Abstract
Background
Medical educators act on the belief that students benefit from formal and informal educational experiences that foster virtues such as compassion, altruism, and respect for patients.
Objective
The purpose of this study is to examine fourth year medical students’ perspectives on how, where, and by whom they believe the virtues associated with good physicianhood have been taught to them.
Design
Fourth year students were assigned a two- to three-page essay that asked them to reflect on how their medical education had “fostered and hindered” their conceptions of compassion, altruism, and respect for patients.
Participants
All 112 students completed this assignment, and 52 (46%) gave us permission to use their essays for this study.
Approach
An inductive, qualitative approach was used to develop themes derived from students’ essays.
Results
Students’ thoughts were organized around the idea of influences in three areas to which they consistently referred. Foundational influences included parents and “formative years,” religious faith, and other experiences preceding medical school. Preclinical education influences comprised formal classroom experiences (both positive and negative effects). Clinical education influences included role modeling (both positive and negative) and the clinical environment (notable for emphasis on efficiency and conflicting cues). Students’ essays drew most heavily on the effects of role modeling.
Discussion
Medical students arrive at our doors as thoughtful, compassionate people. Positive role models and activities to promote critical self-reflection may help nurture these attitudes.
Similar content being viewed by others
References
Pence GE. Can compassion be taught? J Med Ethics. 1983;9(4):189–91.
Fox R. Training in caring competence. In: Hendrie HC, Lloyd C, eds. Educating Competent and Humane Physicians. Bloomington: Indiana University Press; 1990:199–216.
Coulehan J. Today’s professionalism: engaging the mind but not the heart. Acad Med. 2005;80:892–8.
Hafferty F, Franks R. The hidden curriculum, ethics teaching, and the structure of medical education. Acad Med. 1994;69:861–71.
Kenny NP, Mann KV, MacLeod H. Role modeling in physicians’ professional formation: reconsidering an essential but untapped educational strategy. Acad Med. 2003;78:1203–10.
Paice E, Heard S, Moss F. How important are role models in making good doctors? Brit Med J. 2002;325(7366):707–10. (available at: http://bmj.bmjjournals.com/cgi/content/full/325/7366/707. Accessed June 3, 2006).
Shuval JT, Adler I. The role of models in professional socialization. Soc Sci Med. 1980;14A:5–14.
Wright S, Wong A, Newill C. The impact of role models on medical students. J Gen Intern Med. 1997;12:53–6.
Reuler JB, Nardone DA. Role modeling in medical education. West J Med. 1994;160:335–7.
Beaudoin C, Maheux B, Côté L, et al. Clinical teachers as humanistic caregivers and educators: perceptions of senior clerks and second-year residents. CMAJ. 1998;159(7)(available at: http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1232732&blobtype=pdf. Accessed June 30, 2006).
Benbassat J, Baumal R. What is empathy, and how can it be promoted during clinical clerkships? Acad Med. 2004;79:832–9.
Maheux B, Beaudoin C, Berkson L, et al. Medical faculty as humanistic physicians and teachers: the perceptions of students at innovative and traditional medical schools. Med Educ. 2000;34:630–4.
Glick S. The empathic physician: nature and nurture. In: Spiro H, McCrea Curnen MG, Peschel E, St. James D, eds. Empathy and the Practice of Medicine. New Haven: Yale University School of Medicine; 1996:85–102.
Gauthier CC. Teaching the virtues: justifications and recommendations. Camb Q Healthc Ethics. 1997;6:339–46.
Coulehan J, Williams P. Vanquishing virtue: the impact of medical education. Acad Med. 2001;76:598–605.
Charon R, Montello M. Stories Matter: the Role of Narrative in Medical Ethics. New York: Routledge; 2002.
Pellegrino E, Thomasma DC. The Virtues in Medical Practice. New York: Oxford University Press; 1993.
DiCicco-Bloom B, Crabtree BF. The qualitative research interview. Med Educ. 2006;40:314–21.
Coulehan J, Belling C, Williams PC, McCrary SV, Vetrano M. Human contexts: medicine in society at Stony Brook University School of Medicine. Acad Med. 2003;78:987–92.
Jones AH, Carson R. Medical humanities at the University of Texas Medical Branch at Galveston. Acad Med. 2003;78:1006–9.
Montgomery K, Chambers T, Reifler DR. Humanities education at Northwestern University’s Feinberg School of Medicine. Acad Med. 2003;78:958–62.
Hawkins AH, Ballard JO, Hufford DJ. Medical humanities at Pennsylvania State University College of Medicine. Acad Med. 2003;78:1001–5.
Kopelman LM. Values and virtues: how should they be taught? Acad Med. 1999;74:1307–10.
Shapiro J. How do physicians teach empathy in the primary care setting? Acad Med. 2002;77:323–8.
Branch WT. Supporting the moral development of medical students. J Gen Intern Med. 2000;15:503–8.
Konrad T, Williams ES, Linzer M, et al. Measuring physician job satisfaction in a changing workplace and a challenging environment. Med Care. 1999;37:1174–82.
Williams ES, Skinner AC. Outcomes of physician job satisfaction: a narrative review. Health Care Manage Rev. 2003;28:119–39.
Merritt, Hawkins & Associates. 2004 survey of physicians 50–65 years old. Summary report. Available at: http://www.merritthawkins.com/pdf/2004_physician50_survey.pdf. Accessed August 9, 2007.
West CP, Huschka MM, Novotny PJ, et al. Association of perceived medical errors with resident distress and empathy: a prospective longitudinal study. JAMA. 2006;296:1071–8.
Bruce SM, Conaglen HM, Conaglen JV. Burnout in physicians: a case for peer-support. Intern Med J. 2005;35:272–8.
Reisman AB. Outing the hidden curriculum. Hastings Cent Report July–August 2006 9–9(1).
Acknowledgments
We are grateful to members of NEOUCOM’s Class of 2006 who allowed us to use their thoughtful essays.
Conflict of Interest
This research was not funded.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Wear, D., Zarconi, J. Can Compassion be Taught? Let’s Ask Our Students. J GEN INTERN MED 23, 948–953 (2008). https://doi.org/10.1007/s11606-007-0501-0
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11606-007-0501-0