Key Insight #3

"verba non facta"

The Importance of Communication

Facta non verba is a common saying in Latin that translates to "deeds, not words." It advises listeners that actions speak louder than words.

In January of 2022, I was recruited to Phi Delta Epsilon (PhiDE), an international medical fraternity. As an active member, I

Recruitment in PhiDE takes place across about two weeks at the beginning of each semester, and is one of my favorite events. Every semester I get to hear the voices of over a hundred undergraduate students and learn their interests, opinions, aspirations and, most importantly, how they handle medical interview questions. The following picture is of me and my PhiDE little at her initiation in Fall of 2022. This semester was my first time participating in the PhiDE recruitment process.

PhiDE recruitment consists of five events: three open (meaning anyone can attend) and two closed (invitation-only). The open events consist of a meet-and-greet, philanthropy night, and ice cream social. The meet-and-greet and ice cream social both give potential new members (PNMs) the opportunity to speak to current members, with meet-and-greet occurring in a more professional context and ice cream social with a more casual one. The first closed event is speeds, and the final event is interviews. Speeds is similar to a speed-dating setup in that PNMs cycle through 20 current members and have about two minutes with each member to answer a question. These questions consist of riddles, reflections, and, my personal favorite, mini medical interview (MMI) questions. As a PhiDE member, I am required to participate in two of three open events and one of two closed events.

At this year's philanthropy night I was assigned the following MMI question to ask PNMs: "What would you do if you misdiagnosed a patient." I heard a lot of great answers that night. PNMs generally highlighted immediately contacting the patient, engaging in further diagnostic testing, or even giving the patient alternative medical referrals. However, one PNM said they would implement a "facta non verba" ideology where they would focus more on doing things behind the scenes to show the patient how much they care.

This class was my first introduction to the role of communication in healthcare and how it can make or break a patient-provider relationship. I first recognized this connection when we watched two videos of a "good" version and a "bad" version of an interaction between a provider telling a patient they have cancer. Delivering bad news is a sensitive area where good communication practices are of utmost importance.

The first video was "what not to do" in a patient interaction, as seen in Link #1. It showed a provider distracted during the visit and hurried through the encounter without pausing, inhibiting the patient from processing any information and collecting their thoughts.

The second video was "what you should do" in a patent interaction, seen in Link #2. The provider took their time to clearly explain the diagnosis, its implications, and treatment plans while assessing patient understanding and allowing them time to process the news.

After viewing these videos, we conducted an in-depth analysis of each nuanced action the provider made. The comparison between the two videos was stark, and pulling apart the pieces that made them so different seemed like child's play. This activity seated the importance of communication in healthcare within my conscious. The process was so straightforward that no one could argue against the importance of communication in medicine.

SCHC 284 sparked my interest in communication research, but it was not until after the semester that it genuinely became a passion. In the summer of 2021, I began working as a part-time research assistant at the Advancing Chronic Care Outcomes through Research and Innovation (ACORN) Center. During this time, I worked under Dr. Phyllis Raynor and Dr. Robin Dawson, coincidently, my instructor for the SCHC 284 course. Under their guidance, my summer quickly turned into a deep dive into communication. Pictured in Artifact #5 is a screenshot from one of our meetings. Their research focused on developing a tool to measure patient-provider interactions, a project we continue to work on today.

This project aims to create an evidence-based coding rubric that can inform the development of AI software. This software would essentially be used to develop a program to evaluate communication between patients and their providers. The program would give actionable feedback to users on how their communication skills can be improved, making it a viable

these interactions can be a way you communicate something to a patient. The skills I've learned working on this project and from SCHC 284 on how to deliver bad news will be skills I will actively use in my future path as a healthcare provider.

Artifact #1: Image from Sigma Class at our Phi Delta Epsilon initiation in Spring of 2022.

have the opportunity to collaborate with like-minded peers, with similar goals of pursuing a medical degree. PhiDE has introduced me to an irreplaceable community filled with unwavering support which has provided a fulfilling experience as pre-medical student at USC. The fraternity hosts many events and educational opportunities for its members, in addition to their semesterly recruitment process. The photo shown in Artifact #1 is of my recruitment class’s initiation to PhiDE in Spring of 2022 (I am pictured in the bottom left).

Artifact #2: My little and I after her initiation in Fall 2023

As someone with a background in communication research, this answer bothered me because the PNM had failed to recognize the importance of transparency and communication in medicine. Instead of contacting the patient, talking through the next steps, and making a medical decision with the patient's input, they preferred to perform additional testing and create a new diagnosis before approaching the patient. As I thought over their answer later that night, I realized that because of my communication research, I would follow the reverse ideology: “verba non facta.”

The traditional saying of “facts non verba” refers to the idea that actions speak louder than word. This philosophy was echoed in the PNM’s answer since they wanted to engage in additional testing and consult with other providers before approaching the patient. My experience in communication research has shaped my perspective to take on more of a “verba non facta” which means I believe that communication is more important within the healthcare setting.

In Spring of 2021, I took SCHC 284: Introduction to Clinical Laboratory Science, wherewe learned different laboratory testing techniques in a didactic and lab setting. Artifact #3 shows me putting fluorescent material in my professor's eye as a part of one of these labs.

Artifact #3: Video of me putting fluorescent material in Dr. Dawson's eye in SCHC 284

Link #1: What NOT to do

Link #2: What to do

As part of our final group-project for this class, we performed a skit where we implemented clear communication practices to deliver bad news to a patient. My group was assigned Down syndrome, and we acted out how we would tell new parents that their newborn was positive for the condition. Artifact #4 shows the script we drafter for this skit.

SCHC 284 sparked my interest in communication research, but it was not until after the semester that it truly turned into a passion. In the summer of 2021, I began working as a part time research assistant at the Advancing Chronic Care Outcomes through Research and iNnovation (ACORN) Center. During this time, I had the opportunity to work under Dr. Robin Dawson, a member of the ACORN faculty and, coincidently, my instructor for the SCHC 284 course. Under the guidance of her and Dr. Phyllis Raynor, another member of the ACORN faculty, my summer quickly turned into a deep-dive in communication. Their research focused on developing a tool to measure a patient-provider interaction, a project we continue to work on to this day.

Artifact #4: Clear Communication Script for my SCHC 284 Final

Artifact #5: Screenshot from recorded research meeting with Dr. Dawson & Dr. Raynor in July 2021

option for healthcare students practicing their interactions with standardized patients. To better understand the factors at play within the patient-provider interaction, we developed the following framework seen in Artifact #6.

"Verba non facta" is my way of putting a spin on a common saying to emphasize the importance of communication. Working in this field, I realized the importance of being upfront and transparent in all fields of my life, including academics, extracurriculars, and social life. Additionally, my work on the AI project has allowed me to pull apart the details of a patient-provider interaction in surprising detail. Every choice you make in

Artifact #6: Framework we use in this research project when discussing the different factors that impact a patient-provider interaction