Communication is a cornerstone of quality practice. I have observed repeatedly how direct and thoughtful communication leads to better patient welfare and how the opposite can happen. Communication is also a key learning objective for everything I teach, so I knew I wanted to be involved for my own teaching goals, and so far, it's been a rewarding experience.
Cummings School Community Gets in Character for Communication Course
Faculty, staff, and friends play pet owners in mock cases to develop students’ communication skills
A crew of actors and facilitators, including professors, administrators, and supporters of Cummings School of Veterinary Medicine at Tufts University, make guest appearances every semester to help train students in the art of communication as they practice finding the right words, approach, and body language for optimal client interactions.
"Communication is one of the most important and underrated skills of being a veterinarian. It's a skill that every student will use in the profession, regardless of the species or track they choose," says Dr. Julia Wilkinson, V10 (she/her) clinical assistant professor in the Department of Ambulatory Medicine and Theriogenology (AMT) at Cummings School.
Wilkinson directs the Communication courses required for first-, second-, and third-year D.V.M. students. The courses are integrated into the larger Clinical Skills & Communication thread in the new curriculum, spanning three years. In the first-year introductory course, students consider the role of communication in veterinary practice and how it contributes to positive or negative outcomes. Wilkinson teaches students core communication skills with the goal of mastering four: empathy, nonverbal communication, reflective listening, and asking open-ended questions.
The talent shows up in the second and third-year Communication courses, where students put those skills into practice. Facilitators guide case scenarios, and actors portray pet owners. Working closely with Wilkinson is AMT department manager Wellesley Carminati (she/her). They've pulled together a pool of volunteer actors and facilitators to tap into as students hone these skills.
While faculty and staff from across departments have always volunteered, a friend of Cummings School—who happens to be a professional actress—jumped in to play a pet owner three years ago, opening up a new stream of actors for the course.
Tootie Larios wanted to give back to Cummings School in appreciation of her dachshund George's care while undergoing treatment at Henry and Lois Foster Hospital for Small Animals. Larios, who acts in theater, television, and film, has profound admiration for the work done by the veterinarians at Cummings School. In the midst of establishing an endowment to fund internal medicine research, she was asked if she'd like to act in the Communication class.
"I said, 'Count me in,'" recalls Larios. "This has been a wonderful way for me to combine the two big loves of my life—animals and performing. I can help animals by helping train those caring for them. It's a privilege. I'm so glad they asked me."
As with her other acting roles, Larios researches her cases and often brings in props and costumes. She has been such a wonderful addition to the program that Wilkinson and Carminati encouraged other friends of Cummings School to act, too. Some pop in once a semester, and others show up every session. A husband-and-wife team often performs together as a bickering couple unable to agree on treatment. From within Cummings School, social worker Eric Richman and curriculum administrator Sarah Lawson also bring fresh perspectives as actors in the course.
"The value of having outside volunteers for students is huge," says Wilkinson. "It's still a mock scenario, but when it's someone the students don't recognize, it allows those cases to feel more realistic."
From the research labs to Tufts at Tech, faculty from across Cummings School pitch in to facilitate. Regulars include Dr. Fair Vassoler, Dr. Greg Wolfus, Dr. Brian Moore, and AMT team members, Dr. Alexandra Uden, Dr. Adam Ward, Dr. Erin King, and Dr. Robert Dwyer. The sessions have been further enhanced by the addition of several local small animal and equine veterinarians who volunteer as facilitators now, too.
Dr. Meera Gatlin, a professor in the D.V.M./MPH program, often facilitates sessions. "Communication is a cornerstone of quality practice. I have observed repeatedly how direct and thoughtful communication leads to better patient welfare and how the opposite can happen. Communication is also a key learning objective for everything I teach, so I knew I wanted to be involved for my own teaching goals, and so far, it's been a rewarding experience."
Four mock case sessions run every semester (fall for second-years and spring for third-years). Carminati organizes the students into groups of five with one facilitator. The actors are each assigned a case and rotate through the room. Classmates observe one another and provide feedback, tracking the core communication skills.
"Actors and facilitators give the scenarios authenticity, and that allows the students to shine when it comes to communication," says Gatlin. "The organic flow means we can really combine critical thinking and decision-making with communication strategies unique to the scenario, and no scenario ever plays out the exact same way."
Wilkinson recently revamped the scenarios to align with the Clinical Relevance thread of the new curriculum. The cases represent common situations students are likely to encounter in primary care. Second-years learn to discuss with clients the financial side of veterinary medicine and how to approach cases where pet owners have limited resources.
"Third year builds on that, with increasingly difficult client scenarios and situations, including euthanasia, quality of life, and ethical issues," says Wilkinson. "We push students a little more."
In the case of a German Shepherd suffering from degenerative myelopathy, students must address putting the dog down. Students confront an ethical issue with a challenging client in one case, and others include a lethargic goat with a parasite, a colicky horse, and a vomiting Labrador. Wilkinson notes that many of the actors "call dibs" on certain cases. (Sick lizard is a fan favorite.)
"We give actors a background story and some prompts and guidelines, but we don't hold them to details and specifics," says Wilkinson. "We allow the actors to have some freedom in their acting and the story to add realism to the case."
Facilitators guide the action. They often pause scenarios to ask students to self-reflect and garner feedback from peers and sometimes the actors, too.
"We're hoping students work through how they are going to deliver bad news, hold that ethical boundary with a difficult client, and broach that quality of life conversation," says Wilkinson. Students especially struggle with euthanasia. "It's hard to be the first one to say the words. When we have students stuck in that moment, we talk them through it, restart, and finish up successfully."
After participating in the sessions for three years, Larios has high praise for Wilkinson, Carminati, the facilitators, and the students.
"This course is truly unique," says Larios. "Facilitators create a safe environment for students. It removes the need to be perfect and just be present and engaged. The level of engagement is impressive."
Wilkinson and Carminati report that feedback from students is also overwhelmingly positive.
"It's a skills lab, and most students have some degree of anxiety going in," says Wilkinson. "They appreciate the opportunity to muddle through and be awkward in a safe environment before going into clinics and meeting with clients. Many say that watching peers is as beneficial as being the one in the hot seat."
Carminati often hops in to act herself. Based in Woodstock, she has connected with many colleagues in Grafton through the sessions. "I love the interdepartmental cross-overs, external people, and the faculty getting face-to-face with students before rotations start."
Bringing in friends of Cummings School has been a fun twist, enhancing the sessions and providing another touchpoint with the community.
"The reason I became involved with Cummings School was the amazing care George received," says Larios. "What I learned is that this level of expertise, professionalism, and care is the standard and not an exception. To be able to pass this to students will ensure a better world for all animals and the humans who love them."
Wilkinson and Carminati are grateful for the actors and facilitators who volunteer their time to impart these essential skills to the next generation of veterinarians.
"This course is truly a team approach—and a joy to run," says Wilkinson. "When students get into clinics and have that 'aha moment,' and use what they saw their peers do or what facilitators recommended to allow for that successful client interaction, that's when I see the greatest benefit."
Department:
DVM Program