“I wanted to communicate my feelings freely”: a descriptive study of creative responses to enhance reflection in palliative medicine education

BMC Medical Education

Eileen McKinlay¹  Clare O’Leary³  Jo Hilder¹  Sinéad Donnelly²  Lynn McBain¹ 

[1] Department of Primary Health Care and General Practice, University of Otago, Wellington 6242, New Zealand;Wellington Hospital, Riddiford St, Newtown 6021, Wellington, New Zealand;Mary Potter Hospice, 48 Mein St, Newtown 6021, Wellington, New Zealand

关键词: Palliative medicine;    Medical student;    Family medicine;    Reflective writing;    Creative work;    Medical humanities;   

Others  :  1233409
DOI  :  10.1186/s12909-015-0465-4

 received in 2015-07-25, accepted in 2015-10-16,  发布年份 2015

【 摘 要 】

Background

The recent growth of arts and humanities in medical education shows recognition that these disciplines can facilitate a breadth of thinking and result in personal and professional growth. However creative work can be a challenge to incorporate into a busy curriculum. Offering the option of creative media as a way of reflecting is an example of how this can occur. This study aimed to examine the medical student response to being given this option to explore a visit to a patient in a hospice.

Methods

This was a mainly qualitative study. In the 2012 academic programme, the class of 86 students were given the option of using a creative medium to explore their responses to both the visit and their developing communication skills. Students were required to write an accompanying commentary if submitting the creative work option. Sixty-four percent of the class chose a creative medium e.g. poetry, visual art, narrative prose, music. These students were asked to take part in research including completing a short on-line survey and consenting for their creative work and commentaries to be further examined. The creative works were categorised by genre and the commentaries analysed using inductive thematic analysis.

Results

Seventeen students completed the on-line survey and fifteen consented to their work being used for this research. Thematic analysis of the student commentaries revealed the following themes: effectiveness for expressing emotion or ideas that are difficult to articulate; engaging and energising quality of the task; time for reflection; flexibility for individual learning styles and therapeutic value.

Conclusions

Teaching the art of communicating at end-of-life is challenging especially when it involves patients, and teachers want to ensure students gain as much as possible from the experience. Offering the option to use creative media means that students can choose a medium for reflection that best suits them as individuals and that can enable them to benefit as much as possible from their experience.

