“I really like her as a teacher, she can’t help that her topic is soft and fluffy”.
“If I wanted to get touchy-feely I would have studied psychology”
These two comments from one of my early teaching evaluations offer a candid snapshot of how contemplative practices are often viewed by our students, especially as they begin their medical training.
Initially I took the resistance on board as a problem that I could fix. I took to storytelling my lived experience of reflection-in-action and shared my vulnerability, for this was what I was asking of our students. Admittedly this helped increase student engagement a little, yet reflective practice was still met with some eye-rolling, and comments such as “we just make something up when we journal”. Whilst I appreciated my student’s honesty, to be truthful, I was disappointed!
Fast forward eight years, and reflection and contemplation are largely still seen as the bridesmaid to propositional knowledge (book smarts) and the technical skills that sit predominately within the cognitive and psychomotor domains of medicine. What I have learnt in this time is that the highly subjective nature of attending to feelings can be challenging for students who are used to learning structured content. Responding to experience in first person is highly personal, and emotional awareness is also often a new skill to be developed alongside those of critical reflection. If given a choice, I have no doubt that a large percentage of students would readily retreat to the safety of cognitive reflection, that tells of what we do, rather than of our world views and who we are. Perhaps I would do the same in their shoes.
I have also seen how combined experiential and affective reflective approaches help students to deliberately attend to their values and engage in sense-making that ultimately helps them cultivate and move towards embodiment of the values of the medical profession. Our research has shown that contemplative practices help our students to develop resilience, empathic ability and the human capabilities required for navigating the inherently complex landscape of contemporary medical practice.
These days, as a more-seasoned educator of ‘the fluffy stuff’, I have learnt that I cannot “teach” students to abandon their resistance to affective reflection. What I can do is support them to trust the process so they can experience its value firsthand, when they are ready.
I often liken championing reflective journalling in our medical curriculum to my stance when my kids baulked at eating their veggies when they were toddlers. There will most likely be resistance in the beginning, and students may take considerable time to see the benefit, but so much would be lost if we took it away!
- Chan, K.D., et al., Beyond communication training: The MaRIS model for developing medical students’ human capabilities and personal resilience. Medical Teacher, 2020. 42(2): p. 187-195.