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Putting It on the Table: Towards Better Cultivating Medical Student Values

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Abstract

Problem

Medical teachers, like many others in higher education, need to help some students cultivate values essential to good practice. However, there is a paucity of evidence-based practical advice about how to exactly do this. While several educational methods are widely accepted as generally useful for such a purpose, specific pedagogical guidance is lacking. Teachers still need to know how to effectively develop values in the classroom.

Research Aim

As part of an existing curricula with teaching methods already understood to be useful, we pursued the development of specific classroom strategies to more effectively cultivate medical students’ values.

Methods

We undertook a year-long action research project with six experienced medical teachers. Data included group discussion meetings, semi-structured interviews, observations and interpersonal process recall of each teacher’s classroom practice.

Results

Participant teachers developed an understanding of values as highly sensitive, in the sense of their relation to an individual’s sense of self. This understanding explained, in part, the challenges teacher participants had experienced in teaching values. From this understanding, participants developed a specific discourse to help one another understand and describe effective values teaching; one of cultivation, placing in sight and of moving a student from where they started to another place. A specific two-part pedagogy was then developed from this discourse: to avoid engendering negative emotion in the student and to implicitly value or ‘believe in’ the student as a person.

Conclusions

Results have implications for teacher pedagogy and development, and in nominating who might best teach values. Further research should focus on the finer points of language and developing a more specific understanding of how teacher ‘caring’ might help cultivate values.

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Notes

  1. We also acknowledge calls from the profession to investigate what values might constitute the best values to develop in order to care for the patient (Benatar and Upshur 2014).

  2. Teachers were both teachers and researchers—and the primary researcher was also a teacher on the program.

  3. The structure of the medical curriculum is as follows: Year 1: a general health sciences year taken by most potential health care professional students (including potential medicine, dentistry, physiotherapy and pharmacy students). Years 2 and 3: largely classroom based, but with some community contact, and including a backbone of paper cases integrating learning and some early clinical skills learning. Years 4 and 5: Advanced Learning in Medicine (ALM) students rotate through a series of hospital and other departmental attachments. Year 6: trainee intern (TI) year students continue to rotate through departmental attachments.

  4. A colloquialism that refers to how someone might come to think about an idea (cigarette) later (behind the ear).

  5. A colloquialism that refers to something ‘getting better’ or ‘fixing itself’.

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Acknowledgments

We thank Clinton Golding and Tim Wilkinson for supervisory support in the development of these ideas.

Funding

We acknowledge the support of a Medical Education Scholarship and a PhD Publishing Bursary from the University of Otago for the research reported here.

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Correspondence to A. Gamble Blakey.

Ethics declarations

The research was carried out as part of a PhD (Blakey 2016) and granted ethical approval by the University of Otago Human Ethics Committee.

Conflict of Interest

The authors declare that they have no conflict of interest.

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Gamble Blakey, A., Pickering, N. Putting It on the Table: Towards Better Cultivating Medical Student Values. Med.Sci.Educ. 28, 533–542 (2018). https://doi.org/10.1007/s40670-018-0584-8

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