Drawing on my experiences at a teaching-focused university, I show how locating the health humanities in first-year or introductory composition courses improves learning and offers an economical, flexible, and far-reaching approach to bringing a health humanities education to all baccalaureate-level learners, regardless of whether they aspire to careers in the health professions. In terms of improving learning, health humanities composition courses support the disciplinary aims of both fields. Accessible, relevant issues in the health humanities, such as interventions in health debates (...) or representations of illness and healthcare settings, nourish the cognitive and social conditions needed to develop college-level writing skills. The health humanities’ emphases on interdisciplinarity and suspending judgment also inform students’ writing abilities. Composition trains students to write rhetorically by considering purpose, context, genre, mode, and other factors when addressing an audience. This approach to writing helps pre-health humanists communicate intentionally and compassionately about health topics as well as the larger issues they call into question. Because students enroll in health humanities composition courses at an early, formative moment in their studies, they are poised to carry or “transfer” their knowledge to other courses, including those that might prepare them for the workforce. (shrink)

Much has been said about the formative process that occurs via the “hidden curriculum” of medical education during which many students experience a disconnect between the professional values espoused within the formal curriculum and the implicit values communicated through interactions with peers and mentors. Less attention, however, has been paid to the formation of the future medical self that takes place during students’ premedical years, a time in which many undergraduate students seek out immersive clinical experiences —such as medical scribing— (...) before applying to medical school. Despite the fact that medical scribes undoubtedly are affected by their clinical experiences, scribes are rarely offered opportunities to reflect on them. The authors contend that the developmental processes of medical scribes, especially those who intend on pursuing a career in the health professions, ought to be supported. This can be achieved, at least in part, through engaging in well-designed reflective sessions with other scribes. Encouraging students to reflect on their experiences can help them make sense of troubling events and give voice to the inconsistencies and value conflicts within medical practice that are so often ignored. The authors describe the development of their new Reflective Scribe program and offer suggestions for future directions. (shrink)

This paper argues that “backstage” gallows humor among clinical mentors not only affects medical students’ perceptions of what it means to be a doctor but is also symptomatic and indicative of a much larger problem in medicine—namely, the failure to attend fully to the complexity and profundity of the lived experiences of illness, suffering, and death. Reorienting the discourse surrounding gallows humor away from whether or in what context it is acceptable and toward the reasons why doctors feel the need (...) to use such humor in the first place addresses this issue in a more illuminating way. (shrink)

This essay proposes an expansion of the concept of narrative competence, beyond close reading, to include two more skills: the collaborative construction and compelling performance of stories. To show how this enhanced form of narrative competence can be attained, the essay describes Off Script, a cocurricular medical storytelling program with three phases: 1) creative writing workshop, 2) dress rehearsal, and 3) public performance of stories. In these phases, Off Script combines literary studies, creative writing, reflective practice, collegial feedback, and drama. (...) With increased narrative competence, Off Script participants are likely better equipped to engage in more impactful health advocacy and partner with patients more effectively. (shrink)

Reflective capacity is integral to core healthcare professional practice competencies. Reflection plays a central role in teacher education as reflecting on teaching behaviours with critical analysis can potentially improve teaching practice. The humanities including narrative and the visual arts can serve as a valuable tool for fostering reflection. We conducted a multinational faculty development workshop aiming to enhance reflective capacity in medical educators by using a combination of abstract paintings and narratives. Twenty-three family physicians or physicians-in-training from 10 countries participated (...) in the workshop. Qualitative assessment of the workshop showed that the combined use of art and narrative was well received and perceived as contributing to the reflective exercise. Participants generally felt that viewing abstract paintings had facilitated a valuable mood transformation and prepared them emotionally for the reflective writing. Our analysis found that the following themes emerged from participants’ responses: narratives from different countries are similar; the use of art helped access feelings; viewing abstract paintings facilitated next steps; writing reflective narratives promoted examination of educational challenges, compassion for self and other, and building an action plan; and sharing of narrative was helpful for fostering active listening and appreciating multiple perspectives. Future research might include comparing outcomes for a group participating in arts–narrative-based workshops with those of a control group using only reflective narrative or in combination with figurative art, and implementing a combination of qualitative and quantitative methods of assessment. (shrink)

Burnout—a stress-related syndrome characterized by exhaustion, depersonalization, and a diminished sense of accomplishment—is a common phenomenon among medical students with significant potential consequences for student health, professionalism, and patient care. This essay proposes that the epidemic of medical student burnout can be attributed to a technocratic paradigm that fails to value medical students as persons with human needs and limitations. After briefly reviewing the literature on medical student burnout, the author uses two theories to elucidate potential causes: unsatisfactory aspects of (...) the learning environment and a feeling one’s efforts are meaningless or irrelevant. Cultural factors also facilitate burnout in medical students immersed in a clinical environment that cultivates excessive detachment from patient and self, impairing self-care, damaging a sense of self, and impeding the development of a mature, well-integrated professional identity. The ethical implications of medical student burnout are also addressed. Finally, this paper suggests possible preventive and remediative strategies such as optimizing the learning environment as well as narrative approaches that promise enhancement of both individual and institutional well-being. (shrink)

Listening and responding to patients’ stories for over 20 years as an emergency physician has strengthened my appreciation for the many ways that the skills and principles drawn from writing fiction double as necessary clinical skills. The best medicine doesn’t work on the wrong story, and the stories patients tell sometimes feel like first drafts—vital and fragile works-in-progress. Increasingly complex health challenges compounded by social, financial, and psychological burdens make for stories that are difficult to articulate and comprehend. In this (...) essay, I argue that healthcare providers need to think like creative writers and the skills and sensitivities necessary to story construction deserve a vital space in medical education. A thorough understanding of story anatomy and the imaginative flexibility to work stories into open spaces serve as antidotes to the reductive nature of clinical decision making and have implications as patient safety and risk management strategies. The examples that I have selected demonstrate how thinking like a creative writer functions at the bedside, providing tools for clinical excellence and empathy. This approach asks that we re-imagine the importance of story in clinical care: from a vehicle to a diagnosis to its place as a critical destination. (shrink)