Amanda Spadaro Reporter @aspadaro845

TOWN OF WARWICK - Horses have their own way of talking back.

They can be stubborn, uncooperative or dismissive, just like people.

Thats why they are the perfect patient substitutes for first-year students at Touro College of Osteopathic Medicine in Middletown who arelearning about bedside manner, according to Deirdre Hamling.

Hamling is theowner and operator of Raven Hill Farms on Glenmere Avenue, just outside the Village of Florida.

Horses are sensitive to their surroundings and respond immediately to the energy and emotions around them, Hamling said.

Her farm uses Equi-Power Solutions, a program for professional development she developed.

Through unmounted tasks, the horses teach students the importance of nonverbal communication and mindfulness to improve patient interactions.

A horse will size you up almost instantly and decide whether youre a leader or not, Hamling said.

When you lose your confidence, you lose your patient. All that translates into patient compliance and how well you do as a doctor."

This is the second year Touros medical students have been to Raven Hill, and its now mandatory for all first-year students, said Dr. Stephanie Zeszutek, course director for physical diagnosis at Touro.

During a recent session on the farm, a pair of students led a horse through an obstacle course while they balanced a ball on a spoon.

Its a metaphor: How do the doctors own emotions and anxieties, represented by the balancing ball, affect how successful they are with the patient?

Zeszutek said many students dont realize how nonverbal communication affects a doctors work with the patient: What message does their body language send? What energy are they casting through the office?

A student'sapproach may be too relaxed or too aggressive, Zeszutek said. The horses teach the students how to read the situation and respond appropriately.

Trent Williams, a first-year student from Washingtonville, said the program requires self-reflection that would be hard to replicate in a classroom.

The lesson he took home from the stables was that balance is key. Theres a sweet spot between being too laid-back or too aggressive that each horse - or patient - responds best to.

Ryan Colabella ofLong Island thought the horses did plenty of back-talking.

When we were having difficulty with getting them to do a task, it became more and more difficult, he said.

They sensed that we were either trying too hard or getting discouraged.

Chantell Melgarejo, a first-year student from Wellington, Fla., also had trouble getting the horses to follow her. It was quite a surprise for her, since she grew up working with horses.

It turned out that her proactive approach was too aggressive for the horses, she said.

To become a more effective doctor, she plans to develop her plans before jumping in with both feet.

Colabella said hehas a different problem: He doesnt think his approach proves that he is confident in his own abilities.

As a student, he sometimes feels awkward advising an older person on their health, he said.

Another student, Jayson Lowery, admitted his expectations for the class were initially low, but he quickly realized just how much the horses had to teach him.

You dont know how youre portrayed until you can see that from an animal that cant talk, Lowery said.

It was like looking into a mirror.

If you, as the physician, are apprehensive in approaching the patient or dont portray a sense of confidence, the patient is going to sense that immediately, and the horses do the same thing, he said.

Lowery stressed that osteopathic medicine focuses on a holistic approach. Part of that includes how well a doctor relates and connects with the patient.

Were not treating the disease, were treating the person, he said. Your attitude is going to affect how you treat that person.

aspadaro@th-record.com

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Horses stand in as 'patients' to help local med students boost their bedside skills - Times Herald-Record