As a practicing physician for so many years, you do certain things that you don't realize that you're doing or ask questions in a certain way that maybe some teenagers are uncomfortable with. I thought, 'If I can get this great feedback, wouldn't it be wonderful for the residents to go through the same thing?' —Dr. Joni Hemond
SALT LAKE CITY — Communicating with teenagers can be a challenge for anyone. It can be especially difficult if the teenager is at a doctor's office and doesn't want to talk.
A new program at the University of Utah is teaching medical residents in pediatrics how to be better doctors by improving their interviewing skills with the help of teenage actors.
Dr. Joni Hemond, co-director of adolescent medicine rotation for residents at Primary Children's Medical Center, brought the idea to Utah after experiencing it firsthand at a conference in Boston.
"As a practicing physician for so many years, you do certain things that you don't realize that you're doing or ask questions in a certain way that maybe some teenagers are uncomfortable with," Hemond said. "I thought, 'If I can get this great feedback, wouldn't it be wonderful for the residents to go through the same thing?' "
In January, Hemond met with high school students from the Salt Lake School for the Performing Arts. She gave the actors backgrounds for patients to portray when interviewed by pediatricians. Some played teenagers with drug abuse issues, others were suicidal or depressed, and some were pregnant or had body issues.
Chamberlain Schultz, a junior at the school, played Amber Valentine, a student suffering from depression who is suicidal.
"(I put up) many, many walls because I was very despondent," Schultz said. "I hardly ever looked up, but I think that is to be expected."
She said she played the character as truthfully as possible so doctors can be better prepared to help individuals in those situations.
Gabriel Lisonbee, a junior at the charter school, portrayed a teen named Jonathan Hillberg who had a drug problem. In his scenario, he is trying to stop doing drugs and is having withdrawal symptoms. He is getting very sick with flu-like symptoms that won't go away, and his parents are concerned.
The teens have met with the doctors twice a month since late February.
"I had some excellent actors who gave me a hard time and didn't give me a lot of information," Dr. Nora Switchenko said with a laugh, "but it was a great experience to think about how I would act in that situation as a true pediatrician."
While making sure the students give a good performance to help the pediatricians, it was also important that they gave good feedback.
"That can be hard to do," Hemond said. "These are high school students, and they are giving feedback to physicians, and so the tendency is you don't want to be too harsh. You want to be nice, and that's true, but you also have to give enough constructive feedback so that they can take that information and use it in the future."
After the interviews, the teens didn't hold back on their critiques.
"I feel like you kind of made that (confidentiality agreement) a bigger deal than it should have been, and especially with a patient that's closed off in general, you might want to … downplay it," Schultz told the doctor who interviewed her.
"They get to practice the skills that they would use with a normal teenager before they actually go in with a teenager, and we get to say, 'This is what actually made me uncomfortable, and if you did that with me in an actual appointment, I might not respond so well,' " said sophomore Anna Bodily, who portrayed a pregnant teenager who didn't stop talking about everything in her life, making it difficult for the doctor to get a word in edgewise to diagnose the problem.
Switchenko said she learned a lot from the teen actors by getting "objective feedback on how it felt from their perspective as true adolescents."
Jim Gottlieb, a third-year pediatric resident at the University of Utah, said the experience was beneficial.
"A lot of (the feedback) was trying to help us word our questions better, or relate to the patients better, and they were very honest," he said.
Gottlieb said the best advice he received was to be clear about what confidentiality meant in regard to a teen's care. He also learned to use a lot of open-ended questions to encourage the teen to speak.
The benefits are two-fold: Doctors understand how to be more sensitive to teenage patients, and the teens are conquering new acting challenges.
"I learned a lot about the medical world," said Chloe Betts, a ninth-grader who portrayed a girl who was pregnant, promiscuous and didn't like society. "I also learned a lot about serious improv, because I usually do comedic improv and that's fun, but this is more a serious thing."
Several of the young actors have volunteered to help the doctors with the training after the school year ends. Hemond said she hopes to continue the program year-round.