Values-based practice (VBP) provides a framework
and skills enabling medical students and physicians to
work in a respectful and sensitive way with the different
values and perspectives present in practice.
To conventional communication skills training on
eliciting patient Ideas, Concerns, and Expectations, (ICE),
values-based practice adds the acronym ‘StAR,’
encouraging students to also ask patients about their
Strengths, Aspirations, and Resources:
A body of literature backs theory and practice of VBP
in clinical settings. Although there is reason to believe
that incorporating VBP into medical practice leads to
more successful patient encounters, few training
materials for medical students have been produced.
Strengths include personality traits or characteristics
that can help patients cope with the illness or condition
(or have helped the patient cope with illness or disease in
the past).
Morsani College of Medicine (USA) and Warwick
Medical School (UK) have collaborated to produce the
first clinical logbook to include VBP.
The Clinical
Logbook helps students integrate evidence and values
into their own patient encounters, as early as first year.
Aspirations are the hopes of the patient either for the
short-term or long-term; the aspirations can be what
he/she would like to accomplish tomorrow or in ten
years.
The Clinical logbook includes many standard
components of the patient interview. By going further
and focusing on patient-centered components, the
student is encouraged to engage with processes of
values awareness, values reasoning, and values
communication.
Reinforcing these and other VBP
processes
alongside
traditional
evidence-based
approaches can help students work towards balanced
decision-making within a shared framework of values.
Care that is consistent with values-based practice
incorporates two important pillars of excellence –
evidence and values.
The Clinical Logbook teaches students how to
properly discuss: History of Present Illness, Past Medical
History, Family History, Social History, Physical
Examination and Management Plan.
The Clinical logbook also enables students to keep a
record of all of the patients they have seen, a helpful
study tool for clinical examinations.
Resources can be the patient’s cultural, spiritual, or
religious counsel or a support system of family and
friends; it is the support that the patient can rely on
emotionally, financially, and/or otherwise.
The University of Warwick Medical School and the
University of South Florida Morsani College of Medicine
will be utilizing the Clinical Logbook alongside a valuesbased practice curriculum to train groups of first through
fourth year medical students.
Research study design is underway to examine
student logbook responses, focusing on the students’
ability to incorporate both evidence and values into a
balanced, patient-centered decision.
Other medical student training materials are being
developed
including
the
values-based
practice
Instructor’s Manual for medical educators and
computerized online decision simulations for medical
students.
*Presented at the 2012 Cumberland Lodge Colloquium, “From the Classroom to the Clinic: Humanities and Education in Bioethics’” For more information contact: jchevins@health.usf.edu