Professor Graham Easton
Meet Graham Easton, Professor of Clinical Communication Skills, who shares some fascinating insights into patient communication.
1. Could you tell us a bit about what being a Professor of Clinical and Communication Skills involves?
My favourite bit is teaching medical students how to communicate with patients, or how to examine them and make diagnoses and plans. We work closely with brilliant actors who take the role of patients; it’s a great way to learn through “doing”. Since Covid I have been running sessions on how to consult remotely online – via video for example – which needs specific skills. I have also developed, with colleagues, students and local community, an e-learning module on how to have conversations with people who are vaccine hesitant. We run a range of sessions, for example on breaking bad news, managing aggression and violence, and difficult conversations around sexual health. For me, these sorts of challenging conversations with patients go to the real heart of medicine; they are the glue that holds it all together. If you get it right the evidence suggests things usually turn out better for you and your patient. If you get it wrong…not so much. But the job also involves a lot of administration, managing my team of about 12 academics, examining and marking, and helping with the running of the medical school.
2. You research into the use of narratives in medical education and both verbal and non-verbal communication in healthcare. Could you talk a bit about this?
I am fascinated by the potential of narratives – or stories – to help students learn to be doctors. Traditionally many doctors and medical scientists have seen stories as rather unscientific, even childish, but my research suggests medical teachers use them rather often; whether it’s stories about their careers, or a patient case, or even a scientific breakthrough. Narrative learning theory suggests that we humans make sense of the world through stories; good stories can be memorable and engaging, and can often help students to understand the patient’s point of view. Of course, like any powerful tool, they need to be used carefully so as not to lose the big picture or the broader context.
I am currently involved in a fascinating research project : “Communicating through Covid: Supporting Healthcare Professionals’ Non-verbal Communication through Arts-based Education”, which aims to harness ideas and techniques from the arts world to offer practical support to health workers struggling with challenges of communicating in PPE, or through digital means. It’s funded by the Arts and Humanities Research Council (AHRC) as part of the UK Research and Innovation rapid response to Covid-19 and is a collaboration between Performing Medicine, specialists in arts-based professional development and healthcare education, and Queen Mary University of London. It has been fascinating to work with colleagues in art and drama, especially sharing insights about how doctors try to understand patients’ stories, and how Covid can get in the way of that. It’s so often these interdisciplinary collaborations that deliver genuine innovation.
I am a GP, and though not practising at the moment I have helped with Covid vaccination clinics and have been involved with London’s Pandemic Multiagency Response Team, a specialist team handling deaths that don't happen in hospital. My GP colleagues who are at the coalface are getting a really hard time at the moment – people say they can’t get to see them face to face, and I’ve heard several people ask “What are they actually doing?”. I find that so frustrating – and it’s why I wrote my book a few years ago “The Appointment – what your doctor really thinks during your ten minute appointment”. I wanted to show people some of the complexity and challenges of general practice, where anything and anyone can walk through the door. Each chapter tells the story of a new consultation with a patient, and what is going on in my head as I try to build rapport, gather information, make diagnoses and treatment plans. I hope it has given some readers a real insight into the GP’s job.. especially nowadays when resources simply cannot keep pace with demand.
3. What was your educational and training background and what advice you would give to a student wanting to follow in similar footsteps?
I trained at the London Hospital Medical College in the 1980’s, and I can say with certainty that as I drank beer in the Good Samaritan and spent summers resitting exams, returning as a Professor thirty years later could not have been further from my mind!
I have not followed a traditional career path in medical education – mainly because there still really isn’t one. My path followed a portfolio route, with medical journalism and medical education alongside part-time general practice. After GP Training on the Oxford Region scheme, I spent a year doing a masters degree in Science Communication at Imperial College, learning the theory and practical skills of communicating about science and medicine to the public. One of the modules was “Radio” and I spent my work experience at the BBC Science Unit where I was eventually offered a job as a Senior Producer. Subsequently I was asked to present the new medical programme on Radio 4 “Case Notes” which is now “Inside Health”. After 5 years presenting Case Notes, I moved to the BMJ as an assistant editor, where I was responsible for the Careers section and the Medical Education section. I re-appraised my career direction after being closely involved in the BMA bus bombing of 2005, and sat my MRCGP and returned to more general practice and medical education. I loved it, and starting with a Clinical Teaching Fellow job at Imperial College, I moved up through leading on modules then courses and acting head of GP undergraduate teaching at Imperial. I was also a Programme Director for the Imperial GP Specialty training scheme. I studied for an EdD at the Institute of Education [though cashed in my masters before quite reaching the finish line when I got a good publishing deal to write my book!]. Looking back, the further degree and becoming Senior Fellow of the Higher Education Academy were important steps for confidence and credibility.
My advice to a student wanting to follow in my footsteps is to find something you really enjoy, get some professional accreditation and/or education degree [not as a tick box, but because you are genuinely fascinated to learn about it], and then don’t listen to people who say you “must” do anything. Looking back, I did what felt right to me, followed my curiosity, and I have enjoyed an incredibly varied career with absolutely no regrets.