Correspondence: Dr Avik Chatterjee, Internal Medicine and PediatricsResidency Program, Department of Internal Medicine ResidencyProgrammes, Yale–New Haven Hospital, PO Box 208033, NewHaven, Connecticut 06520-8033, USA. Tel: 00 1 203 785 7941;Fax: 00 1 203 785 3922; E-mail: avik.chatterjee@yale.edu

doi: 10.1111/j.1365-2923.2012.04261.x

Broadening horizons: looking beyond disability

Satendra Singh

What problems were addressed? People withdisabilities, whether these are visible, invisible orreflect chronic illnesses, are important contributorsto society, and the investment of medicalhumanitarian approaches in them is rewardingand enriching. Unfortunately, ‘disability’ and‘rehabilitation’ have been commoditised andtransformed into a commercial enterprise or profit-making sector in the modern capitalist world. Thus,medical education needs to encourage a utopianculture in which empathy precedes sympathy anddisability is viewed as infinite ability. Disabilityperspectives can broaden the medical humanitieshorizon through the creative exploration ofperceptions of disability, particularly given theprevalence of dogmatic beliefs that people withdisabilities are sick, suffering, diseased and inperpetual pain, and that they represent everythingthe ‘normal’ world most fears: tragedy, loss, the darkand the unknown.What was tried? The Medical Humanities Group ofthe University College of Medical Sciences and GuruTeg Bahadur, Delhi formed a special interest groupon disability designated ‘Infinite Ability’. The mainpurpose behind the formation of the group was thepromotion and coordination among medical personswith disabilities of medical humanitarian approachesthat would focus on four competency-based learningobjectives of narrative medicine: graphic medicine;interpersonal and communication skills; patient care,and professionalism.

The group organised an experiential workshop onAugusto Boal’s ground-breaking work ‘Theatre of theOppressed’,1 which we believe represents the firstsuch initiative for medical students. We continued‘Confluence’, our medical humanities lecture series,using the theme of ‘looking beyond disability’, starteda blog on which narratives could be written, sharedpaintings related to disability and painted by peoplewith disabilities, celebrated observances such as theInternational Day of Persons with Disabilities, andused street theatre to sensitise the general public.

What lessons were learned? The decentralisation ofdisability serves as a cornucopia for medicalhumanities in that it can provide wide opportunitiesto develop narratives, inculcate compassion, spreadempathy and build a foundation for inclusion. Healthcare professionals need to understand that the socialmodel of disability must be explored over and abovethe medical model; this initiative was intended to leadto sensitisation among the medical fraternity. Welearned that creative ideas become innovations onlyat the crossroads of persistence and insistence. Wedid not expect to bring about a sea change inattitudes, but we did find that people paused,pondered and contributed towards looking beyonddisability. We learned that cultural responses topeople with perceived impairments are by no meansuniversal. Society and the cultures within it, if they arewilling to, can definitely consider as well asaccommodate the needs of so-called disabled people.Medical students, faculty staff, non-teaching staff andpatients alike contributed to this exploration ofdisability and a specially constituted enabling unitpromoted the use of imagination as a tool forcontinuous improvement. This initiative representsan attempt to offer a clear and understandable focuson a value system that can and should be changed:specifically, this value system is rooted in almost allsocieties and is dependent on a particular view of thehuman condition.

REFERENCE

1 Schaedler MT. Boal’s Theatre of the Oppressed and howto derail real-life tragedies with imagination. New DirYouth Dev 2010;125:141–51.

