Family- and Community-Centered Experience (FCCE)

The Family- and Community-Centered Experience (FCCE) is an outgrowth of GCSOM’s very successful Family-Centered Experience (FCE), which matched students with families living with chronic illnesses or disabilities in order to understand health outside of a medical facility and to cultivate students’ compassion, empathy, and communication skills by practicing sensitivity and honesty in difficult conversations. The expanded FCCE includes families who may not have a chronic illness or disability but whose lived experience impacts their health — physical, mental, emotional, social, environmental, spiritual or financial. This program allows for community members to be our students’ educators, and for students to listen and learn from people with lived experiences that have impacted their health or the health of the community.

What is FCCE?

The FCCE complements the biomedical and clinical skills training by providing students with experiences that demonstrate the personal side of medicine and health. Through regular meetings over the course of a year, students learn from community members about their individual needs and the needs of the community and better understand the social determinants of health, helping to not only hone their communication skills and sense of empathy, but also move them to social action and change. Volunteers who participate in FCCE benefit from being heard and sharing their stories, as well as in guiding the development of compassionate and patient-centered physicians and helping to shape the future of healthcare.

Families who participate in FCCE are volunteers who want to help improve healthcare through the development of compassionate physicians and who would like to share their story and have it truly heard. Students are trained in narrative medicine and narrative humility to help best honor the stories their families share. Students and families meet five times over the course of 10 months (at agreed-upon locations or via Zoom), for approximately one hour each visit. Every visit has a focus (e.g., personal story, experiences of stigma and bias), but students are encouraged to follow the narrative their family wants to share. Students participate in four verbal and two written reflection sessions during the 10-month period, which respect the privacy of the family’s story. FCCE also informs student learning experiences throughout their medical education at GCSOM.

The FCCE will help ground students in patient-centered and relationship-centered primary care. It will prepare students to form relationships with diverse families, identify their needs, and work with them to develop service-learning opportunities that will address that need effectively. Over time, the FCCE will attempt to meet community needs and gaps in services. 

Medical education outside the classroom

In Rachel Remen’s words, “There is a great deal more to personal wholeness than physical health and more that medicine can offer beyond curing of illness.”

The professional skills developed through engagement with this learning activity include empathic communication (including listening); a non-judgmental approach to discussing unique points of view; ethical considerations of the individual; and systemic and critical analysis of the complex relationships between people, their families and their environmental supports, and society’s approach to health, illness and well-being. 

Through the FCCE, medical students learn: 

• The impact of illness on one’s sense of self, one’s relationship with family and friends, the environment, activities and future goals and aspirations
• The impact of social factors (e.g., racism, access to education, built neighborhoods) on one’s sense of self, one’s relationship with family, friends, and society and future goals and aspirations
• The influence doctors and other perceived figures of authority have on the way people view themselves and their identities 
• How beliefs and assumptions of healthcare providers and society affect a person’s identity, including gender, age, race/ethnicity, national origin, language spoken, appearance and other social statuses 
• How to incorporate people’s previous experiences into a medical practice that can be characterized as family-centered and values dignity, respect, information sharing, participation and collaboration 
• How to be attentive and respectful listeners and to honor a person’s story
• Respect for the volunteer family’s values and rights to privacy