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Dr. Allan
Hamilton, head of the UA department of surgery, teaches his medical
students about body language crucial to doctor and patient interactions.
However, instead of pictures and
diagrams, he employs the help of horses to make his point.
Since January, three University
of Arizona students have had the opportunity to study an unique
course offered as a spring elective -Medicine and horsemanship:
An Introduction to Nonverbal Human Interaction at the Bedside.
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When Jennifer Slack,
a first year medical student, read the title of the course,
she thought the class was "a little bit strange"
and wondered how the instructor was going to conduct the class.
But now, she says, the course has made her more sensitive
and aware of her small movements - such as when she enters
a room to interview a patient.
"Am I walking in with too
much arrogance or too much energy?" Slack says.
"I don't want to intimidate
the patient, so I kind of lean over just a little bit and
not make direct contact with the patient right away,"
she adds.
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Every Friday
afternoon, students meet at Hamilton's Ranch on the east side of
town, where about 34 pets wander around, and the students learn
horsemanship exercises for two hours.
The idea, stemming from Hamilton's
lifelong interest in horses, at first surprised his peers, Hamilton
says, but then it quickly moved into the curriculum as being the
first of its kind in the nation. The course is designed to teach
students about non-verbal communication that the horses use, which
will eventually translate into students' body language.
The use of appropriate body language
is the main component for a successful physical examination as well
as for bedside manners, Hamilton says. Young physicians need to
learn to handle difficult moments such as fatalities and how to
comfort patients' families, he adds.
By learning how to communicate non-verbally
with a horse, students will adapt these techniques in their professional
career, he explains.
"Their body language is going
to be a lot better," Hamilton says. " I think they are
going to be much more tuned-in to what they are saying to their
patients, so their words and their bodies talk together, which means
they are going to talk much more from the heart and much more authentically."
Hamilton, who received his medical
education from Harvard University, assisted a professor who was
known as one of the busiest cardiologist in the world. Yet, he took
the time to listen to his patients by making them feel like they
were his only patient. This professor had a great influence on Hamilton
in terms of showing him the significance of relating to patients,
he says.
"I think that is part of what
is missing in medicine nowadays," he says. "So often are
our body languages, 'I don't have time for you, I am in a hurry,
or I got paper work to do.' Perfectly, what you are saying is 'Hey,
your are not the important thing here,' and I think one of the things
is a horse won't let you get away with that."
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During the course, Hamilton realized
that horses can teach people about patience, gentleness
and relating non-verbally, he says.
"Being with the horses
has taught me how to be a better human being," Hamilton
says. "There is not an ounce of deception in a horse.
Whatever is in their hearts, they show you.
"And if someone says,
'You are just like a horse,' that means what you say is
what you feel and what you do is what you say."
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Hamilton
has also used horses to tutor children and troubled juveniles in
past years. Speech-disordered and autistic children can establish
communication better with a horse than they can without, he says,
adding that after seeing the results, he came up with the idea to
use horses in his medical teaching.
Chinook, a quarter horse in his 20s,
runs wildly, drawing circles in the corral, as medical student Oren
Gottfried tries to establish eye contact with the animal.
"Keep talking to her, keep talking,"
Hamilton says to Gottfried, who stands in the middle of the fenced-in
area releasing his shoulders down, looking pale.
"My
power doesn't work, Gottfried replies, staring at the horse.
"You have to establish some contact
with her and put some energy on it and see if you can move her towards
you," Hamilton suggests. Gottfried is successful after a couple
of tries - Chinook comes to him and waits calmly.
"She's done good. Tell her that,"
Hamilton says, sitting on the fences, "Do the friendly game."
The term "friendly game"
- rewarding the horse - was coined by world-famous horse trainer
Pat Parelli. The rewarding aspect is only one of seven games used
in learning exercises. The friendly game can apply to patients,
Hamilton says, but he stresses that he is not equating patients
with horses. Student in Hamilton's class have started to apply what
they learn to their actual patient examinations and say they believe
it works. Karl Rosen, a third-year medical student, says although
working with horses tends to be hard for him, he is already more
tuned in with his non-verbal communication.
When the class works as a whole at
the end of each session, they watch the videos of students interviewing
patients, and they critique each other.
"This gives you the chance to
step back," he says. "It gives you more of a blueprint
for the next general surgery." |
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