This elective provided a unique opportunity to collaboratively work with students in other programs from UCSF and apply health coaching skills to patient care. I specifically signed up for this program to practice motivational interviewing and health coaching skills regarding topics that are considered more uncomfortable to talk about in the health field. My goal was to enhance my communication skills around these topics for the benefit of my future practice and patient care. Additionally, I wanted more exposure to the way other people approached patient care, and in this case that was my fellow colleagues. I learned a lot from my partners each session and the need for these patients to receive these types of meetings to better understand and manage their health.
The first patient I saw was referred to our program for health coaching on their recent diagnosis of diabetes mellitus. I was paired with a Nurse Practioner and together we determined the main agenda we wanted to talk about with this patient. I really appreciated the thoughtful questions, pauses and various motivational interviewing skills my partner demonstrated throughout the appointment. I felt my partner displayed true skill with the “Ask, Tell, Ask” technique, providing patient education when needed, and checkback moments to ensure the patient understood the information just shared with them. For example, my partner asked if the patient understood the reason for their hospital visit and whether they knew what their A1c levels meant. The patient said they knew nothing about their stay and had never heard of the A1c test or its significance in regard to their numbers. My partner explained these things in laymen terminology and then asked the patient in their own words to rephrase the knowledge as if they had to explain all of this to a family member. The flow of the conversation was at ease and opened the conversation to more topics regards the patient’s health and needs and willingness to take control of their health.
The above example provided a better understanding of the skills that this elective emphasized and helped me start to apply them with patients during each session. Not only were these sessions insightful encounters with each new partner, but it also emphasized to me that our visits were not only about patient education. Although I was surprised by the amount of people we came across throughout the sessions that did not know about their health status and required some patient education such as my first patient, it was also more apparent that some people needed the motivational interview to start to make a change in their current health status and feel empowered. I found this to be a very challenging to skill with each patient I came across whether it involved someone with substance abuse, psychiatric presentations, diabetes or hypertension. Sometimes these visits turned into social visits, and I felt it was still important to the patient and helped them feel like they were not alone.
In my program at UCSF we have a whole year before we are in clinic again. Electives such as Word on the Wards that provide opportunities to engage with other students and volunteer our time to patients in our community is invaluable. Not only are we advancing our skills and communication with other disciplines, but we are also giving back to the community and providing health coaching or patient education to a population that is underserved. This was a truly unique opportunity and setting to work in because time was not limited, and we could really sit down with a patient and address their needs. I appreciated this experience and plan to continue in the Fall to further my practice as a developing health professional and community member.