Teaching the art of doctoring: an innovative medical student elective

Abstract

The authors describe a longitudinal third- and fourth-year elective, ‘The Art of Doctoring’, introduced in an attempt to counteract perceived frustration and cynicism in medical students at their home institution during the clinical years. The course goals aimed at helping students to develop self-reflective skills; improve awareness of and ability to modify personal attitudes and behaviors that compromise patient care; increase altruism, empathy and compassion toward patients; and sustain commitment to patient care, service and personal well-being. These goals were accomplished through introduction and development of five skill sets: learning from role models and peers; on-site readings of works by medical student- and physician-authors; self- and other-observation; self-reflective techniques; and case-based problem-solving. The course involved regular in-class exercises and homework assignments, as well as a personal project related to improving personal compassion, caring and empathy toward patients. Students also learned to use a coping algorithm to approach problematic clinical and interpersonal situations. Class discussions revealed three issues of recurring importance to students: loss of idealism, non-compliant patients, and indifferent, harsh or otherwise unpleasant attendings and residents. Quantitative and qualitative student evaluations overall indicated a generally favorable response to the course. Problems and barriers included attendance difficulties and variable levels of student engagement. Future directions for this type of educational intervention are considered, as well as its implications for medical education.

Additional information

Notes on contributors

Johanna Shapiro

JOHANNA SHAPIRO is a professor in the Department of Family Medicine and director of the Program in Medical Humanities & Arts. Her areas of scholarly interest are the doctor–patient relationship and how exposure to literature and the arts can increase medical students’ empathy for patients.

Lloyd Rucker

LLOYD RUCKER is Professor of Medicine and Associate Dean of Curricular Affairs. His interests include enhancing student, resident and faculty teaching skills; physician–patient communication; humanities and medicine; evidence–based medicine; and medical education curricula.

Daniel Robitshek

DANIEL ROBITSHEK is Associate Professor of Medicine and an attending physician in the hospitalist program. He is also Medical Director, Progressive Care Unit at UC Irvine Medical Center as well as the director of the Curriculum in Spirituality and Healthcare. His interests focus on the role of spirituality in medicine.