Authentic community as an educational strategy for advancing professionalism: a national evaluation of the Healer's Art course.

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.