Abernathey Earns Praise for Performance, Integration of Assistive Tools in Clerkships
- By Jennifer Nachbur
Despite the beautiful spring day, Kelli Shonter’s three-year-old son Liam had a bad cough, and a visit to the pediatrician’s office was in order. As the mother of two young children, she and her family had shared many experiences at Hagan, Rinehart & Connolly in Burlington, and often met University of Vermont medical students, but this time was a bit different.
“It was a truly awesome experience,” says Shonter, describing the interaction between her son and UVM College of Medicine Class of 2015 student Elizabeth Abernathey.
A native of Jericho, Vt., and a Dartmouth College alumna, Abernathey is deaf and works with a sign language interpreter and uses a special stethoscope. She spent several years working in health policy and research prior to beginning medical school at UVM in August 2011.
“Her confidence and communication skills were superb,” Shonter says. “She was very upfront with Liam about what was going on, why someone else was in the room, and why her stethoscope was different. He was captivated by her!”
In the pediatrics clerkship, which includes outpatient and inpatient components, students aim to hone clinical and communication skills and gain an understanding of the role of the pediatrician in caring for patients, as well as the influence of family, community and society on health care of children and adolescents. Abernathey’s unique ability to forge a strong connection with both Shonter and Liam showcased her natural aptitude in these areas.
The experience at Hagan, Rinehart & Connelly was the first of Abernathey’s many rotations in the Clerkship level of the UVM College of Medicine’s curriculum and one she thoroughly enjoyed. But, she admits, “I didn’t want my excitement for beginning the clinical phase of my training to influence my inclination towards the specialty.”
In the nearly nine months since her first clerkship in pediatrics, she’s completed clinical training in internal medicine, surgery, obstetrics and gynecology, and neurology. Prior to the start of each rotation, she sits with the director to familiarize him/her with her use of an interpreter and special stethoscope. While this process took an hour and a half before the first clerkship, it now is much less time-consuming. “I’ve gotten it down to a succinct, clear explanation,” says Abernathey.
“Liz has a wonderful rapport with her patients,” says hospitalist Jennifer Borofsky, M.D., an assistant professor of medicine who was Abernathey’s attending during her internal medicine inpatient rotation. “Her warm bedside manner is more noticeable than any of her accommodations, and the same holds true when she works with the medical team – she is totally engaged, asking questions and contributing to medical decision-making,” she adds. “I would forget the interpreter was there.”
Abernathey concurs. “It’s less of a novelty – people are used to seeing me with an interpreter,” she says.
Third-year internal medicine resident Deva Sharma, M.D., worked with Abernathey for a couple of weeks and remarked on her work ethic and interpersonal skills. “She has many gifts as a health care provider and budding physician, and one is her ability to listen to her patients and advocate for them.”
To date, Abernathey’s most logistically challenging clerkship has been surgery, where addressing issues like positioning an interpreter, masks preventing lip-reading and background noise from equipment required creative strategies. Abernathey and her interpreter – stationed outside the sterile field in the back of the OR – wore wireless FM assistive devices connected to a microphone worn by the lead surgeon and developed a system of subtle nods to communicate when key points were not clear.
“It was a really good experience,” says Abernathey, adding that the process became fluid by the end.
“With each clerkship, I’ve become more comfortable with the unknown and there’s less that fazes me. Things happen behind the scenes, but generally, everything has worked very well.”
During her most recent clerkship – neurology – Abernathey spent an afternoon with pediatric neurologist Peter Bingham, M.D. Before they saw patients together, the two spent time talking about Abernathey’s experience, what would be a fit for her, her view of how it would work, and discussed encountering people’s expectations and their surprise.
“One reflection I had is that when I or someone from the hearing world can put aside the accommodations, you realize that everything can go quite well,” Bingham shares. “Liz is adept and inquisitive and excels in asking questions and asserting her curiosity.”
During their rotation together, Bingham observed that Abernathey’s patient encounters yield an important benefit for the clinician, patient, and family.
“If the family or patient is a little distracted by the trainee’s sign language interpreter and I respond to it by going forward with my work as usual, then the family can follow this lead and it becomes a learning experience for them,” he says. “There’s an incidental satisfaction for the family to see how it works – Liz is realistic about it and can work with and around her circumstances. People need to know that in my field – to consider possibilities, not be limited by deficits. There’s value in that lesson.”
Currently, Abernathey has three months more to go with her clerkships and is preparing to begin psychiatry, as well as planning out her fourth year. “I would love to get back to that pediatrics practice!” she exclaims.