The Faculty of Medicine’s Flexible Enhanced Learning (FLEX) course encourages students to immerse themselves in activities and projects that enrich their educational experience and support their future career aspirations.
We checked in with Alyssa Zucchet, a second-year Southern Medical Program student who is working on a podcast series that examines sensitive health care topics. She recently teamed up with a health outreach nurse at Interior Health (IH) to interview them about their work in the community.
What was the motivation behind your project?
AZ: While working on a project last year about human sexuality and discussing its content with peers and the public alike, I noticed that I got very different reactions from different people. These experiences made me wonder how people that were uncomfortable with conversations about sex, even within a medical context, could have conversations about their own sexual health with their health care providers. Then, that thought expanded into me wondering how any topic with stigma attached to it (for example, sexism, substance abuse, homelessness, gender identity, etc.) could be productively discussed in a medical setting if people seem, in general, so unwilling to talk about these things. I wanted to design a project that could give me insight into how these discussions are approached by health care providers in medical settings, how stigma affects these conversations, and what we can do as a community to decrease stigma and make these conversations easier.
How do discussions about sensitive topics impact patients?
AZ: This is the very question I hope this project will help me answer. Having only produced two episodes thus far, I can tell you that a common theme seems to be that patients either avoid seeking the care that they need if it relates to a stigmatized issue, or they do not know how to access the care they need. For instance, a woman may avoid speaking with her physician about a chronic pain issue for fear of being brushed off as “overreacting,” a fear based in the sexist tendencies that still exist within the medical community. The reality is that these issues are affecting people’s health, which is why we need to talk about it.
How can health professionals reduce stigma to help support uncomfortable conversations?
AZ: There are two things you have to be able to do as a health care provider in order to have successful conversations about sensitive topics: (1) get the patients to come to you or go to your patients and (2) be accepting and non-judgemental. Personally, the first point seems to be the most difficult. If people are unwilling to talk to you about an issue they are having, it’s difficult to even get them to come to the office. Within Interior Health, there are health outreach nurses who go into the community, to health fairs and shelters, to meet with patients where they are, rather than expecting them to come to an office. Another approach is to just bring up the sensitive issues in routine medical office visits, even if that isn’t what the patient is seeking care for. Even if the patient is just there for hypertension medications, it is a great opportunity to sensitively screen for issues of sexual health, etc. When it comes to actually approaching sensitive conversations, the main idea seems to be leave your opinions at the door and focus on what the person in front of you wants from their care.
What is your hope for the podcast series?
AZ: I originally created this podcast to address my own questions. Now that I’m working on it and telling others about it, I realize that others may have the same questions. I hope that it can be a resource for both budding and seasoned health professionals to brush up their knowledge on stigmatized issues within health care, how to deal with them, and what resources are available (at least locally). Also, I hope that talking about and bringing awareness to stigmatized issues will encourage others to talk about them, thereby decreasing the silence created by stigma and the stigma in-and-of-itself.
What impact has this project had on your own education?
AZ: I’ve found that this project has allowed me to fill in knowledge gaps I sometimes find my education has left me with. While doing research for this project and interviews for the podcasts, I have had the opportunity to connect with local resources and learn practical skills to provide care that is mindful to social determinants of health. I have learned how to provide harm reduction for people who use substances, how to respectfully and sensitively speak with people that have experienced trauma, especially sexual trauma, etc. I can only imagine how much more I will learn from my local health care community over the next few months.
The full podcast series can be viewed at www.alyssazucchet.com.