Walking the Talk: The IUSM Relationship-Centered Care Initiative

What is RCCI?

In January 2003, Indiana University School of Medicine began a three-year process of self-study and organizational development known as the Relationship-Centered Care Initiative. The project is supported by a three-year grant from the Fetzer Institute.

Thomas Inui, President and CEO Regenstrief Institute and Associate Dean for Health Care Research, Richard Frankel, Professor of Medicine and Professionalism Competency Director, and Debra Litzelman, Associate Dean for Medical Education and Curricular Affairs, are the principal investigators.

The focus of RCCI is the social environment, or informal curriculum, of the medical school. IUSM is studying how to transform the informal curriculum of a medical school to foster relationship - attentiveness to human interactions - in all aspects of medical school and practice. The desired outcome is a social environment that consistently reflects and reinforces the moral, ethical, professional, and humane values expressed in the School’s formal curriculum.

Background: Why RCCI?

In 1994, the Fetzer Institute published Health Professions Education and Relationship Centered Care, based on the work of the Pew-Fetzer Task Force on Advancing Psychosocial Health Education. An important conclusion of this report is that healing relationships are at the core of humane and effective medical care: relationships between physicians and patients, among members of care provider teams, between care providers and their communities, and physicians’ own self-awareness and self-care.

While IUSM has made great strides in articulating an innovative formal curriculum based on nine core competencies, the administration recognizes that the formation of a physician’s professional identity is not accomplished solely through the formal curriculum. Learners tend to assimilate and propagate patterns of relating that they experience during their day-to-day training. If we desire our graduates to demonstrate empathy, thoughtful inquiry, and positive, respectful, and collaborative interactions, then that is what our community must consciously model.

The Process:

RCCI began with a small administrative workgroup and a Discovery Team consisting of competency directors, students, two external consultants, Anthony Suchman, M.D. and Penny Williamson, Ph.D., and a project coordinator. The Discovery Team now has over 100 members, representing the entire IUSM community, and continues to grow. Using the process of appreciative inquiry, the team has collected over 180 interview stories of the system at its best.

Core strengths and values of the IUSM community have been identified. Inspired by these findings, participants are engaged in fostering these core strengths and values through various activities including campus publications and forums, training opportunities, departmental partnerships, and faculty committees.

Emerging Impacts:

A remarkable array of RCCI impacts are recognizable, including new group processes within existing committees of the school, new value-based publications on the character of the IUSM community, a student honor code attracting formal faculty commitments, new faculty-student networks for collaborative action, national workshops, and requests for consultative efforts at other medical schools.

How can I become involved?

For more information about the project, or to join in RCCI activities, email Dave Mossbarger, Project Manager.

IUSM Helping Hands Project