Course Descriptions

Medical Science, Medical Humanities,
and the Quest for Empathy
(1997 - Current)

Felicia Cohn, Ph.D., Lloyd Rucker, M.D., Johanna Shapiro, Ph.D.

Description: Two three-hour clinical humanities sessions as part of an eight session didactic series are required for all third year medical students participating in the Junior Medicine Clerkship. (Other sessions include communication skills, bioethics, and four case discussions examining doctor-patient communication, clinical reasoning, and medical decision-making).

Participants: Approximately 18 students per quintile; total of 92 third year students

Faculty: Lloyd Rucker, M.D., Medicine Clerkship Director, Associate Dean of Curricular Affairs; Johanna Shapiro, Ph.D., Director of Medical Humanities in Family Medicine

Patient-Student Values Narrative

Objectives: At the end of the clinical humanities sessions, students will

Understand the role of the humanities in a) developing insight into the doctor-patient relationship b) cultivating understanding and empathy for both patients and physicians
Discover how to use expressive art, literature or music to better understand the patient, the physician, and the physician-patient relationship with special emphasis on the medical student experience
Recognize the humanities as a resource for maintaining empathy, understanding, and compassion throughout careers in medicine

Format:

Session I: Group discussion.

In preparation for this discussion session, we distribute a series of brief literary essays, writings, and poems written primarily by medical students about their initiation into clinical medicine. Students are expected to read these materials before attending the session, and be prepared to discuss them in the context of their experiences with patients or their experiences as a patient, patient’s relative, or patient’s friend.

Required Reading:

"A Good Story" (book chapter) Michael Crichton: humorous account of Crichton’s experiences as a medical student; explores the various meanings of patients’ stories, and the importance of close listening to patients

"Morning Report" (poem) – Veneta Masson: a student describes an encounter with a patient early in her training that raises issues about life and death and what the patient can give to the health provider

"The Log of Pi" (poem) – Marc J. Straus: talks about how to respond to the really important, difficult-to-answer patient questions that cannot be answered solely by "facts," but involve hope and faith

"I Stare Out" (poem) – David Kopacz – a third year medical student expresses anger both toward a demanding resident and a stressful on-call situation, and uses distancing and detachment as coping mechanisms

"Transformation" (poem) – Michelle Steele Rebelsky: a medical student struggles with her conflicting roles as daughter and physician when her mother undergoes a breast biopsy and waits for the results

"Invasions" (book chapter) – Perri Klass: written when Klass was a third year student at Harvard, this essay explores intimacy and privacy issues in clinical practice and warns against callousness

"On Being a Patient" (essay) – Allison S. Clay: a third year student suddenly becomes a patient and discovers life looks very different from the other side of the doctor-patient relationship

Session II: Group presentations.

Each student prepares a creative project or presentation. These may consist of

personal essay
creative writing or poetry
movie or video
artwork
music

The presentations may be verbal, visual, performance, or analytical. Students may also choose to describe their own experience as a patient or the experience of someone close to them.

The only requirements are these:

Every student must do something
Every student must turn in something: either the original work or a brief written description of that work, including a description of its significance to the student.
Oral anecdotes or stories about encounters with patients are acceptable. These must be accompanied by a written document describing the incident or relationship; spontaneous oral presentations do not fulfill the requirement.
No single work should be longer than 5 minutes. Students may work together in groups, in which case they can pool their time and use multiples of the 5 minutes. However, when working in groups, each of the participants must demonstrate a significant contribution to the project.

We do not engage in criticism or dissection of the students' work. Instead, students will practice attentive listening and being fully present while creative works are shared. Our goal is not literary or artistic analysis. Rather, it is to provide students the opportunity to understand their patients, their roles, and themselves through the humanities. We do discuss student general perceptions about the value of creative process, as well as lessons learned from group sharing of projects.

Evaluation: Students complete a brief pre-post self-report questionnaire at the introductory session to the clerkship, immediately after completion of the final humanities session, and at the end of the third year. Items focus on the perceived usefulness of the humanities to increase understanding of and empathy for patients and physicians, and whether medical humanities should be a required component of the medical school curriculum.