The Future of Apologies

Aaron Lazare spoke on the topic of apologies at the inauguration of Chancellor Michael Collins at the University of Massachusetts Boston. This text is taken from Lazare’s 2004 book On Apology published by Oxford University Press and reprinted here with permission

Second thoughts on education: new technologies, teaching and learning

This work seeks to explore and evaluate some of the evolving technological tools available for instruction and learning in the field of education. An assessment is made of the value and effectiveness of using new technologies, and associated educational theories on existing and emergent technologies are considered. A study is made of Second Life, an online virtual reality simulator, and its educational potentials are considered along with those of video-gaming and other emerging learning tools and spaces. These are the foundations for the discussion about the potentials of integrating new technologies into teaching, learning, and education as a whole.Ce travail engage à explorer et analyser certains des instrumentstechnologiques disponibles pour l’instruction et l’apprentissage dans le domaine del’éducation. L’utilisation des nouvelles technologies dans le domaine sont mis enrevue, et les théories associées aux outils existant et émergeant sont évalués. Uneétude est faite de Second Life, un logiciel simulant la réalité virtuelle, et sespotentiels éducatifs sont considérés avec ceux des jeux vidéo et d’autres nouveauxgenres d’apprentissage. Ceci fait la base de la discussion concernant les potentielsde l’intégration des nouvelles technologies dans l’enseignement, l’apprentissage, etl'éducation dans son ensemble

Teaching communication in clinical clerkships: models from the Macy initiative in health communications

Medical educators have a responsibility to teach students to communicate effectively, yet ways to accomplish this are not well-defined. Sixty-five percent of medical schools teach communication skills, usually in the preclinical years; however, communication skills learned in the preclinical years may decline by graduation. To address these problems the New York University School of Medicine, Case Western Reserve University School of Medicine, and the University of Massachusetts Medical School collaborated to develop, establish, and evaluate a comprehensive communication skills curriculum. This work was funded by the Josiah P. Macy, Jr. Foundation and is therefore referred to as the Macy Initiative in Health Communication. The three schools use a variety of methods to teach third-year students in each school a set of effective clinical communication skills. In a controlled trial this cross-institutional curriculum project proved effective in improving communication skills of third-year students as measured by a comprehensive, multistation, objective structured clinical examination. In this paper the authors describe the development of this unique, collaborative initiative. Grounded in a three-school consensus on the core skills and critical components of a communication skills curriculum, this article illustrates how each school tailored the curriculum to its own needs. In addition, the authors discuss the lessons learned from conducting this collaborative project, which may provide guidance to others seeking to establish effective cross-disciplinary skills curricula

Effect of communications training on medical student performance

CONTEXT: Although physicians\u27 communication skills have been found to be related to clinical outcomes and patient satisfaction, teaching of communication skills has not been fully integrated into many medical school curricula or adequately evaluated with large-scale controlled trials. OBJECTIVE: To determine whether communications training for medical students improves specific competencies known to affect outcomes of care. DESIGN AND SETTING: A communications curriculum instituted in 2000-2001 at 3 US medical schools was evaluated with objective structured clinical examinations (OSCEs). The same OSCEs were administered to a comparison cohort of students in the year before the intervention. PARTICIPANTS: One hundred thirty-eight randomly selected medical students (38% of eligible students) in the comparison cohort, tested at the beginning and end of their third year (1999-2000), and 155 students in the intervention cohort (42% of eligible students), tested at the beginning and end of their third year (2000-2001). INTERVENTION: Comprehensive communications curricula were developed at each school using an established educational model for teaching and practicing core communication skills and engaging students in self-reflection on their performance. Communications teaching was integrated with clinical material during the third year, required clerkships, and was supported by formal faculty development. MAIN OUTCOME MEASURES: Standardized patients assessed student performance in OSCEs on 21 skills related to 5 key patient care tasks: relationship development and maintenance, patient assessment, education and counseling, negotiation and shared decision making, and organization and time management. Scores were calculated as percentage of maximum possible performance. RESULTS: Adjusting for baseline differences, students exposed to the intervention significantly outperformed those in the comparison cohort on the overall OSCE (65.4% vs 60.4%; 5.1% difference; 95% confidence interval [CI], 3.9%-6.3%; PCONCLUSIONS: Communications curricula using an established educational model significantly improved third-year students\u27 overall communications competence as well as their skills in relationship building, organization and time management, patient assessment, and negotiation and shared decision making-tasks that are important to positive patient outcomes. Improvements were observed at each of the 3 schools despite adaptation of the intervention to the local curriculum and culture

The role of apologies in professional discipline

We live in times of 'apology mania', says Lee Taft, or at least 'national conversation' about the role and meaning of apologies. Roy Brooks talks of an 'age of apology'. Some 10 years after these pronouncements, little has changed. Apologies are ubiquitous and debated in the public and political domain. And they continue to be used and imported into legal jurisdictions. For instance, legislation removes civil liability for saying 'sorry' in certain contexts and may reward apologies in mitigation of sentence