MedEdPORTAL (Jul 2010)
Pain and the Humanities: Exploring the Meaning of Pain in Medicine Through Drama, Literature, Fine Arts and Philosophy
Abstract
Abstract Introduction This course is designed to enrich the experience of students preparing for clinical medicine by providing a brief, multicultural exposure to the humanities. It includes materials that describe, portray, and involve reactions to pain that have been selected from drama, literature, fine arts, and philosophy. The course was designed to provoke discussion, challenge participants to reflect deeply about their responses to pain, and bring learners to the point of meaningful emotional growth. Methods An 8-hour humanities-based curriculum (as 4 two-hour sessions embedded in the Johns Hopkins University School of Medicine professionalism course) was delivered to multiple groups of 24 or fewer students. The objectives included: guiding medical students in acknowledging emotional aspects of pain and developing empathetic responses; prompting discussion and awareness of distinctions among pain and suffering experiences, specifically bodily pain vs. that due to psychosocial causes; encouraging the formation of professional values that incorporate conscientiousness and a non-judgmental stance toward those experiencing pain. Students were required to participate within the classroom and complete an assignment. Results Quantitative analysis demonstrated several key findings. First, pain narratives were highly effective in evoking affective awareness of pain experience. Second, multi-cultural materials were highly valued by students and led to invigorated reflections on the meaning of pain in a socio-cultural context. Third, philosophic inquiry into professional values was more effective when discussions of literary pain narrative and fine arts preceded philosophy (concrete to abstract), in contrast to presenting philosophy first. Qualitative analysis revealed that: emotional suffering, (e.g., isolation, heartache, etc.) is nearly universal for students at this stage, while physical pain is not; distinguishing physical pain from psychological or social suffering was initially difficult for some students, but the majority improved in this capacity; and that students were challenged to define their own values which served to enhance awareness of other's value systems. Discussion The pain and humanities curriculum provided a much-needed opportunity for the pre-clinical students to examine the meaning of pain in a medical context. Because pain is a complex experience, innovative approaches to teaching about pain are essential.
Keywords