【 授权许可】

   
2015 McBain et al.

【 图 表 】

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【 参考文献 】

• [1]Kumagai AK, Kumagai AK. Perspective: acts of interpretation: a philosophical approach to using creative arts in medical education. Acad Med. 2012; 87(8):1138-1144.
• [2]Rodenhauser P, Strickland MA, Gambala CT. Arts-related activities across U.S. medical schools: a follow-up study. Teach Learn Med. 2004; 16(3):233-239.
• [3]Thompson T, Lamont-Robinson C, Younie L. ‘Compulsory creativity’: rationales, recipes, and results in the placement of mandatory creative endeavour in a medical undergraduate curriculum. Med. 2010; 15:5395.
• [4]Potash J, Chen J. Art-mediated peer-to-peer learning of empathy. Clin Teach. 2014; 11(5):327-331.
• [5]Kelly M, Bennett D, O’Flynn S, Foley T. A picture tells 1000 words: learning teamwork in primary care. Clin Teach. 2013; 10(2):113-117.
• [6]Walsh SM, Chang CY, Schmidt LA, Yoepp JH. Lowering stress while teaching research: a creative arts intervention in the classroom. J Nurs Educ. 2005; 44(7):330-333.
• [7]Younie L. Art in medical education: Practice and diagloue (Case Study). In: Medicine, Health and the Arts: Approaches to the Medical Humanities. Bates V, Bleakley A, Goodman S, editors. Routledge, Oxon and New York; 2014: p.85-103.
• [8]Rucker L, Shapiro J. Becoming a Physician: Students’ Creative Projects in a Third‐year IM Clerkship. Acad Med. 2003; 78(4):391-397.
• [9]Rabow MW. Drawing on experience: physician artwork in a course on professional development. Med Educ. 2003; 37(11):1040-1041.
• [10]LoFaso VM, Breckman R, Capello CF, Demopoulos B, Adelman RD. Combining the creative arts and the house call to teach medical students about chronic illness care. J Am Geriatr Soc. 2010; 58(2):346-351.
• [11]McIntosh P. Action research and reflective practice: Creative and visual methods to facilitate reflection and learning. Routledge, London and New York; 2010.
• [12]Perry M, Maffulli N, Willson S, Morrissey D. The effectiveness of arts-based interventions in medical education: a literature review. Med Educ. 2011; 45(2):141-148.
• [13]Ousager J, Johannessen H. Humanities in undergraduate medical education: a literature review. Acad Med. 2010; 85(6):988-998.
• [14]Schwartz AW, Abramson JS, Wojnowich I, Accordino R, Ronan EJ, Rifkin MR. Evaluating the impact of the humanities in medical education. Mt Sinai J Med. 2009; 76(4):372-380.
• [15]Staricoff RL. Arts in health: the value of evaluation. J R Soc Promot Heal. 2006; 126(3):116-120.
• [16]Boud D, Keogh R, Walker D. Reflection: Turning experience into learning. Routledge, London, England; 1985.
• [17]Chaffey LJ, De Leeuw EJ, Finnigan GA. Facilitating students’ reflective practice in a medical course: literature review. Educ Health. 2012; 25(3):198-203.
• [18]Mann K, Gordon J, MacLeod A. Reflection and reflective practice in health professions education: a systematic review. Adv Health Sci Educ. 2009; 14(4):595-621.
• [19]Weissman DE, Quill TE, Block SD. Missed opportunities in medical student education. J Palliat Med. 2010; 13(5):489-490.
• [20]McKinlay E, Donnelly S. Learning through narrative writing: Medical students talk to patients in a hospice. Focus Health ProfEduc. 2014; 16(1):69-82.
• [21]McKinlay E, McBain L, Stanley J, Johnston Taylor E, Robertson G. Does multimodal palliative care education help medical students talk with patients at end-of-life? Focus Health ProfEduc. 2014; 15(3):64-80.
• [22]White CB, Perlman RL, Fantone JC, Kumagai AK. The interpretive project: a creative educational approach to fostering medical students’ reflections and advancing humanistic medicine. Reflective Pract. 2010; 11(4):517-527.
• [23]Dawson B. With You: The Mary Potter Hospice Story. Wairau Press, Auckland, NZ; 2014.
• [24]Thomas DR. A General Inductive Approach for Analyzing Qualitative Evaluation Data. Am J Eval. 2006; 27:237.
• [25]Dew K. A health researcher’s guide to qualitative methodologies. Aust N Z J Public Health. 2007; 31(5):433-437.
• [26]Lawrence RL. Knowledge construction as contested terrain: Adult learning through artistic expression. New Dir Adult Contin Educ. 2005; 2005(107):3-11.
• [27]Huye H. Using Poetry and Art Analysis to Evoke Critical Thinking and Challenging Reflection in Senior-Level Nutrition Students. J Nutr Educ Behav. 2015; 47(3):283-285.
• [28]Hooker C. Ethics and the arts in medical humanities. Ethics and the arts. Macneill P, editor. Springer, London; 2014.
• [29]Brown S-A. Creative expression of science through poetry and other media can enrich medical and science education. Front Neurol. 2015; 6:3.
• [30]Boud D, Walker D. Promoting reflection in professional courses: The challenge of context. Stud High Educ. 1998; 23(2):191-206.
• [31]Macnaughton J. The humanities in medical education: context, outcomes and structures. Med Humanit. 2000; 26(1):23-30.
• [32]Wald HS, Reis SP. Beyond the margins: reflective writing and development of reflective capacity in medical education. J Gen Intern Med. 2010; 25(7):746-749.
• [33]University of Otago. The Art of Palliative Medicine. University of Otago, Dunedin, NZ. 2014. http://www.otago.ac.nz/otagobulletin/news/otago076106.html. Accessed 5 Feb 2015.