Physicians Hall Front

Pediatric Resident Stresses Importance of Scaffolding Conversations

In an op-ed, Robert Trevino, MD, PhD, discusses the significance of scaffolding when communicating with patients.

As a pediatric resident and former member of Teach for America, Dr. Trevino understands the importance scaffolding, a communication strategy that requires a person to understand the other person’s perspective. Throughout his time in a classroom, he remembers teaching the same lesson multiple ways for all the students to understand the lesson. Even though scaffolded teaching requires more effort and time, Dr. Trevino believes it is an important technique for learning.

As Dr. Trevino transitioned into practicing medicine, he realized the impact of scaffolding conversations while communicating with his patients and their families. He believes that this idea of scaffolded teaching is similar to the health disparities in medicine. “We know the barriers, such as systemic racism and social determinants of health, that negatively affect the health of our children,” he writes. “These issues are often out of the hands of families and definitely out of the hands of kids, which makes roles in medicine and pediatrics even more challenging because it is not only the patient’s health on the mind of the family at the time of our conversation.”

Dr. Trevino describes the importance of incorporating scaffolding conversations while talking with medical students, too: “Often the students do not realize the science and the skill of scaffolding in medicine and the importance of cultivating it for professional development in any specialty.”

In his op-ed, Dr. Trevino includes five tips for medical professionals on how to scaffold conversations with both patients and families:

  • Recognize that it is an essential component of everyday conversations in medicine, be it with patients and families or other medical professionals; it is a skill that has to be understood and an art to be practiced and cultivated
  • Understand non-medical family-friendly descriptions and plans as a part of your preparation before starting a conversation with families.
  • With patients and families, gaining a quick assessment of their knowledge and health literacy goes a long way to scaffolding the conversation to meet their needs.
  • Use techniques such as:
    • Pictures or analogies to make connections
    • Repetition and summarizing to highlight key points
    • Teach back to assess for understanding
  • Appreciate classroom teachers in your life and have respect for their profession —scaffolding is something they must do multiple times per class, multiple classes per day, and it is not an easy skill to master.

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