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UA medical students learn the importance
of body language
by trying to get horses to complete simple tasks.
The five
denim-clad medical students were at a loss. All their scientific
book learning couldn't help them now.
They were looking at a nervous 1,000-pound
horse that wouldn't do its part to complete a basic exercise.
They ran at Mahto, flailed their arms and yelled, "Ha!"
in an effort to move him into a corner of the sand-filled arena.
Just when they thought they'd got
him going in the right direction, he bolted the other way.
Dr. Allan Hamilton, who on this
windy Saturday afternoon had exchanged his white coat for boots,
jeans and a cowboy hat looked on, a bemused smile twitching beneath
his mustache. Gathering the students, he asked them what they
thought was going wrong.
"He's spooked," they responded.
"Why is he spooked? Five jackasses
running around with a lot of energy in their bodies!" he
boomed good-naturedly to their laughter. "You guys are putting
too much energy into your body language."
Regrouping, the students approached
the animal with less energy. Working together to form a human
fence, they soon maneuvered the paint stallion into the corner.
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The exercise
the University of Arizona College of Medicine students had just
completed on a grassy ranch off Tanque Verde Road was part of an
unusual class that uses horses to teach future doctors how to be
better communicators.
Called Medicine and Horsemanship,
the class is the only one of its type in the United States. |
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While no
one is equating horses to humans, Hamilton said working with horses
teaches patience, gentleness and nonverbal communication skills,
all of which are essential to a good doctor-patient relationship.
"This is a dramatic shortcut
to some of those skills," said Hamilton, a neurosurgeon, UA
professor and head of the department of surgery.
"Horsemanship requires the exquisite
understanding of nonverbal communication and the sensitivity to
the import of body language" is the way Hamilton explained
it in his written class description.
"There is no endeavor that will
more quickly and effectively teach you awareness of your own body
language and energy level than learning the principles of round
pen groundwork with horses."
"Horses are so perceptive,"
said first-year medical student Wendi Kulin. "You can't make
any false moves around a horse."
Hamilton began offering the class
three semesters ago, and word is quickly spreading.
"We've had calls from all over
the United States from medical students asking about it," Hamilton
said.
The noncredit class consists of eight
sessions. After learning about horse safety, the students spend
the next seven sessions engaged in horsemanship exercises. They
learn to soothe, guide and teach tasks to the horses. They don't
ride them. Most of the students have little or no experience with
horses.
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After the class, they discuss
how the lesson applies to patient care scenarios.
Hamilton said the exercise
with Mahto demonstrated things about energy and teamwork
that he could have talked himself "blue in the face"
trying to teach as effectively.
One of the key lessons, Hamilton
explained in the discussion session afterward, was, "When
you put too much energy into the system, the system gets
out of control."
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Imagine a team of doctors, nurses and technicians
called together to care for a victim of a car accident or a shooting.
The resident comes running into the trauma bay filled with a sense
of urgency and out of breath.
The message being given, Hamilton
said, is, "Good God, this situation is out of control! Look
what kind of condition he's in."
"You want to bring the energy
level down because bringing it down makes thing more efficient,"
he said.
Slow you breathing. Lower your voice.
And never run to a trauma, he advised the students.
Hamilton, who is from New York City,
began training horses a decade ago. He soon saw how what he was
learning working with horses applied to his profession.
Hamilton recognized his manner of
striding up to a patient could be perceived as aggressive. He noticed
that groups of doctors on rounds charged into a patient's room like
invading soldiers. He saw that patients were sometimes treated like
"a slab of meat," prodded and poked by a doctor with little
warning.
"If you did that with a horse,
it would jump out the window," he said.
A physical examine should be reassuring,
he said. With appropriate use of touch, such as patting the patient
on the shoulder or holding a patient's wrist to take a pulse even
though machines check pulses now a doctor establishes a bond with
the patient, Hamilton said.
And that's not so different from the
way a good horseman initiates contact with a horse by gentle stroking
and petting, he said.
"We spend so little time on teaching
doctors to communicate effectively and develop bonds with their
patients… .Yet, in no bond outside of marriage is the sincerity
and integrity of communication so important," Hamilton said.
Kulin and other students said the
class has been an invaluable experience.
"Dr. Hamilton's idea is that
learning how to be non-threatening and give off a really positive
and approachable attitude is a really good thing to have when you
are dealing with patients normally," Kulin said.
"We have such little time with
patients today that you don't want to blow it by seeming arrogant
when you come in the room."
"If you're more conscious of
how you act, it will come across to the patient," said second-year
student Mohammad Vaziri. "It's not only our job to treat the
patient but to make the experience as least traumatic as possible."
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