Internal medicine residents hone nonverbal skills with unlikely subjects

Adriana Reyes, M.D., participates in a hands-on workshop that pairs internal medicine residents with horses.

USA Health residents have been spending quality time outside to focus on how to better communicate with their patients. Future physicians and horses may make an unlikely match, but at medical schools across the United States, it’s not an uncommon one.

Medicine and Horsemanship – the Department of Internal Medicine’s newest hands-on workshop – pairs resident physicians with horses to help increase their awareness of nonverbal communication and apply those lessons in working with their patients.

Haris Manan, M.D., was quick to recognize the significance.

“The bond between a rider and a horse underscores the importance of effective communication, trust, and mutual understanding – principles that resonate profoundly in patient-doctor relationships,” he said. “Just as with horses, patients respond to a calm and confident demeanor.”

Haris Manan, M.D., works with a horse during
the seminar.

Similar seminars are offered through medical schools across the U.S., often as a response to a commonly cited complaint in multiple studies – lack of effective communication between doctors and patients.

During the seminar, Leena Patel, M.D., experienced how horses responded to even subtle movements, such as not stepping back when the horse approaches, which would signal its dominance, or standing straight and tall when walking the horse backwards, which establishes the handler’s position of leadership, even if the handler is shorter.

“As a physician, it reminded me that I am constantly observed as I observe the patient. That even when I am just looking at my watch for whatever Teams notification I got, I can appear as if I’m less interested or not fully invested,” Patel said. “It’s just a good reminder of how subtle things, such as eye contact, posture, and hand/leg movements can influence someone’s perception of you.”

According to a study published in the journal PLOS ONE, horses are good teachers when it comes to honing nonverbal communication skills because of their wide range of facial expressions, 17 to be exact.

Because horses and humans display similar facial emotions when expressing fear, surprise and sadness, equine-assisted training helps students better understand how to establish trust and respect with patients.

Residents appreciated being able to get outside out of their typical stressful environment, but they especially valued their program to give them the opportunity to hone important skills in a new way.

“This activity not only boosted my overall wellness, but also allowed us to refine our nonverbal communication skills and understand nonverbal clues, which can impact our overall interactions with patients,” said Anas Khouri, M.D. “These are skills that we need as much as clinical skills to be successful physicians and I am glad that our program recognizes and cultivates these aspects of our development."