Student Perceptions of the Clinical Relevance of the Medical Humanities Student Selected Unit (SSU) Shiv Chandé Medical

1. Student Perceptions of the Clinical Relevance of theMedical Humanities Student Selected Unit (SSU) Shiv ChandéMedical Education Academic Unit Introduction Key Findings Conclusions • Students saw the medical humanities as helping them to address psycho-social aspects of the patient experience. • The majority of students adopted a broad definition of clinical relevance which included bio-psycho-social elements: • “Psychosocial things are important as the • patient must be treated as a person. • You must consider everything in medicine • about the patient, not just the disease. • It is not just science, science, science.” • This meant that students were typically able to identify some aspects of the medical humanities that were clinically relevant. • Even those students who struggled to see the clinical relevance of the medical humanities were able to describe aspects of their creative outcomes that were clinically relevant. • They also acknowledged that their perceptions of clinical relevance have changed or will change in the future with more experience in the clinical setting. • However, students perceived a hierarchy of clinical relevance which prioritised practical skills and basic science. These were given greater priority and time investment in order to manage what was perceived to be a heavy and complex curriculum. • This hierarchy was informed by 5 key factors. The University of Southampton’s School of Medicine introduced the Medical Humanities SSU in the 2007/2008 academic year. This is compulsory for the whole cohort of year 1 students and includes options in: art, drama, creative writing, film and music. It is assessed through a creative outcome and a reflective account. Students prioritise basic sciences and practical skills over the medical humanities and other psycho-social subject areas. This is not because students are unable to see the clinical relevance of the medical humanities but instead reflects a learning strategy they adopt in order to help them manage a complex and busy curriculum. If students are to gain the greatest benefit from the medical humanities, the factors which inform the hierarchy of clinical relevance and the nature of the curriculum which encourages the adoption of the learning strategy should be addressed. Research Aims • Previous research at Southampton found that students struggled to see the clinical relevance of the Medical Humanities. • Shapiro (2009) and Thistlethwaite (2006) reached similar conclusions. • This research aimed to further investigate students’ perceptions of the clinical relevance of the medical humanities: • What do students understand clinical relevance to mean? • Do student perceptions of clinical relevance change over time? • How beneficial to clinical practice to students perceive the medical humanities? • What might help students recognise the clinical relevance of the medical humanities? References • Kendall K, Skidmore J, Parry M, Turner L (2008) ‘They Will Help Make Students Become Better Doctors’: An Evaluation of Student Selected Units in Year 1 at the University of Southampton. Poster Presentation, AMEE, Prague, Czech Republic, 30 August – 3 September. • Shapiro J, Coulehan J, Wear D, Montello M. (2009) Medical humanities and their discontents: definitions, critiques, and implications. Academic Medicine, 84 (2):192-198. • Thistlethwaite J. (2006) Medical students and literature: are we expecting too much? Medical Education, 40 (2): 187. • Busy and Complex Curriculum • Learning Strategy • Hierarchy Priortising Basic Sciences & Practical Skills • 5 Factors Informing Hierarchy of • Clinical Relevance: • Perceived pre-existing knowledge of psycho-social aspects & no previous basic science & practical skills knowledge • Psychosocial aspects of medicine comprise less of exams • than basic sciences • Belief that existing psycho-social skills are adequate to be a doctor • Perception that being a competent clinical decision maker (resting on basic sciences and practical skills) is more important than empathy, understanding & compassion (resting on psychosocial skills) • Learning from medical humanities & • other psychosocial areas is less apparent when compared to basic sciences • & practical skills • Student culture Methods & Analysis • Systematic random sampling was used to select students from years 1-4. • 45 students were recruited into 8 focus groups. • Each focus group included students from the same year but who had undertaken different medical humanities options. • Focus groups were tape-recorded and transcribed, • Features of grounded theory and constant comparison were used to identify and develop themes iteratively from ongoing data collection and analysis.