Reflecting with Compassion on Student Feedback
Social Sciences in Medicine
Keywords:Student feedback, social science, medical education, health professional education, compassionate pedagogy
This reflective piece of writing explores the experience of gaining medical student feedback that is negative in the context of teaching social sciences in a medical school. There are a number of different ways in which an educator can explore negative feedback and respond. Some ways may be less helpful than others even though they reflect prevailing dominant thinking within higher education and how students are perceived.
Compassionate pedagogy provides an avenue for allowance of challenging feedback and situations, as well as an unpacking of assumptions made about teaching and medical students, in a way that is respectful of the teacher, student and ultimately the patient. Since the way students are treated can be seen as an exemplar for how they will then go on to view and treat the patient, the compassion gap within universities (that train health professionals to then work with patients) is astonishing as noted by Waddington (2016).
Drawing on theory from the social sciences as well as medical humanities, this paper uses reflective practice (Foley, 2002), critical pedagogy (Freire, 2000) as well as intelligent kindness (Ballett & Campling, 2011) to analyse a student feedback experience within medical education and asks the question of how can compassion be integrated in a biomedical field where the emphasis is on science, with all the implications that has for the learner? This question centres on the relative valuing of objective facts over subjectivity of experience.
Using compassionate pedagogy, some suggestions or, food for thought, are made on how to re-interpret negative student feedback that negotiates the tricky area between social science and medicine, whilst not negating either.
Behavioural & Social Sciences Teaching in Medicine (BeSST) Sociology Steering Group. (2016). A Core Curriculum for Sociology in UK Undergraduate Medical Education. Cardiff: Cardiff University.
Becker, H. S. (1961). Boys in White: Student culture in medical school. London: Transaction Publishers.
Becker, E. (1973). The Denial of Death. London: Souvenir Press Ltd.
Belkin, G. S. (2001). Causation about what? Relevant to whom? Linking psyche and society. Culture, Medicine and Psychiatry, 25, 345-349.
Biesta, G. (2004). “Mind the Gap!” Communication and The Educational Relation in C. Bingham, & AM. Sidorkin (Eds.), No Education Without Relation, New York: Peter Lang Publishing.
Biesta, G. (2013). The Beautiful Risk of Education. Boulder, Colorado: Paradigm Publishers.
Bleakley, A. (2011). Medical Education for the future: identity, power and location. New York: Springer.
Bleakely, A. (2017). The Perils and Rewards of critical consciousness raising in Medical Education. Academic Medicine, 37(7), 289-291.
Bohm, D. (2002). Wholeness and the implicate order. London: Routledge.
Bollas, C. (1989). Forces of destiny: psychoanalysis and human idiom. London: Free Association Books.
Brookfield, S. (1995). The getting of wisdom: what critically reflective teaching is and why it’s important. Becoming a critically reflective teacher. Jossey Bass: San Francisco.
Bugaj, T. J., Cranz, A., Junne, F., Erschens, R., Herzog, W., & Nikendei, C. (2016). Psychosocial burden in medical students and specific prevention strategies. Mental Health & Prevention, 4, 24-30.
Butler J. (1993). Bodies that matter. New York: Routledge.
Centers for Disease Control and Prevention (CDC). 2018. Adverse Childhood Experiences. https://www.cdc.gov/violenceprevention/acestudy/index.html
Cerea, A. (2018). Culture and psychism: the ethnopsychoanalysis of Georges Devereux. History of Psychiatry, 29(3): 297-314.
Clark, D. O., Frankel, R. M., Morgan, D. L., Ricketts, G., Bair, M. J., Nyland, K. A., & Callahan, C. M. (2008). The meaning and significance of self-management among socioeconomically vulnerable older adults. Journal of Gerontology, 63B(5), S312- S319.
Cleland, J. A., Nicholson, S., Kelly, N., & Moffat, M. (2015). Taking context seriously: explaining widening access policy enactments in UK medical schools. Medical Education, 49(1), 25-35.
Coombes, R. (2018). Medical Students need better mental health support from universities, says BMA. BMJ, 361. bmj/361/bmj.k2828.full.pdf
CSDH. Closing the gap in a generation: health equity through action on the social determinants of health. Final report of the Commission on Social Determinants of Health. 2008. Geneva: World Health Organisation.
Crawford, R. (1977). You are dangerous to your health: the ideology and politics of victim blaming. International Journal of health services, 7(4), 663–680.
David. (2018). https://twitter.com/flamingdavid/status/1011731196588552192 26th June; 3:01pm @flamingdavid
Ellsworth, E. (1992). Why doesn’t this Feel Empowering? Working through the Repressive Myths of Critical Pedagogy. Chapter 6 in Luke, C., and Gore, J. M. (Eds). Feminisms and Critical Pedagogy. New York: Routledge.
