Medical Students learn to read the 'signs'
There was a lot to say last week when 25 medical school students met with a group of eight Hillsboro High School teenagers.
At one point in the fifth floor room in Light Hall, there were eight different conversations going on at once.
But the only sound that could be heard was a few nervous giggles from the medical students.
The eight teenagers are hearing impaired. They were invited to Vanderbilt by the medical students, who are enrolled in "Caring for the Deaf Patient," an elective class intended for first- and second-year students who want to learn more about taking care of patients who are deaf or who have significant hearing loss.
The American Tinnitus Association funds the class.
It was the first meeting between the medical students and the high school students, whose reactions to the attempted sign language ranged from amusement to respect.
The primary objective of the course is to familiarize future physicians with issues facing the deaf community and to help bridge the gap between health care teams and hearing impaired patients. There are more than 28 million Americans who are deaf or hearing impaired. Most of the Hillsboro students could only communicate with sign language. A few both signed and talked. The assignment was to be able to communicate with the students without asking for help from the students¹ teachers or from Samantha Terzis, a Nashville interpreter who serves as the class instructor.
During the meeting the medical students rotated from one deaf student to the next in 10 minute sessions where each was given a script with questions to ask ‹ names and ages; year in school; whether their parents sign; if they have ever been in the hospital; if they like doctors; and what they think is the best and/or worst thing about being deaf.
"Our goal is to practice using all the communication methods we talked about," Terzis told the group at the beginning of the class. "If you don¹t know the words for something, point to the sentence on your paper. It¹s important for you to be able to communicate. The method doesn¹t matter. Don¹t frustrate yourselves," Terzis told the medical students, who were struggling with how to communicate such words as "sister," "graduation," and the different meanings of the word "like."
Although the medical students were pleased with what they learned during the brief 40-minute meeting, they also realized they had a long way to go.
One medical student mistakenly signed that he himself was 15 years old.
And when asking about family members, medical student Kellie Klein meant to ask one of the deaf students if she was the baby of the family. Instead, she asked the girl if she had a baby.
And then there was the finger spelling of the word "turkey," when Klein asked the student about her Thanksgiving.
The girl smiled and wiggled hand under her chin, showing Klein the much-shorter sign language symbol for turkey.
The doctors-in-training learned quickly that jumbled communication can cause some serious problems in the doctor-patient relationship.
Seven of the eight Hillsboro students had spent some time in a hospital. None had ever used an interpreter to talk to a doctor. During the question-and-answer session, most of the students admitted they were either afraid of, or disliked, doctors.
After the teenagers returned to school, Terzis and the medical students met to discuss the meeting.
Some said they were tempted to pretend they understood what the deaf students were trying to say even when they didn¹t.
"You¹ll get caught if you fake it," Terzis told the students. "And if they¹re your patients, what if that one comment you pass up is the patient telling you that he or she has been nauseated for the past six months? That¹s important information that you might be missing."
One of the deaf students told a medical student he had broken his leg while running track, a sport he had participated in since he was 6.
The medical student thought the Hillsboro student had broken his leg while running track at age 6.
The elective class came about after Jeff Pollard, a third-year medical student, and Yasmine Ali, a second-year student, saw a need for better communication between deaf patients and their physicians. They took their idea to Dr. Deborah C. German, associate dean for Students, who endorsed the idea and helped the students find sponsorship. Jeanette J. Norden, Ph.D., associate professor of Cell Biology, is the course director.
Ali, a martial artist, had been teaching tae kwon do to a deaf student last year and was frustrated that she was unable to communicate well.
"I couldn¹t help but feel ashamed that I, as a medical student, had no idea about how to communicate with him in any meaningful way. There seemed to me to be something incongruous about being in medical school and having no clue how to deal with the deaf or hearing impaired and I realized that it wasn¹t something I was getting from the regular medical school curriculum."
Ali said that one of the most eye-opening parts of the class was a six-hour period where the students were required to be "deaf."
They wore 30-decibel earplugs and were instructed not to speak a word while performing certain tasks during those hours. One student told the group he went grocery shopping at Kroger and realized that not being able to communicate with other people made him seem rude when he couldn¹t even say "excuse me" when he bumped into another person in the aisle.
"Communication losses take away your ability to be nice," Ali said. "It¹s amazing what we take for granted."
Other class topics and assignments have included working with deaf people on several occasions in many different settings; lectures on tinnitus (ringing in the ears that often leads to deafness); the proper use of medical interpreters; pros and cons of cochlear implants; hearing loss in the elderly; counseling parents of deaf children; and insurance and legal liability concerns. The students have also learned medical sign language as well as some basic American Sign Language.
Pollard said the future of the class depends on whether the students can find a new sponsor.
Drinda Rawlings, one of the students¹ Hillsboro High School teachers who accompanied the group to Vanderbilt, said the meeting was good for both sets of students.
"What happened here today was wonderful. Our students were assuming responsibility for themselves today and for their communication," she said. "We saw one of our non-readers and non-spellers sign and spell today. He knew that in this situation he knew more than anybody else and he took responsibility."