Bringing the Patient Experience into the Classroom

Betty Hsiao, MD, wants to know what her patients are thinking.

An assistant professor of medicine (rheumatology, allergy and immunology) at Yale School of Medicine (YSM), Hsiao develops long-term relationships with the individuals she treats for various rheumatologic conditions.

“You first meet and care for a patient by discussing initiation of treatment, but later on, that treatment may change, depending on the disease trajectory, the patient’s life circumstances, or insurance changes,” Hsiao says. “I want to understand more about what goes into the medical decision-making process from the patient’s perspective.”

Incorporating patients’ preferences is especially important when addressing rheumatologic diseases that have many treatment options, such as rheumatoid arthritis, Hsiao notes. When rheumatologists choose a treatment, they commonly assess a patient’s disease activity through exam findings, blood work, and imaging. But, Hsiao explains, they might not take into account the impact of the condition or medications on the patients themselves.

Additionally, there are aspects to the patient decision-making process that rheumatologists may not be aware of, Hsiao says. For example, Hsiao and her mentor, Liana Fraenkel, MD, MPH, have found that when considering a new medication, patients often want to learn about other patients’ experiences with it first.

A few years ago, Hsiao sought to introduce the patient perspective to first-year students at YSM. She invited individuals living with rheumatic disease to a session of a rheumatology didactic series, where they spoke about their complex illnesses and what they wished future doctors knew about their experience.

“Many patients living with rheumatic disease say that it’s an invisible illness because others can’t tell that they are living with this condition,” Hsiao says.

With funding from a recent Rheumatology Research Foundation Clinician Scholar Educator Award, Hsiao plans to study how best to incorporate the patient experience into educational sessions for medical students. She also plans to expand these sessions by developing a cohort of patient educators and creating a curated set of patient narrative videos that will be made available to other institutions.

“This type of training not only helps students understand the patient’s point of view but also makes the learning experience more dynamic and engaging,” Hsiao says. “Bringing the patient’s voice into the classroom will prepare our students to care for diverse people with rheumatic disease, whether early on during residency or later in their careers when they are practicing physicians.”