Reflecting and relating through Schwartz Rounds

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one woman in nurse's uniform and another woman on sand dunes at the beach
(L-R) Student Doctors Madeleine Gallagher and Sydney Isaacs

The University of Liverpool is proud to have been the UK’s first to introduce interprofessional Schwartz Rounds to students across its nine different healthcare disciplines in training.

Rounds provide students with a safe space to come together to share experiences and discuss the emotional and social aspects of their work. According to the Point of Care Foundation’s Schwartz Rounds in Higher Education Project Lead Laura Golding they help “support students’ wellbeing and capacity to offer compassionate care whilst in training – and beyond – by normalising strong emotions that arise from their work”.

The University’s Schwartz Round project team picked up a Learning, Teaching and Student Experience Award last summer (link) for their work with the Rounds, which have continued to go from strength to strength this academic year with participation from staff and students from the School of Medicine. They come to a conclusion with the year’s final Round this April, focusing on the theme of Flying the Nest (link).

Vice Dean Clinical Dominic Johnson joined Liverpool School of Medicine at the beginning of the academic year as an experienced Schwartz Round facilitator and was quick to jump into the Rounds by participating in November’s theme, We're Human Too.

“You have a panel of three people who tell a story in relation to the topic of the Round. They can be very different people – I've been to Rounds where we’ve had a Chief Executive or a nurse, matron, physio, a psychiatrist, Medical Director. They are always powerful stories, and they always resonate.

What happens next is it’s then opened up to the rest of the room and people reflect on what it has brought up for them and then the conversation sort of flows from there and you come away feeling sort of connected."

I think the process of sharing something quite intimate in a busy day gives you a little injection of empathy, compassion and understanding that I don’t think I've experienced in another type of forum.

Year Two Student Doctor Madeleine Gallagher was a panellist on January’s Round, Being on the Outside, after being approached by Laura who felt her experience as both a registered nurse and student doctor would make for a unique perspective.

"There are many times throughout my life I've felt like a person on the outside so I began thinking the different stories I could tell. Laura met with me beforehand to help me decide and ‘find’ my story. I spoke about my experience of caring for a 52-year-old man on end-of-life care in his own home.

How, in the eight hours I was there I could be so intimately and deeply involved in some of the most difficult times for the patient and his family, but also not be.

As neither a relative or a friend, and unlikely to ever see them again, I am a transient person in their journey. This is something so many people in healthcare may experience but not realise. That you can be so involved yet still on the outside of it all.

The biggest thing I've taken from Schwartz Rounds is that everyone can relate to the stories and the theme in one way or another.

Often as individuals we feel like we are alone in what we experience, however, the Rounds make us realise we are not. It allows you to connect to others and validate each other's feelings in a very supportive environment.

Rounds can help students develop in so many ways: listening, empathy, reflection, emotional maturity and communication just to name a few.

My advice to students is if you are free to attend, you should. You will hear from different people and their experiences, which can be really interesting and enlightening. There is no obligation to contribute either, you can just sit and listen.”

March’s theme of Accepting that you can't fix everything was a special one with both Year Three Student Doctor Sydney Isaacs and Professor Hazel Scott, Dean of the School of Medicine, featuring on the panel.

Sydney says the theme spoke to her as she believes medicine can be ‘plagued by an unattainable perfectionism that requires that we have an answer and a fix for everything’.

“As medics we are the often the final people that a situation is passed on to when it can't be resolved with other resources that the patient has available to them. Patients come to us with tremendous hope and that is infectious. It is therefore a very difficult situation when we are unable to provide an answer or a positive outcome.

My biggest takeaway from the Rounds is the realisation of how affected we all still are by the events that happen to us in our medical careers. Each of us as speakers experienced profound emotion in recalling our stories.

It was eye-opening to see how an event that happened to someone unrelated to ourselves can be carried with us and still need processing a long time later, whether that was my own experience at the very beginning of my medical journey or the Dean reflecting on a story from a different time in hers."

In exploring the challenges of medicine, we are also reminded of the privilege that we have in our profession and why we do what we do.

Professor Scott appreciated the opportunity to recall a challenging case in her clinical practice and reflect on how ‘we can make the mistake of thinking that it’s just us who are carrying a burden, before realising that the whole team around us are carrying it with us.’

“I was asked an insightful question during the Schwartz Round - how I carried on when the day related to the patient that I was describing was not going well.

The answer was that I got through it because one of the nurses quietly, thoughtfully, brought me a cup of tea and a fancy biscuit from the staff stash, before closing my clinic room door for a few minutes.

Schwartz emphasises the immense value that such ‘small acts of kindness’ can play in restoring our balance and that of others around us.”

Discover more

  • Whether you’re a Schwartz Round regular or it’s your first time, don’t miss the chance to attend the last session this year on the theme of Flying the Nest, Thursday 27th April. Register for free on eventbrite (link).
  • Learn what others have gotten out of the sessions in the Schwartz Rounds highlight humanity in healthcare article (link), which features some FAQ including common misconceptions. Hint, you won’t be forced to contribute to the discussion!
  • Find out more about Schwartz Rounds at the University of Liverpool on the dedicated Student Experience webpage (link) and contact the team at schwartz@liverpool.ac.uk if you are interested in taking part as a panellist next year.
  • Explore other ways in which you can take charge of your wellbeing on the School of Medicine’s Wellbeing Support web area (link).