The effect of medical students’ gender, ethnicity and attitude towards poetry-reading on the evaluation of a required, clinically-integrated poetry- based educational intervention

BMC Medical Education

Yaakov Naparstek¹  Arie Ben Yehuda¹  Laura Canetti²  Matan J Cohen¹  Irit Mor-Yosef Levi¹  Ronen Schneider¹  Bracha Mazal¹  Gadi Lalazar¹  Orly Barak¹  Mordechai Muszkat¹ 

[1] The Department of Medicine, Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel;The Department of Psychology, Hebrew University, Jerusalem, Israel

关键词: Medical education;    Medical humanities;    Poetry;    Art-based intervention;   

Others  :  1091431
DOI  :  10.1186/1472-6920-14-188

 received in 2014-02-18, accepted in 2014-08-29,  发布年份 2014

【 摘 要 】

Background

Art -based interventions are widely used in medical education. However, data on the potential effects of art-based interventions on medical students have been limited to small qualitative studies on students’ evaluation of elective programs, and thus their findings may be difficult to generalize. The goal of this study is to examine, in an unselected students’ population, the effect of students’ gender, ethnicity and attitude towards poetry on their evaluation of a clinically-integrated poetry-based educational intervention.

Methods

A required Clinically- Oriented Poetry-reading Experience (COPE) is integrated into the 4^th year internal medicine clerkship. We constructed a questionnaire regarding the program’s effects on students. Students completed the questionnaire at the end of the clerkship. We performed a Confirmatory Factor Analysis, and examined the relationship between students’ evaluation of the program and students’ ethnicity, gender, attitude towards poetry-reading, and the timing of the program (early/late) during the fourth year.

Results

144 students participated in the program, of which 112 completed the questionnaires. We identified two effect factors: “student-patient” and “self and colleagues”. The average score for “student-patient” factor was significantly higher as compared to the “self and colleagues” factor.

Evaluation the “student- patient” effect factor was higher among Arab and Druze as compared to Jewish students. Students’ attitude towards poetry-reading did not correlate with the “student-patient” effect, but correlated with the “self and colleagues” effect. The evaluation of the “self and colleagues” effect was higher among students who participated in the program during their second as compared with the first clerkship. Students’ gender was not associated with any of the effects identified. Students favored obligatory participation in COPE as compared with elective course format.

Conclusions

According to students’ evaluation, a format of integrated, obligatory poetry-based intervention may be suitable for enhancing “student-patient” aims in heterogeneous student populations. The higher evaluation of the “patient-student” effect among Arab and Druze as compared to Jewish students may be related to cultural differences in the perception of this component of medical professionalism. Further research can provide insight into the effect of cultural and ethnic differences on actual empathy of medical students in patient encounters.

【 授权许可】

   
2014 Muszkat et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Charon R, Banks JT, Connelly JE, Hawkins AH, Hunter KM, Jones AH, Montello M, Poirer S: Literature and medicine: contributions to clinical practice. Ann Intern Med 1995, 122:599-606.
• [2]Charon R: The patient-physician relationship. Narrative medicine: a model for empathy, reflection, profession, and trust. J Am Med Assoc 2001, 286:1897-1902.
• [3]Shapiro J, Coulehan J, Wear D, Montello M: Medical humanities and their discontents: definitions, critiques, and implications. Acad Med 2009, 84:192-198.
• [4]Perry M, Maffulli N, Willson S, Morrissey D: The effectiveness of arts-based interventions in medical education: a literature review. Med Educ 2011, 45:141-148.
• [5]Collett TJ, McLachlan JC: Evaluating a poetry workshop in medical education. J Med Ethics 2006, 32:59-64.
• [6]Lancaster T, Hart R, Gardner S: Literature and medicine: evaluating a special study module using the nominal group technique. Med Educ 2002, 36:1071-1076.
• [7]Jacobson L, Grant A, Hood K, Lewis W, Robling M, Prout H, Cunningham AM: A literature and medicine special study module run by academics in general practice: two evaluations and the lessons learnt. Med Humanit 2004, 30:98-100.
• [8]Lewis W, Grant A: “The dark side of the spectrum …” a “day of suffering” for medical students. Med Humanit 2003, 29:43-45.
• [9]Kirklin D, Meakin R, Singh S, Lloyd M: Living with and dying from cancer: a humanities special study module. Med Humanit 2000, 26:51-54.
• [10]Muszkat M, Ben-Yehuda A, Moses S, Naparstek Y: Teaching empathy through poetry: a clinically based model. Med Educ 2010, 44:503.
• [11]Clark LA, Watson D: Constructing validity: basic issues in objective scale development. Psychol Assess 1995, 7:309-319.
• [12]Floyd FJ, Widaman KF: Factor analysis in the development and refinement of clinical assessment instruments. Psychol Assess 1995, 7:286-299.
• [13]Raykov T, Tomer A, Nesselroade JR: Reporting structural equation modeling results in psychology and aging: Some proposed guidelines. Psychol Aging 1991, 6:499-503.
• [14]Hu L, Bentler PM: Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Struct Equ Model 1999, 6:1-55.
• [15]Pedersen R: Empathy development in medical education- a critical review. Med Teach 2010, 32:593-600.
• [16]Neumann M, Edelhäuser F, Tauschel D, Fischer MR, Wirtz M, Woopen C, Haramati A, Scheffer C: Empathy decline and its reasons: a systematic review of studies with medical students and residents. Acad Med 2011, 86:996-1009.
• [17]Stepien KA, Baernstein A: Educating for empathy. A review. J Gen Intern Med 2006, 21:524-530.
• [18]Newton BW, Barber L, Clardy J, Cleveland E, O’Sullivan P: Is there hardening of the heart during medical school? Acad Med 2008, 83:244-249.
• [19]Hojat M, Vergare MJ, Maxwell K, Brainard G, Herrine SK, Isenberg GA, Veloski J, Gonnella JS: The devil is in the third year: a longitudinal study of erosion of empathy in medical school. Acad Med 2009, 84:1182-1191.
• [20]Costa P, Magalhães E, Costa MJ: A latent growth model suggests that empathy of medical students does not decline over time. Adv Health Sci Educ Theory Pract 2013, 18:509-522.
• [21]Aull FB: What can poetry teach physicians? Am J Med 2005, 118:1310.
• [22]Horowitz HW: Poetry on rounds: a model for the integration of humanities into residency training. Lancet 1996, 347:447-449.
• [23]Ahlzen R, Stolt CM: Poetry, interpretation and unpredictability: a reply to Neil Pickering. J Med Ethics 2001, 27:47-49.
• [24]Pickering N: The use of poetry in health care ethics education. Med Humanit 2000, 26:31-36.
• [25]Jones WS, Hanson JL, Longacre JL: An intentional modeling process to teach professional behavior: students’ clinical observations of preceptors. Teach Learn Med 2004, 16:264-269.