COMMENTARY

Want Med Students to Be Better Doctors? Make Them Teach

Amelia B. Warshaw

Disclosures

July 27, 2018

"Sex Ed by Brown Med" is a student-run elective that has become one of the school's most popular. It provides students with the opportunity to gain on-the-ground experience while becoming empathetic and effective stakeholders in middle-schoolers' health, education, and well-being. The program provides an opportunity for medical students to test-drive the key skills that will determine their success as physicians: communication, flexibility, patient-doctor collaboration, and what Magee calls "knowledgeable empathy."

"The medical students, hungry to be impactful and connect, are young enough to remember the feelings and thoughts of adolescence, and they are old enough and knowledgeable enough to use that memory to their advantage." Magee adds, "It's a perfect fit; both the students at the middle school and the students at the medical school feel the positive impact of the program."

Indeed, a survey of over 100 past "Sex Ed by Brown Med" student-teachers found that teaching sexual health education overwhelmingly increased medical students' awareness of their role as communicators. More than two thirds of the students surveyed reported an increase in their ability to "use clear language to communicate medical topics." More than half said they believed they were better able to communicate using "inclusive language."

Replacing the Abstract With Real-World Experience

My own experience in the program forced me to think on my toes and taught me how to gauge my students' comprehension of material relevant to their personal health. Most important, it encouraged me to engage in a dialogue with the students about some of the most personal and intimate topics that doctors discuss with their patients—including sex, sexuality, consent, self-esteem, high-risk behaviors, alcohol, and drugs.

My class of middle-schoolers was a shy and quiet bunch, making it hard to tell whether they understood, were embarrassed, or were just totally disengaged. For that reason, our most successful session was also one of the most basic: What are condoms, how are they used, and where can someone get them? Somehow, our reserved class turned the lesson into a rowdy call-and-response.

"What's the best way to protect against pregnancy and STIs from sex?" "Condoms!"

"How old do you have to be to buy condoms?" "Any age!"

"Are two condoms better than one?" "No way!"

This went on a loop for about 20 minutes, with everyone from the class troublemaker to the shyest girl in the group shouting along. From then on, we tried to make every session have some element of call-and-response. It was a bigger lesson as well, as it turns out that a version of call-and-response also works well in the exam room to check patients' understanding of everything from drug dosing to discharge instructions. Lesson learned: When we included them in the conversation, our class taught us how they learned best.

Rather than meeting patients in the emergency room or inpatient wards, through the "Sex Ed by Brown Med" program, med students meet young students in the real world. Instead of studying about social determinants in the abstract, we see their effects on individuals, up close and personal through the dramatic role reversal that turns student-doctors into public school teachers. When it comes to helping medical students understand the critical communication tools they need to connect with their patients, make students become the teachers.

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