The Companion Curriculum: medical students' perceptions of the integration of humanities within medical education.

Background: The contributions of arts and humanities to medical education are known in the medical education community, but medical schools' offerings vary. The Companion Curriculum (CC) is a student-curated set of optional humanities content for medical students at the University of Toronto. This study evaluates integration of the CC to identify key enabling conditions for medical humanities engagement. Methods: A mixed-methods evaluation gauged usage and perceptions of integration of the CC among medical students using an online survey and focus groups. Narrative data underwent thematic analysis, supported by summary statistics of quantitative data. Results: Half of survey respondents were aware of the CC (n = 67/130; 52%), and, once prompted with a description, 14% had discussed it in their tutorial groups. Of students using the CC, 80% reported learning something new regarding their roles as communicators and health advocates. Themes were the perceived value of the humanities, internal student barriers, institutional neglect of the humanities, and student critiques and recommendations. Conclusion: Despite participants' interest in medical humanities, our CC remains underused. To improve humanities' visibility in the MD curriculum, our results indicate that greater institutional support, including faculty development and early curricular integration, is required. Further study should explore reasons for gaps between interest and participation.

Contexte: L'apport des arts et des sciences humaines à la formation médicale est bien connu du milieu de l'enseignement médical, mais l'offre des programmes à cet égard varie d'une faculté à l'autre. Le Companion curriculum (CC) est un recueil de contenu facultatif en sciences humaines, préparé par des étudiants et destiné aux étudiants en médecine de l'Université de Toronto. En évaluant l'intégration du CC au programme de formation, cette étude vise à dégager les principales conditions propices à un engagement en faveur des humanités médicales. Méthodes: Une évaluation à méthodes mixtes, à l'aide d'un sondage en ligne et de groupes de discussion, a permis de mesurer l'utilisation du CC par les étudiants en médecine et leur perception quant à l'intégration de cet outil. Les données narratives ont fait l'objet d'une analyse thématique, étayée par des statistiques sommaires de données quantitatives. Résultats: La moitié des répondants au sondage connaissaient le CC (n=67/130 ; 52%) et, une fois qu'on le leur a décrit, 14 % en avaient discuté dans leurs groupes de tutorat. Parmi les étudiants qui l'avaient utilisé, 80 % ont déclaré avoir appris quelque chose de nouveau concernant leurs rôles de communicateur et de promoteur de la santé. Les thèmes abordés étaient la valeur perçue des sciences humaines, les réserves des étudiants, le manque d'intérêt envers les sciences humaines au sein des établissements d'enseignement médical, ainsi que les critiques et les recommandations formulées par les étudiants. Conclusion: Malgré l'intérêt des participants pour les humanités médicales, notre CC demeure sous-utilisé. Nos résultats indiquent que le renforcement de la visibilité des sciences humaines dans le programme d'études médicales nécessite plus de soutien de la part des établissements, y compris par une formation des enseignants et par l'intégration des sciences humaines tôt dans le cursus du programme. Une étude plus approfondie permettrait d'explorer les raisons de l'écart entre l'intérêt et la participation.

Cocreating Meaning Through Expressive Writing and Reading for Cancer Caregivers.

PURPOSE: Caregivers of patients with cancer cope with socioemotional challenges, which can adversely affect their well-being. We developed an intervention, expressive writing and reading (EWR), to promote emotional processing and social connectedness among caregivers. In a single-arm pilot study, we assessed its feasibility and perceived usefulness. METHODS: Caregivers participated in weekly 1.5-hour EWR workshops offered over 20 weeks. After 4 sessions, they completed semistructured interviews, which were analyzed using qualitative descriptive analysis. FINDINGS: Of 65 caregivers approached, 25 were eligible, 18 consented, and 9 (50%) caregivers completed at least 4 workshops and the interview. Their responses revealed 3 themes: "inner processing," "interpersonal learning," and "enhanced processing and preparedness." Perceived benefits of EWR included emotional and cognitive processing (individual and collaborative), learning from the emotions and experiences of other caregivers, and preparing for upcoming challenges. CONCLUSIONS: Expressive writing and reading can be a safe and cost-effective supportive intervention for caregivers of patients with cancer.

Narrative means to professional ends: new strategies for teaching CanMEDS roles in Canadian medical schools.

PROBLEM ADDRESSED: Medical students in training are rarely encouraged to engage in reflective thinking around clinical encounters. Writing exercises can be an effective route for encouraging student reflection. OBJECTIVE OF PROGRAM: The purpose of this pilot project was to determine if using reflective writing in teaching the CanMEDS roles helps to increase students' understanding of the roles in the clinical context. PROGRAM DESCRIPTION: A pilot project was undertaken with 10 third-year medical students at the University of Toronto in Ontario. Students wrote about a different CanMEDS role for each session based on supplied writing prompts. Students also completed a Narrative Reflection Tool at the end of each group session. A selection of writing samples was assessed for reflection and for an understanding of the CanMEDS roles. Students were also given an opportunity to provide feedback on the program. CONCLUSION: Students demonstrated a good grasp of the CanMEDS roles, strong reflective capacity, and engagement in the learning process. Results suggest reflective writing has an important role in encouraging personal reflection and reflective thinking in the clinical context.

Coming out to care: caregivers of gay and lesbian seniors in Canada.

PURPOSE: This article reports on the findings of a study whose purpose was to explore the experiences of caregivers of gay and lesbian seniors living in the community and to identify issues that emerged from an exploration of access to and equity in health care services for these populations. DESIGN AND METHODS: The study used a qualitative methodology based upon principles of grounded theory in which open-ended interviews were undertaken with 17 caregivers living in three different cities across Canada. RESULTS: Findings indicated several critical themes, including the impact of felt and anticipated discrimination, complex processes of coming out, the role of caregivers, self-identification as a caregiver, and support. IMPLICATIONS: We consider several recommendations for change in light of emerging themes, including expanding the definition of caregivers to be more inclusive of gay and lesbian realities, developing specialized services, and advocating to eliminate discrimination faced by these populations.