The Clinical Hand: A curricular map for relationship-centered care.

Abstract

Learning and teaching the complex craft of relationship-centered care in the context of the competing demands of clinical family medicine can be challenging. The "Clinical Hand" is an educational aid, which serves as a curricular map specifying what content and skills are important for relationship centered care. The Clinical Hand illuminates seven features of the clinical encounter. "Opening the Hand" symbolizes the importance of relationship and healing intention. The "Grip of Power" highlights the significance of locating, owning, aiming, and sharing power in the relationship. The "Wrist Lines of Guidance" name three goals for every visit and three types of clinical encounters. The "Fingers of Direction" identify five sequential tasks for each encounter, and the "Nails for Trouble" remind residents of the BATHE technique. The "Palm of Hope" represents a diagnostic and management tool, and a "Swinging Cultural Ape" emphasizes the importance of evolution, culture, and the need to "keep swinging." The use of the Clinical Hand in a residency program is briefly discussed.