P3.224: Teaching Humanities to Medical Students: Moving from the Classroom to the Clinic

Background: While humanistic practice is an essential component of medical school curricula, there are few applied experiences that instill this perspective. We implemented an innovative narrative medicine rotation that provides insights into family function during illness, health systems issues, and the complexity of interdisciplinary care for the acutely ill.

Methods: For the last 17 years, we have offered an innovative clinical rotation to third- and fourth-year students. For two weeks, students are relieved of clinical duties and spend time with several children and their families on the pediatric oncology service, interacting with them wherever they are: in clinic, the inpatient unit, waiting rooms, hallways, or the OR. Students create a daily narrative about their experiences, which is submitted to the course director at the end of the rotation. Using qualitative methods, a trained research team analyzed the first 120 narratives submitted by students from the initiation of the rotation in 2008 through 2019. Working together, the team came to consensus on five themes.

Results: The narratives revealed: 1) A heightened sense of empathy; 2) The ability to self-structure clinical time and experiences; 3) Enhanced communication with both team members and patients, especially during “down time” in waiting rooms; 4) An appreciation of and empathy for family dynamics during acute and chronic illness; 5) Insights into important system issues such as hospital admission, consent processes and prolonged waiting times. Specific excerpts from the journals illustrate these themes, as well as the 7 humanism core competencies, as defined by the Arnold P. Gold Foundation framework for humanism (IECARES).

Conclusion: We demonstrate the power of a brief but educationally sound experiential teaching method that counters empathy drift and burnout. Such experiences, if broadly offered, may increase student interest in pursuing a career in pediatrics and pediatric subspecialties. However, since most students reported a beneficial impact of the rotation, even if not intending to specialize in pediatrics or oncology, it could be used in other specialties. Through immersion in health systems challenges confronting families and the processing of learning activities through narrative, students express a new perspective on humanism during a critical time in their medical training. Allowing students the freedom and time to interact with and listen to patients and families has the potential to transform medical education.