Course allows students to understand pregnancy from patient’s perspective

When Emily Ballenger of San Jose delivered her twins, Julia Burch and Carrie Belle, last August at Lucile Packard Children’s Hospital Stanford, she also was credited with helping train a medical student in the art of patient-centered care and relationship building.

Early in her pregnancy, Ballenger was partnered with a medical student as part of an elective course at the School of Medicine. First-year medical student Sunny Kumar attended almost all of Ballenger’s prenatal appointments and learned lessons that can come only from time spent with a real patient.

“This class stands apart as a unique experience, really following a single patient over an extended period of time,” Kumar said.

The course is designed to help preclinical medical students experience pregnancy from the patient’s point of view, providing a months-long opportunity to develop a relationship with a patient that can influence the work of future physicians no matter what field of medicine they choose. The students focus on identifying with the patient’s experience rather than on their role as medical provider. The course directors are Yasser El-Sayed, MD, obstetrician in chief at Stanford Children’s Health and professor of obstetrics and maternal-fetal medicine at the School of Medicine, and Janelle Aby, MD, clinical associate professor of pediatrics.

Preeclampsia

Ballenger and her husband, James, planned to have Kumar attend their babies’ birth, as well as the first few pediatric appointments, as parents in the program often do.

With several members of her family in, or preparing for, careers in medicine, Ballenger knew how valuable an educational partnership could be for future doctors. “Before I met him, I was nervous,” she said. “But then he showed up and we talked for about 20 minutes, and it was like making a new friend.”

Ballenger was 37 weeks into her pregnancy when she developed preeclampsia and was admitted to Lucile Packard Children’s Hospital Stanford for induction. She was in labor for 28 hours before delivering healthy twin girls on either side of midnight, resulting in two unique birthdays. Kumar stayed with the couple through the entire labor process.

He was an amazing advocate for me and helped us figure out what we wanted to do at each step.

“He and James took turns talking to me and helping me through the contractions and pain, and helped me decide what interventions and pain management I wanted,” Ballenger said. “Sunny was great and knew what my wishes were going into labor because we had talked about it throughout my pregnancy. He was an amazing advocate for me and helped us figure out what we wanted to do at each step.”

Patient perspective comes first

While many medical schools today have similar programs, Stanford has offered the course for more than 20 years.

“I encourage my patients to participate because it’s a win for obstetric and pediatric patients,” said Susan Crowe, MD, Ballenger’s obstetrician and a clinical associate professor of obstetrics and gynecology at the School of Medicine.

“I really believe that the patient-centered care we strive for can be better achieved if we train our physicians to learn from and listen to our patients themselves. One of the biggest strengths of the program is that the patient perspective comes first. It sets the groundwork for that way of thinking in terms of training medical students,” added Crowe, who directs Outpatient Breastfeeding Medicine Consultative Services at Stanford Children’s Health.

The extra support during pregnancy is a win for participating moms, too. “I just know I have the best of care right now,” Ballenger said during her pregnancy. “I have every level of doctor looking out for me.”

Through the experience, Kumar said, he learned some valuable lessons about the importance of patient relationships. “I can say wholeheartedly that the human connection is what really drew me to medicine,” he said. “And that’s something that I will continue to value throughout my career.”