Correspondence: Satendra Singh, Medical Humanities Group,Medical Education Unit, UCMS, Delhi-110095, India. Tel: 00 91 997178 2076; Fax: 00 91 11 2259 0495; E-mail: dr.satendra@gmail.com

doi: 10.1111/j.1365-2923.2012.04246.x

‘Imitating Art’: ethics, humanities andprofessionalism in undergraduate medicaleducation

Marinaldo Horacio Medeiros, Delane Maria Rego,Maria Jose Vilar & George Dantas Azevedo

What problems were addressed? Recent trends inmedical education point to the need for the

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development of ethical humanist skills andprofessionalism.1 Brazilian national curriculumguidelines (NCG) highlight the desired professionalprofile of a humanist, critical and reflective doctorwith the capacity to act at different levels of healthcare. Accordingly, two public medical schools in thestate of Rio Grande do Norte in northeastern Brazilhave used an innovative educational model fordeveloping ethical humanist skills in undergraduatemedical students using the arts. This active method isnot focused on the acquisition of technical andscientific knowledge, but on goals ofcomprehensiveness and humanisation in thedevelopment of medical practitioners.What was tried? Undergraduate medical students inYears 1 and 2 participated in a workshop entitled‘Imitating Art’ in order to develop appreciation ofartworks by renowned painters and to identifyrelationships with their current educationalexperience and future professional practice. Themasterpieces analysed included, among others,Mona Lisa (da Vinci), The Scream (Munch) and TheAnatomy Lesson of Dr Nicolaes Tulp (Rembrandt).Students were encouraged to deconstruct thepaintings and rebuild them, thereby acting asprotagonists in an artistic context by reproducingscenes from medical practice. In this process,details such as adjusting light, colours andexpressions were addressed by the students. Afterrereading the staging of the art masterpiece,photographic records were made and students werestimulated to reflect on the entire process. Theworkshop was evaluated using an online survey withthe aim of highlighting perceptions on thedevelopment of the following competenciescontained in the NCG: health care; decisionmaking; communication; leadership; administrationand management; continuing education; ethics;professionalism, and teamwork.What lessons were learned? Students welcomed theImitating Art workshop, reporting that it expandedtheir view of ethical humanist attitudes. Two thirds ofthe students responded that the workshop favouredthe development of the majority of NCGcompetencies. Additionally, 90% specifically pointedto perceptions on the development of teamwork,leadership, decision making, communication andprofessionalism. Student-generated reproductionswere classified by faculty members as high-qualitypictures and with high potential to promote criticalreflection. Thus, this student-centred educationalintervention resulted in a practical and creative workenvironment that supported the development ofimportant components involved in thecomprehensive formation of doctors and other health

professionals. Because most students and educatorscontinue to value the acquiring of technical andscientific knowledge above other learning, theadoption of this innovative learning activity, inconjunction with the art, seems to represent apromising strategy for encouraging them to meetcurrent educational requirements.

REFERENCE

1 Perry M, Maffulli N, Willson S, Morrissey D. The effec-tiveness of arts-based interventions in medical education:a literature review. Med Educ 2011;45 (2):141–8.

Correspondence: Professor Maria Jose Vilar, Medicina Clınica,Universidade Federal di Rio Grande do Norte, Avenida NiloPecanha 620 – Petropolis, Natal, Rio Grande do Norte 59012-300,Brazil. Tel: 00 55 84 3342 9709; Fax: 00 55 84 3202 3763;E-mail: vilarmj@ufrnet.br

doi: 10.1111/j.1365-2923.2012.04263.x

Enhancing medical professionalism throughinteractive seminars

Kelly McGarry & Carol Landau

What problems were addressed? Historically,students of medicine learned professional valuesthrough clinical experiences and mentoring. Today,the process of training doctors is far more complexand technological, and sometimes removes traineesfrom direct interaction with patients. Medicaleducators and the public express concern about thedepersonalisation of medical care. Although manyorganisations prioritise efforts to enhance medicalprofessionalism, medical students still graduate withlimited humanistic qualities, cynicism and a sense ofentitlement.What was tried? We developed an innovative 8-weekprofessionalism curriculum to: (i) identifycomponents of and, especially, barriers againstprofessionalism; (ii) develop advanced skills incommunication, and (iii) provide a format for self-reflection, emotional engagement and sharing, whichare critically important skills for the lifelongmaintenance of professionalism. Curricular topicsincluded the hidden curriculum,1 health carefinance, health care disparities, managing difficultpatients, communicating with patients and theirfamilies, conflicts of interest, doctor wellness andimpairment, and advocacy. The junior author andanother faculty member facilitated each 90-minute

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