of a third person’s perspective in facilitating constructive feedback on clinical communication and building rapport with both patients and colleagues alike. 

Overall, I enjoyed the process as well as working alongside someone else, as it was interesting to see how we both viewed the topic and how we combined our different ideas to produce a coherent and meaningful result. We each discussed our own personal experiences and thoughts, and tried to make sure they were both voiced through this assignment. Additionally, it was also beneficial to hear the thoughts our other colleagues had on our presentation, as each person has their own personal experience which shapes their views and beliefs on this issue.

If I were to approach this task again, I think I would like to show more initiative in choosing the medium through which we presented our topic. I think that PowerPoint to me was the default, and I chose not to consider any other. Perhaps, a more creative medium would’ve inspired me to approach the topic of compassion in a different way, and maybe I would’ve learned more from the process. 

I enjoy working with others towards a shared goal, but naturally we had different ideas that we felt were important. On reflection, I think the discussions we shared regarding the content of our presentation were beneficial to our learning, both improving our teamwork and allowing us to justify our ideas. 

Reflections on creative enquiry piece and process

Process

We both felt a bit unsure about the creative aspect of the project as neither of us had done something as such before. We both felt most comfortable with doing a presentation, as for us it was the best way to portray our content

As medical students, we are often not given the space to be very creative, and I found it liberating to show that aspect of ourselves.

We as a group of 4 collaborated to produce a creative piece that was inspired by a retired doctor that I saw on one of the wards. We wrote a ‘HAIKU’ poem to describe how the doctor becomes a patient later in life where doctors of the younger generation care for him. I found this experience very exciting & interesting because it allowed us a group to describe our thoughts and feelings in an artistic, creative way, which is something we never did before in medical school.