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A Matter of Trust.

Elizabeth M Hendren1, Arno K Kumagai

  • 1E.M. Hendren is chief medical resident, Department of Medicine, Women's College Hospital, University of Toronto, Toronto, Ontario, Canada; ORCID: https://orcid.org/0000-0003-0905-4585. A.K. Kumagai is professor and vice chair for education, Department of Medicine, University of Toronto, researcher, Wilson Centre, University Health Network, and F.M Hill Chair in Humanism Education, Department of Medicine, Women's College Hospital and University of Toronto, Toronto, Ontario, Canada; ORCID: http://orcid.org/0000-0001-7088-0208.

Academic Medicine : Journal of the Association of American Medical Colleges
|August 29, 2019
PubMed
Summary

Building patient-physician trust involves navigating power dynamics and unconscious bias. Dialogue is key to fostering trust in both patient-physician and student-teacher relationships, enhancing person-centered care.

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Area of Science:

  • Medical Education
  • Patient-Physician Relationship Dynamics
  • Communication in Healthcare

Background:

  • Trust is foundational to patient-centered care and the patient-physician relationship.
  • Building trust is complex due to power dynamics, perceived competence, and unconscious bias.
  • Learners face challenges in establishing trust with patients and preceptors.

Purpose of the Study:

  • To examine challenges in building trust within the patient-physician relationship.
  • To explore trust dynamics in the student-teacher relationship within medical education.
  • To identify dialogue as a framework for developing trust.

Main Methods:

  • Conceptual analysis of trust-building processes.
  • Exploration of relational and social aspects of trust.
  • Examination of dialogue as a communication strategy.

Main Results:

  • Dialogue facilitates understanding of individual perspectives, values, and goals.
  • Dialogue strengthens the patient-physician relationship by fostering mutual understanding.
  • Dialogue enhances the student-teacher relationship by promoting learner agency and self-trust.

Conclusions:

  • Dialogue is a crucial relational tool for developing trust in healthcare settings.
  • Effective communication through dialogue strengthens both patient-physician and student-teacher relationships.
  • Fostering trust is essential for person-centered care and competent medical education.