November 10, 2004

Unique Medical School Program Pairs Students with Patients Over All Four Years of Education

(Philadelphia, PA) – Effective communication between physicians and patients is a vital ingredient in the delivery of quality patient care. Yet the traditional medical education doesn’t expose the student to the patient until the second or even third year of their four-year program of study. To close that gap and help foster professionalism and humanism in medical students, the University of Pennsylvania School of Medicine has launched an innovative program that pairs medical students with patients for the entire duration of the students’ medical education training. Known as the Doctoring Longitudinal Patient-Centered Experience (DLPCE), the program not only gives first-year students an up-close-and-personal opportunity to learn about diseases and illnesses, but also allows them to learn about living with these conditions through the patient’s perspective – and therefore enhance their ability to communicate with their patients and become more skilled and sensitive doctors.

“Although our medical students had extensive contact with patients during their four years, virtually all of these experiences were ‘student-centered,’ in that much of their learning came from lectures, manuals, and textbooks that was later applied to the clinical setting,” explains Paul N. Lanken, MD, Professor of Medicine and Medical Ethics and Associate Dean for Professionalism and Humanism. “With this program, we have added an element to our existing curriculum that helps students learn about diseases and illnesses from the patient’s – not a textbook’s – point of view. Students can now understand what these conditions mean to the patient, and can develop and sustain meaningful and effective communication with the patient.”

As part of the DLPCE program, patients with chronic health conditions – such as diabetes, heart disease, and Parkinson’s – from West Philadelphia, and other Philadelphia neighborhoods and suburbs, are paired with two students during the first year of medical school. Over the course of the next three years, students are in contact with those patients at least once a month, as well as when the patient is hospitalized or visits the office of his or her doctor. Students also visit patients in their homes to become sensitive to the patient’s daily surroundings and the health care resources that may, or may not, be available in the neighborhood.

After the first year, it is anticipated that students will have the skills and knowledge to act as “health coaches” for their patients by providing nutritional education, reinforcing and encouraging behavior modification to correct unhealthy lifestyles, and reviewing medication dosages and times under the supervision of the patient’s personal physician. By the third year of the program, it is hoped that the students will have gained enough experience to serve as patient advocates and help the patient and family navigate the inner-workings of the health care system again under the guidance of the patient’s physician.

Like any professional school program, students complete written assignments which become increasingly more complex and integrated as the program proceeds – mirroring the students’ growing recognition of the factors and realities that influence a patient’s condition and well-being. Medical school faculty support the students and their experience in several ways during the entire program. Students meet regularly with their patient’s physician to discuss the medical and human issues surrounding the patient’s condition and treatment program. Students also share their patient-related experiences in monthly small group sessions, facilitated by three faculty clinicians, that discuss the psychological, social, and cultural aspects of the patient’s condition and how the experience is affecting the students.

Ms. Dollie Meets Andrew and Autumn

While undergoing dialysis at Presbyterian Medical Center, Ms. Dollie Williams noticed that Penn medical students were visiting some of the other patients. “When I learned that they were part of this program, I joked with my doctor, ‘Hey, why didn’t you ask me?’,” she chuckles. She got her wish: shortly after that conversation with her doctor, she agreed to be paired with students Andrew Wilmot and Autumn Michelle Martin. “I felt comfortable with them right away,” says Ms. Williams. “They were wonderfully down-to-earth, respectful, and let me ‘take charge.’ Over the past several months, they’ve become even more observant of my needs and have been at my side even when I was quite ill and in the hospital.”

The students, too, believe that the program enhances their medical education and benefits the patient. “I chose to pursue a career in medicine because it really affects change in an individual’s life as well as society as a whole,” says second-year student Martin. “One of my major focuses in choosing a medical school was on community and public health opportunities, and as I looked at other schools with similar programs, I believed that the experience of following a patient over four years would be invaluable. When I found out about Penn’s program, I was very excited.”

“I don’t think a doctor can fully appreciate the importance of what he does without getting the opportunity to follow up on his patients, and see the impact of his care,” explains Wilmot. “It has been a really profound experience forming this bond with Ms. Williams, and I hope I get to know my future patients the same way I’ve gotten to know her.”

“I’m so proud to be part of this experience,” says Ms. Williams. “These students are eager to learn from my life, to get involved. They’ll make better doctors, hands-down.”

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PENN Medicine is a $2.7 billion enterprise dedicated to the related missions of medical education, biomedical research, and high-quality patient care. PENN Medicine consists of the University of Pennsylvania School of Medicine (founded in 1765 as the nation’s first medical school) and the University of Pennsylvania Health System (created in 1993 as the nation’s first integrated academic health system).

Penn’s School of Medicine is ranked #3 in the nation for receipt of NIH research funds; and ranked #4 in the nation in U.S. News & World Report’s most recent ranking of top research-oriented medical schools. Supporting 1,400 fulltime faculty and 700 students, the School of Medicine is recognized worldwide for its superior education and training of the next generation of physician-scientists and leaders of academic medicine.

Penn Health System is comprised of: its flagship hospital, the Hospital of the University of Pennsylvania, consistently rated one of the nation’s “Honor Roll” hospitals by U.S. News & World Report; Pennsylvania Hospital, the nation's first hospital; Presbyterian Medical Center; a faculty practice plan; a primary-care provider network; two multispecialty satellite facilities; and home health care and hospice.

This release is available online at http://www.uphs.upenn.edu/news/News_Releases/nov04/DLPCE.htm