Table 2.
Major themes underpinning student companion curriculum use
| Theme | Description | Quotations (source)a |
|---|---|---|
| Perceived value of humanities in medical education | Students recounted perceived goals and benefits of the arts in medical education, speaking from personal, professional, and global perspectives: Benefits to personal development referenced introspection, humility, empathy, and comfort with ambiguity. Professional benefits were captured in terms of patient connection and communication skills. Activism and advocacy were voiced as central features of the humanities. |
“Literature allows you to form a subjective point of view on something and add some nuance into your perspective” (FG1-P3). “The humanities component after CBLb gives an idea of the patient’s experience, and therefore helps to understand ... what might be important to work on with them” (S#85). “Truly good doctors understand the patient experience—that they listen to their patients, that they are also critical about their place in society and context historically, and who they are and what they represent.” (FG1-P2). |
| Student barriers to using the companion curriculum | Students shared many barriers impeding CCc engagement. Time, burnout, student culture, and the content itself were obstacles identified to engagement with the CC. Students reflected on these barriers as byproducts of the culture of objectivity in medical education. | “Since it’s not tested, we don’t read it” (S#14). “I feel like I have enough work on my plate with the mandatory stuff to begin with” (FG2-P5). “Don’t find it important” (S#118). “Its unclear what the point of the activities are” (S#19). “Significance of the curriculum not really instilled” (S#42). “I think it's hard; like it's a very intense environment to begin with. And the people are very serious and scientific. And so it's hard to make space for [the humanities] and even express it” (FG2-P7). |
| Institutional neglect of humanities in medical education | Students lamented the structural barriers preventing effective integration of the CC—and the humanities more broadly—into the medical curriculum. These challenges were discussed as issues of prioritization, visibility and promotion, and faculty development. | “It seems forced, random, irrelevant when taught out of context … I personally value the humanities, but other students aren’t taught to value them” (S#90). “All the skills that I think I bring to being a good doctor, like I could easily not have any of those skills and do just as well in medical school. And it's so frustrating … why did you accept me in this program if those are the things that make me stand out, and made me seem like a great enough candidate to come in, but now that I'm in here, they seem completely useless?” (FG1-P1). “Tutors are expected, even if they’re not themselves experts in that field … to understand the answer on the guide and deliver it appropriately” (FG1-P2). |
| Student critiques and recommendations | Survey and focus group responses offered numerous suggestions for CC improvement related to implementation, content, and nomenclature. Students differed on ideal CC location in the curriculum, suggesting the group reflection component (Portfolio), seminars, and lectures. More than where it sits, students were concerned about how to situate the CC appropriately. | “How is it actually going to be received; what's actually going to happen when it's out there in the world” (FG1-P2). “We need concrete teaching elsewhere in the curriculum that gives us tools for reflective writing and analyzing pieces of text” (S#130). “Even if [students] are being forced to do something humanities, if they have a choice between what they’re doing in humanities, I think that inherently makes them buy into it more” (FG1-P2). |
a
FG1 = Focus Group 1, FG2 = Focus Group 2, P = Participant number, S# = Survey number. bCBL = Case-Based Learning. cCC = Companion Curriculum.