Jamilah . Grant-Guimaraes,,New Hyde Park,NY,Linda . Volpe,,Bayside,NY,Edwin F. Simpler,,Bayside,NY,Alice . Fornari,,Hempstead,NY
Third year medical students, who are most accustomed to clinical settings where curing is the goal of care, have limited to no exposure to rehabilitative or chronic care of children. Distinctions between curing and healing are important principles to understand from the clinical perspective.
To analyze the effectiveness of a recently developed innovative program in which third year medical students formally reflect in writing upon an experience at a pediatric chronic care and rehabilitation facility. Reflective writing is required in the MS3 curriculum as a formative assessment of their learning from early patient care experiences
During their pediatric clerkship medical students spend a day with clinicians and patients at a chronic care/rehabilitation facility. Following this experience all students are required to write a reflection in response to a prompt: "During your brief experience what characteristics of clinicians have you observed that focus on healing rather than curing?". All narrative reflections are submitted via the course management system utilizing a journal feature. The clerkship director collates all narrative responses, assuring they are deidentified. Using a constructivist approach the clerkship director and selected faculty, including those from the above-noted facility, read 31 students' reflections and explored experiences. Using an inductive approach the reviewers explored specific details using themes as expressed in the reflections, supported by direct quotes that adress the students' overall learning.
During the 2014-2015 academic year 31 MS3 reflections were collated. A preliminary review of the narratives generated the following results expressed as percentages of noted themes:
Communication/Interaction/Relationship - 38%
Inclusion of families/Parents - 42%
Addressing discomfort/Well-being/Quality of life - 65%
With the increasing growth of the field of pediatric chronic care it is especially important for medical educators to give students an effective introduction to this subspecialty. We believe these excerpts demonstrate the ability of third year medical students to learn the distinction between curing and healing in pediatrics. Supported by the thematic data generated from the narratives; in addition, our outcomes support the use of narrative as a methodology to capture salient moments early learners are experiencing. We anticipate this methodology can be applied in other pediatrics clerkships for selected learning experiences.