Plenary Speakers
Hossam Hamdy, MD, FRCS (Ed), FRCP, PhD Med Education Professor of Surgery and Medical Education, Gulf Medical University, United Arab Emirates
Systems thinking in teaching, learning and assessment of communication in health professions education.
All over the world and for many years, health professions education programs have been using different approaches in teaching communication skills. Empirical evidence of its effectiveness is small and confidence in the results is low (Gilligan C. et. al. Cochrane Systematic Reviews 2021) An important contributing factor to the inadequate outcome is that communication is considered a skill, (Sarangi S. Communication and Medicine 2022) a form of behavior which we teach it like other procedural skills following a linear reductionist approach.
It has been commonly labeled as a ‘soft skill’ in contrast to the ‘hard skills’ i.e., Knowledge and clinical expertise. In fact, it should be considered ‘Hard skill’ as it is core for the successful outcome of the patient journey in the healthcare system.
In this presentation, I argue that Medicine is a social science. It is about people and human interaction embedded in the rapidly changing healthcare system. Ineffective communication training in healthcare, is a multifaceted, multidimensional, complex ‘Wicked problem’. It should be viewed through the lens of a systems thinking, holistic approach, recognizing the communication system components, and the interrelatedness of these components (religion, culture, social, economic, providers, and students perspectives) and how they work in healthcare practice and health professions education.
The presentation builds on the work of Christian Matthiessen’s ‘Systemic functional linguistic theory’, Engel’s Biopsychosocial conceptual model and Community of Practice theory” (Wenger and Lave 1991)
Bio: Hossam Hamdy, MBchB, DS, MS, FRCSEd, PhD Education
Prof. Hossam Hamdy is a Professor of Surgery and Medical Education and the Chancellor of Gulf Medical University in the United Arab Emirates. An internationally known medical educator, active researcher, has been involved in the development of several medical schools in the MENA region. His work and contribution to Medicine and Medical Education has been acknowledged and won him the Sheikh Khalifa Award for Higher Education for “Distinguished Professor in Teaching” in 2011, honorary Fellow of Association for Medical Education in Europe (AMEE) in 2021, decorated by the Republic of France with the prestigious decoration as “Chevalier Dans L’ordre Des Palmes Academiques” / “Knight of the Order of Academic Palms” in 2011 and was awarded the WHO Health Workers Recognition Award: Health Professionals Education in 2021 for his achievements in Medical Education.
Dr Caroline Jagoe, School of Linguistic, Speech & Communication Sciences, Department of Clinical Speech & Language Studies, Trinity College Dublin, Ireland
Dr Caroline Jagoe is Assistant Professor in the Department of Clinical Speech and Language Studies, Trinity College, The University of Dublin. With a clinical background in speech and language therapy, she has worked in the public health system in South Africa and in Ireland, and has collaborated on projects addressing disability inclusion in a wide range of countries including Ethiopia, India, Iraq, Mozambique, and Somalia. Her research addresses participation of people who are frequently marginalised in research and programming in humanitarian and development settings, with a specific focus on the inclusion of people with communication disabilities. She is a recipient of the prestigious IRC Laureate Grant, for the project Co-Construct and the academic lead of the partnership between Trinity College Dublin and the United Nations World Food Programme addressing inclusion in food assistance programming.
Discriminatory epistemic injustice: The silencing of communication disability in research practices
The accepted knowledge-making practices of academia represent a system of power relations that have the effect of silencing some knowers, with certain groups at heightened risk. Epistemic injustice - the unfair devaluing of a person, or a groups’, knowledge and system of knowing – is not a new concept and has been applied to studies on communication and healthcare. Despite this burgeoning literature, I will argue that epistemic oppression remains persistent and underrecognized with regards to communication disability, taking the perspective that this heterogenous group face very particular risks of epistemic injustice. This injustice demands a radical rethinking of the seeming minutiae that make up our research processes across disciplines.
In this presentation I will discuss epistemic injustice and communication disability through two lines of argument. Firstly, drawing on evidence from healthcare and social science research, I will argue that the de facto exclusion of persons with communication disabilities results in a hermeneutic injustice with real world consequences. Secondly, focusing on aphasia research, I will argue that the accepted approaches in systematic reviews, the composition of research teams, as well as publishing practices all have an equally damaging effect on hermeneutic justice by devaluing the knowledge contributions of researchers from the Global South and restricting linguistic access to the knowledge generated from their own communities. I will conclude by suggesting that ethical research practices should therefore take anticipatory action at a structural level to ensure epistemic responsibility to persons with communication disabilities and the local professionals who work alongside them.
Professor Mary Catherine Beach, School of Medicine, Center for Health Equity and Berman Institute of Bioethics, Johns Hopkins University, USA
Mary Catherine Beach is a professor in the School of Medicine, with appointments in the Center for Health Equity and the Berman Institute of Bioethics, at Johns Hopkins University in the United States. Dr. Beach’s research focuses on humanizing healthcare by promoting respect for patients as well as improved patient-clinician communication. Much of her work has been targeted towards improving healthcare quality for patients who face systemic disadvantage and in the setting of HIV/AIDS and sickle cell disease (SCD). Her research has been funded by the National Institutes of Health, the Agency for Healthcare Research and Quality, the Robert Wood Johnson Foundation, and the Greenwall Foundation. Dr. Beach has won numerous awards for her scholarship and mentorship, including the Jozien Bensing Research Award from the European Association for Communication in Healthcare (EACH) in 2010, and the 2017 recipient of the George L. Engel Award for outstanding research contributing to the theory, practice and teaching of effective healthcare communication and related skills. In 2022, Dr. Beach was elected as a Hastings Center Fellow.
Moral Dimensions of Respect Expressed through Language in Healthcare
Respect is fundamental to all human interactions and especially important in healthcare. In Western bioethics, the long-held, dominant view of respect focuses almost exclusively on respect for patient autonomy, which provides the basis for informed consent and involving patients in treatment decisions. Yet this narrow notion of respect is criticized as being too ‘American’ or individualistic, and some have advocated for a broader ‘European’ view of respect that is focused on respect for autonomy, dignity, integrity, and vulnerability.
Through the lenses of philosophy and linguistics, I will discuss in this presentation how different facets of respect manifest in how health professionals communicate with and about patients. I will demonstrate this through examples of patient-clinician dialogue and excerpts of text from medical records. Because these different facets of respect are conceptualized primarily from the perspective of academics, who draw their observations about morality from different experiences than those of many patients, I will also compare theories with how respect is experienced by patients. I intend to argue that the medical field should enrich how respect is talked about, taught, and fostered within clinical settings, and that health communication scholars would do well to embrace the moral constructs that underlie the research and communication skills training of health professionals.