Blog
Flourishing symposium, 2022
It was a privilege to host our third flourishing symposium. Flourishing was explored as something interpersonal and relational. Something which involves connection with others and ourselves recognising our humanity, vulnerability and brokeness and engaging with compassion and care for self and others....
Lived experience of creative enquiry, 2021
Speaking openly with my SSC group about many of the struggles of university life gave me a newfound confidence and hearing about shared worries helped to quell my own. I now felt much more in contact with these feelings and had the ability to share and convey these feelings with friends and family. Now that I could vocalise to other people around me it gave me a much better understanding on how I was feeling myself. I found that once I began sharing my feelings with people around me that it opened other people up to feel more comfortable to share how they were feeling with me
Lived experience of creative enquiry in medical education, Elle Tallgren, Sept, 2021
'......I don't have to bounce back from every hard experience like I had permanent springs under my shoes- they are not permanent and they get rusty easily. The journey towards flourishing allows me to take painful experiences with me, explore them through creative enquiry, and accept them as part of me rather than as flaws I would like to exclude from my life....'
Self Compassion – April 2022, Uchenna Umeh (Year 5 medical student)
There is no doubt that medical students need to acquire a solid foundation of clinical knowledge. This ensures that upon graduation, students are well equipped to embark on their careers in medical practice both safely and effectively. Medical schools make sure of this through a carefully developed curriculum and routine assessments. Keeping academic standards high encourages students to endeavour to reach their full academic potential but it can also mean that their own wellbeing is neglected.
In fact, several studies show that medical students often report high levels of burnout and depressive symptoms when compared with their peers on other university courses. (1, 2) This reveals an important area for improvement regarding mental health and wellbeing in medical students.
Self-compassion encompasses demonstrating warmth, self-kindness, mindfulness and understanding towards oneself. It can be compared to the consideration or grace we would likely extend to a good friend. (3) Cultivating a learning environment where this is encouraged can lead to students developing greater emotional intelligence, improved self-esteem, reduced anxiety, and overall strengthened mental wellbeing.
Realistically, how could this be achieved?
In a survey conducted by Butcher et al, medical students suggested that schools could introduce “wellness-based group discussion sessions built into the med school curriculum”, courses as well as “relaxing activities”. (4)
Many universities do provide counselling services, but some students may fail to access these until they reach an extreme where they feel unable to cope. Other barriers could include lack of availability and timetable issues. Therefore, ensuring that wellbeing focused activities are scheduled into the curriculum could help to tackle some of these issues. It could also be argued that creating mandatory sessions could result in an additional burden for students. However, these activities would ideally be removed from examinable material which may help to reduce potential stress from this curriculum addition.
Encouraging students to become more adept at expressing their lived experiences regarding mental health could be a potential extension of creative methods of learning that currently exist. A workshop for Year 1 medical students at Queen Mary University London allowed students to use creative enquiry (exploring lived experience through the arts) (5) as a basis to reflect on their experiences of medical school. The session was conducted with a relatively small number of students and often, discussions would branch out into smaller groups of three or four students. This meant that everyone in the group got to know each other quite well and allowed a safe space for those who may naturally be less vocal in larger group settings. This experience seemed to be very beneficial for the students who took part. On a wider scale, more opportunities that encourage peer-to-peer, open discussions where students feel safe and supported, could be a step toward developing a stronger culture of self-compassion in medical school and beyond. (6)
References
1. Dyrbye LN, West CP, Satele D, Boone S, Tan L, Sloan J, Shanafelt TD. Burnout among U.S. medical students, residents, and early career physicians relative to the general U.S. population. Acad Med. 2014 Mar;89(3):443-51.
2. Ghodasara SL, Davidson MA, Reich MS, Savoie CV, Rodgers SM. Assessing student mental health at the Vanderbilt University School of Medicine. Acad Med. 2011 Jan;86(1):116-21.
3. Mills J, Chapman M. Compassion and self-compassion in medicine: Self-care for the caregiver. AMJ 2016;9(5):87–91
4. Butcher M, Thompson T, et al. Assessment of Student Perspective on Improving Wellness in Medical School. Advances in Medical Education and Practice. 2021; 12: 1-67-1079
5. Younie L, Swinglehurst D. Creative enquiry and reflective general practice. Br J Gen Pract. 2019;69(686):446-7.
6. Peters D, Horn C, Gishen F. Ensuring our future doctors are resilient BMJ 2018; 362
Compassion - September 2021, Kathleen Rafferty (year 5 medical student)
Compassion from Latin roots ‘com’ and ‘pati’ means to suffer with, however today we might define compassion as ‘a sensitivity to the distress of self and others with a commitment to do something about it and prevent it’ (2). Research suggests (3,4) the action component of compassion can have a positive effect on the individual, which could potentially mitigate the negative emotional toll that can occur through empathy alone. This action component also positively impacts patient care, even small acts of kindness can contribute to alleviate patient suffering and improve outcomes (5).
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Flourishing symposium - Sept, 2020
Last week we ran a virtual ‘Flourishing in Medicine’ symposium in recognition of the burnout epidemic and mental health crisis reported amongst doctors and students in reports by the BMA, GMC and HEE in 2019. Flourishing draws on nature as metaphor with seasons of blooming and loss, the importance of rootedness, nurture and ecosystem connection i.e. relationships between people. Aristotle’s ‘eudaimonia’ has been linked to flourishing including the ideas of authentic connection with our values and meaningful engagement in the world.
The interactive symposium saw over 40 attendees crossing hierarchies including medical students, clinicians, professors; crossing disciplines from arts, human geography, education, psychology, medicine, medical education and crossing continents, USA and UK. Through creative enquiry processes we explored the concept of flourishing together, and engaged with creative enquiry processes and submitted texts. We thought together about how to create systems with vulnerable leadership, engagement with intersubjectivity and lived experience as well as witnessing clinician and student joys and challenges in our current climate of perfectionism and heroism.
Memorable moments included hearing a poem from Dr Kathleen Wenaden, hearing from Harris talk about his lived experience volunteering in hospitals with his plastic bag gif, and hearing from Professor Hedy Wald on professional identity formation, promoting resilience and wellbeing. The quality of the shared space and dialogue across the diverse group was also moving.
Louise Younie
