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Authentic Community as an Educational Strategy for Advancing Professionalism: A National Evaluation of the Healer’s Art Course

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Abstract

Background

Efforts to promote medical professionalism often focus on cognitive and technical competencies, rather than professional identity, commitment, and values. The Healer’s Art elective is designed to create a genuine community of inquiry into these foundational elements of professionalism.

Objective

Evaluations were obtained to characterize course impact and to understand students’ conceptions of professionalism.

Design

Qualitative analysis of narrative course evaluation responses.

Participants

Healer’s Art students from U.S. and Canadian medical schools.

Approach

Analysis of common themes identified in response to questions about course learning, insights, and utility.

Results

In 2003–2004, 25 schools offered the course. Evaluations were obtained from 467 of 582 students (80.2%) from 22 schools participating in the study. From a question about what students learned about the practice of medicine from the Healer’s Art, the most common themes were “definition of professionalism in medicine” and “legitimizing humanism in medicine.” The most common themes produced by a question about the most valuable insights gained in the course were “relationship between physicians and patients” and “creating authentic community.” The most common themes in response to a question about course utility were “creating authentic community” and “filling a curricular gap.”

Conclusions

In legitimizing humanistic elements of professionalism and creating a safe community, the Healer’s Art enabled students to uncover the underlying values and meaning of their work—an opportunity not typically present in required curricula. Attempts to teach professionalism should address issues of emotional safety and authentic community as prerequisites to learning and professional affiliation.

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Acknowledgements

The success of the Healer’s Art depends on the commitment and energies of many, including the course directors and faculty at each participating school across the country. We are indebted to them for their help in carefully collecting the course evaluations. Jan Ellis, MA, former Associate Director of the Healer’s Art National Program, was instrumental in coordinating many elements of this research effort. Kim Gallelli, Ph.D., formerly of Commonweal, was helpful in preparing and reviewing the manuscript. We wish to thank Susan Folkman, Ph.D.; Patricia O’Sullivan, Ph.D.; and Dean David Irby, Ph.D., for their thoughtful reviews of the manuscript. Our deepest appreciation to Dean Joseph F. O’Donnell, M.D.; Dean Nancy Oriol, M.D.; and Dean Molly Osborne, M.D., Ph.D., for their leadership, support, and guidance throughout the dissemination and evaluation of the Healer’s Art. The Healer’s Art is a program of the ISHI at Commonweal, which has been generously supported by many foundations and individuals.

Financial Support

The Healer’s Art course is supported by grants to ISHI at Commonweal from private donors and the George Family Fund, the MACH Foundation, the Barnard OSHER Foundation, and the Flow Fund.

Conflicts of Interest

Two of the authors of this manuscript (MWR and RNR) also serve as faculty in the Healer’s Art course at one of the 22 medical schools included in the analysis. One author (RNR) originally developed the course and continues to direct its national dissemination.

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Authors and Affiliations

  1. Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, 1701 Divisadero St. #500, San Francisco, CA, 94143-1732, USA

    Michael W. Rabow MD

  2. Osher Center for Integrative Medicine, Department of Medicine, University of California, San Francisco, San Francisco, USA

    Judith Wrubel PhD

  3. Department of Family and Community Medicine, Institute for the Study of Health and Illness at Commonweal, University of California, San Francisco, USA

    Rachel Naomi Remen MD

Authors
  1. Michael W. Rabow MD
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  3. Rachel Naomi Remen MD
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Corresponding author

Correspondence to Michael W. Rabow MD.

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Rabow, M.W., Wrubel, J. & Remen, R.N. Authentic Community as an Educational Strategy for Advancing Professionalism: A National Evaluation of the Healer’s Art Course. J GEN INTERN MED 22, 1422–1428 (2007). https://doi.org/10.1007/s11606-007-0274-5

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  • DOI: https://doi.org/10.1007/s11606-007-0274-5

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