Bengal Tigers Welcome


Photo by Mike Boswell / CC BY-SA 2.0 

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Author: Susan Splichal

Finding an effective way to communicate is essential in both medicine and education; the influence of an educational leader on staff, students and their families often leaves an impression as indelible as a physician’s impact on a patient. However, if we hope to move from the fundamental effort not to harm to the greater goal of fruitful communication, sometimes communicative success means meeting others on their own terms.

Active listening in medicine and education

Listening well and interacting, while remaining amenable to differing views, encourages non-judgmental discussion. Sensitively relating to others strengthens mutual goal-setting and cooperative results. The best veterans working in education and medicine are generally noted for their approachable, responsive, and unbiased demeanor. Able to tactfully manage conflict, stay focused, and motivate others, the best leaders have a firm grasp on interpersonal dynamics and skillfully deal with delicate situations through openness to varied perspectives. 

As a professor with an educational leadership background now teaching in a medical school, I find it uplifting to see a blending of attributes in both academic domains. Students preparing for the practice of medicine where the life of a patient is literally and figuratively in their hands are required, through bioethics discussions, standardized patient medical interviewing practice, and professional development dialog, to hone their communication techniques and to apply lessons learned. The best educational leaders, via adroit communication, speak with authority but not dominance, persuading groups to reach consensus, and interacting diplomatically.

Guiding effectively is very often coupled with leading by example: through watching a school administrator who does the job well and observing a physician who empathically relates to patients, professionals effectively model desirable behaviors. Authorities in their fields arrive at integrative solutions, through appropriate vocal tones with attentive facial expressions and body language alongside carefully worded written communications, all conveying a collaborative intent.

Communication: an art not a science

But communication is an art not a science: medical school graduates returning to visit us often relay snippets from patients’ lives which speak eloquently to learned leadership traits. Their narratives powerfully highlight the poignant challenges faced by so many of the people they see. Their stories are interwoven with core medical principles which govern the totality of their interactions. Fragments from patients’ lives which infuse the physician’s thoughts, emerge from an alliance of medical school preparation and meld with proficiencies honed in residency and the ultimate responsibility of becoming entrusted with another’s life. Concerns that are mirrored in the doctor’s eyes: care, worry, quiet triumph, sharing snippets from their patients’ difficulties, forming the mosaic of their days and speaking to the ever-changing milieu of medical practice.

Finding the ‘hook’

Of the numerous stories told by former students this particular one is unforgettable as an example of the resourcefulness of human nature. One of our graduates is now a primary care physician in a large metropolitan area in the United States. Dr. Wagner is a tall, soft-spoken physician with warm eyes, gentle manner, and a welcoming voice. His clinic attends the needs of society’s most vulnerable: some homeless HIV/AIDS patients and others suffering from poverty-related diseases, including mental health issues which are compounded by their often formidable physical concerns. 

An outreach program undertaken by Dr. Wagner’s clinic includes one to visit individuals without permanent homes – many of whom reside in makeshift shelters. Their boundless capacity to innovate is no more powerfully evident than in this particular example.

I ain’t no pimp

Dr. Wagner first met John during outreach care living in a makeshift shelter under a bridge.  John’s current experience with homelessness had manifested, among other targets, in a profound suspicion toward all health care providers.  After protracted and genial yet firm cajolement he finally consented to a clinic visit. Yet once inside the reception area, he refused point blank to go any further.  John walked into the reception area but, once there, would not go beyond the waiting room chairs.  Dr. Wagner spoke quietly with his patient in the reception room and was met with a rather rambling diatribe culminating in a fearful denial of the need for any treatment. Concluding his vehement diatribe with a flourish:

“I ain’t no pimp. I’m a Bengal tiger.” 

Never one to give up, Dr Wagner thought for a minute, then as if inspired ran over to the nurse’s desk. After a flurry of activity, his nurse resumed at her computer and called John to the door of the waiting area. Poking his head round the door he smiled and stepped straight into the examination room. Smiling, Dr. Wagner congratulated his nurse on their joint prompt action as they surveyed their handiwork in the form of a boldly printed sign pinned to the entrance to the examination room:

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 Susan Splichal photo BELMAS July 2016

Susan Splichal, PhD, MS, is a Qualitative Researcher and an Assistant Professor with the Department of Family & Community Medicine at the University of North Dakota School of Medicine & Health Sciences (UNDSMHS), Grand Forks, North Dakota, USA. Dr. Splichal’s degrees include a BS in English and languages, MS in Educational Leadership, and PhD in Educational Foundations and Research. She teaches medical students in the areas of bioethics, communication, professional development, and medical interviewing within the Clinical Sciences and patient-centered learning (PCL) within the Basic Sciences. Her research interests center on physician-patient communication, the medical school learning environment, andragogy, curriculum development, and medical student assessment. Dr. Splichal and two SMHS colleagues recently authored a qualitative student assessment tool, copyrighted and trademarked by UND, now administered within the UNDSMHS curriculum. A native of Minneapolis, Minnesota, Dr. Splichal was a Director of Education prior to joining the UNDSMHS in 2006.

If you have an interest in leadership preparation, please consider joining the BELMAS Leadership Preparation and Development Research Interest Group (RIG). To join the RIGs, become a BELMAS member or click the box alongside the relevant RIG groups on your 'My Details' page. Views or opinions expressed in BELMAS blog articles are solely those of the author and do not represent the views or expressions of BELMAS or BELMAS RIGS.

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