Medical students' creative projects on a third year pediatrics clerkship: a qualitative analysis of patient-centeredness and emotional connection.

Johanna Shapiro,Diane Ortiz,Minha Sarwar,You Ye Ree

doi:10.1186/s12909-016-0614-4

Johanna Shapiro, Diane Ortiz + Show 2 more

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https://doi.org/10.1186/s12909-016-0614-4

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Abstract

BackgroundIncreasingly, medical educators are incorporating reflective writing and original creative work into educational practices with the goals of stimulating student self-awareness, appreciation of multiple perspectives, and comfort with ambiguity and uncertainty. This study investigated students’ creative projects to assess the extent to which they adopted a patient/relationship-centered, emotionally connected position toward patients and families.MethodsOver a 10 year period, students on a required third year pediatrics clerkship individually or in groups completed either a reflection or an education project using a creative medium. 520 projects (representing 595 students, 74.7 % of total eligible students) were qualitatively analyzed according to various thematic and emotion-based dimensions.ResultsThe majority of projects were personal narrative essays and poetry. The largest number of project themes related to the importance of patient/relationship-centered medicine with patients. The next largest number of projects focused on health education of parents, patients, or classmates. In telling their stories, students were more likely to use a personal voice representing either their or the patient’s perspective than an objective, impersonal one. In terms of emotional tone, projects were more likely to be serious than humorous. The largest number of students’ emotions expressed an empathic tone. Students identified a large number and wide range of both negative and positive feelings in themselves and their patients. The majority of student emotions were positive, while the majority of patient and family emotions were negative.ConclusionsStudents’ preference for patient-centered, relational themes, as well as their tendency to favor the first voice, empathic tone, and willingness to express a range of positive and negative emotions in presenting their projects, suggests that they valued emotional connection with patients and families during the pediatrics clerkship experience.

Highlights

Medical educators are incorporating reflective writing and original creative work into educational practices with the goals of stimulating student self-awareness, appreciation of multiple perspectives, and comfort with ambiguity and uncertainty
Background pediatric clerkships are guided by goals and objectives specified by the APA/COMSEP General Pediatric Clerkship Curriculum [1], we know little about the subjective experiences of students in this required clinical training
Reflection is implicated in core ACGME competencies [5], and reflective writing is considered to be a means of deepening empathy [6], enhancing learner wellbeing, stimulating critical thinking [7], developing ethical mindfulness [8], stimulating tolerance, and enhancing capacity to manage complexity and ambiguity [9]

Summary

Introduction

Medical educators are incorporating reflective writing and original creative work into educational practices with the goals of stimulating student self-awareness, appreciation of multiple perspectives, and comfort with ambiguity and uncertainty. Pediatric clerkships are guided by goals and objectives specified by the APA/COMSEP General Pediatric Clerkship Curriculum [1], we know little about the subjective experiences of students in this required clinical training. While achievement of objective goals is assessed through various methods [2, 3], we lack effective ways of examining students’ thoughts and feelings about clerkship participation. Medical education has evinced a growing interest in incorporating reflective practices into medical student and resident training. A systematic review of reflective writing concluded that the practice could make a contribution to improving empathy in medical students [10]. Reflection activities most often take the form of written exercises, but may include the use of other creative media [11]

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