Abstract
BackgroundMedical students show a decline in empathy and ethical reasoning during medical school that is most marked during clerkship. We believe that part of the problem is that students do not have the skills and ways of being and relating necessary to deal effectively with the overwhelming clinical experience of clerkship.ApproachAt McGill University in Montreal, starting in January 2015, we have taught a course on mindful medical practice that combines a clinical focus on the combination of mindfulness and congruent relating that is aimed at giving students the skills and ways of being to function effectively in clerkship. The course is taught to all medical students in groups of 20, weekly for 7 weeks, in the 6 months immediately prior to clerkship, a time when students are very open to learning the skills they need to take effective care of patients.EvaluationThe course has been well accepted by students as evidenced by their engagement, their evaluations, and their comments in the essays that they write at the end of the course. In a follow-up session at the simulation centre one year later students remember clearly and enact what they were taught in the course.ReflectionThe next steps will be to conduct a formal evaluation of the effect of our teaching that will involve a combination of qualitative methods to clarify the nature of the impact on our students and a quantitative assessment of the difference the course makes to students’ experience and performance in clerkship.
Highlights
Medical students show a decline in empathy and ethical reasoning during medical school that is most marked during clerkship
There is evidence that rather than experiencing an increase in empathy and ethical reasoning as they progress in their training, medical students experience a decrease in these key ways of being [1, 2]
At McGill University in Montreal, starting in January 2015, we began to teach a core course for all medical students aimed at training students how to be, and remain, present to their patients and themselves in the intense clinical environment that they would experience in clerkship
Summary
There is evidence that rather than experiencing an increase in empathy and ethical reasoning as they progress in their training, medical students experience a decrease in these key ways of being [1, 2]. This may be part of the problem, the issue may be fundamentally that students are not given sufficient skills and ways of relating before clerkship that would prepare them to manage effectively their clinical and professional relationships. We believe this is a problem that is general to medical schools across the world but perhaps most immediately relevant to North American medical schools where clerkship can be such a challenging experience for students [4] during the latter part of their medical school trajectory, there may be differences between Canada and the United States related to a different emphasis on clinical grades in matching for competitive subspecialties
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