Building Dialogues Between Medical Student & Autistic Patients: Reflections on the MD program’s Patient Immersion Experience

The Patient Immersion Experience (PIE), part of the MD Program’s longitudinal Physicianship course, pairs medical students with individuals with chronic medical conditions to promote an understanding of the lived experience of illness. In October 2017, medical students AW and SC were matched with patient mentor MF, an autistic person[1] and artist. A year later, in the fall of 2018, MF invited his autistic friend AK to participate in collaborating in developing an “interpretive project”, a required capstone component of PIE organized by faculty-lead, PBM. Transcripts of online Google Doc conversations involving SC, AW, MF and AK, that took place over a 3-month period, were used to create a multimedia learning artifact that was exhibited as part of an annual Patient Appreciation Event organized at the end of the year. Rather than simply focusing on transmission of “information”, with SC and AW (as medical students) asking questions and AK and MF responding to it, a commitment was made to an ongoing mutual exchange of ideas. Four main topics were discussed: 1) the value of open communication with others, 2) how the process of informed consent differs for autistic people, 3) hope for a better future for healthcare, and 4) moving forward. These conversations point to the relationship-enhancing possibilities of open, back-and-forth dialogue as an antidote to monological approaches to medicine, providing insights into ways dialogue can enhance both a sense of agency and relational connections, generate new creative thinking, and promote a more holistic, person-centred approach to healthcare.