Elmore R. F., Forman, M. L., Stosich, E. L., & Bocala, C. (2014). The internal coherence assessment protocol & developmental framework: building the organizational capacity for instructional improvement in schools. Strategic Education Research Partnership. www.serpinstitute.org
Epstein, R. (2017). Attending: Medicine, mindfulness, and humanity. New York: Scribner.
Erschens, R., Herrmann-Werner, A., Bugaj, T. J., Nikendei, C., Zipfel, S., & Junne, F. (2016). Methodological aspects of international research on the burden of anxiety and depression in medical students. Mental Health & Prevention, 4, 31-35.
Foley, D. E. (2002). Critical ethnography: the reflexive turn. Qualitative Studies in Education, 15(5), 469- 490.
Foucault, M. (1973). The Birth of the Clinic – An Archeology of Medical Perception. New York: Vintage Books.
Freire, P. (2000). Pedagogy of the Oppressed. 30th Anniversary Edition. New York: The Continuum International Publishing Group Ltd.
Fricker, M. (2009). Epistemic Injustice: Power and the ethics of knowing. Oxford: Oxford University Press.
General Medical Council (GMC). 2018. Outcomes for Graduates. www.gmc-uk.org.
Gibbs, P.(2017) Higher Education: A compassion business or edifying experience? In P. Gibbs (Ed.), The Pedagogy of Compassion at the Heart of Higher Education (pp1-16). London: Springer.
Gilbert, P. (2017). Compassion: definition and controversies. In P. Gilbert (Ed.), Compassion: Concepts, Research and Applications (pp. 3-15). London: Routledge.
Gilbert, P., & J. Mascaro (2017). Compassion Fears, Blocks and Resistances: An Evolutionary Investigation. In E. Seppala, E. Simon-Thomas, S. L. Brown, M. C. Worline, C. D. Cameron & J. R. Doty (Eds.) The Oxford handbook of Compassion Science (pp. 399-418). New York: Oxford University Press.
Gotzsche, P. C. (2013). Deadly medicines and organized crime: How big pharma has corrupted healthcare. London: Radcliffe Publishing.
Hawton, K., Clements, A., Sakarovitch, C., Simkin, S., & Deeks, J. J. (2001). Suicide in doctors: a study of risk according to gender, seniority and specialty in medical practitioners in England and Wales, 1979 – 1995. J Epidemiology Community health, 55, 296-300.
Hafferty, F. W., & B. Castellini, (2009). The hidden curriculum: a theory of medical education. In C. Brosnan & B. S. Turner (Eds.), Handbook of the Sociology of Medical Education (pp. 15-35). London: Routledge.
Health Foundation. (2016). Supporting self-management: A guide to enabling behaviour change for health and wellbeing using person- and communitycentred approaches. https://www.health.org.uk/sites/health/files/RtVSupportingSelfManagement.pdf
Kendall, K., Collett, T., de Longh A., Forrest S., Kelly, M. (2018). Teaching sociology to undergraduate medical students. Medical Teacher. https://doi.org/10.1080/0142159X.2018.1505038
Kotsis, S. V., Chung, K. C. (2013). Application of See One, Do One, Teach One Concept in Surgical Training. Plastic Reconstructive Surgery, 131(5), 1194–1201.
Kottke, T. E. (2011). Medicine is a social science in its very bone and marrow. Mayo Clinic Proceedings, 86(10), 930-932.
Kristeva, J., Moro, M. R., Odemark, J., Engebretsen E. (2017). Cultural crossings of care: an appeal to the medical humanities. BMJ Medical Humanities, 0, 1-4.
Kumagai, A. K., Jackson, B., & Razak, S. (2017). Cutting close to the bone: student trauma, free speech, and institutional responsibility in Medical Education. Academic Medicine, 93(3), 318-323.
Lather, P. (1991). Getting Smart – Feminist Research and Pedagogy with/in the Postmodern. New York: Routledge, Chapman and Hall.
Lempp, H. (2009). Medical school culture. In C. Brosnan & B. S. Turner (Eds.), Handbook of the Sociology of Medical Education (pp.71-88). London: Routledge.
Lowe, W. A., Adams, J., Ballinger, C., Armstrong, R., Lueddeke, J., Protheroe, J., McAffery, K., Nutbeam, D., & Russell, C. (2014). Patients’ and health professionals’ views, preferences and experiences of lower levels of literacy and musculoskeletal patient education: a qualitative analysis. Arthritis Research UK.
Lowe, W. A. (2010). Health and ‘I’: an analysis of curricular phenomena in education of health professionals through the focus of critical pedagogy. Unpublished Thesis. School of Education, Murdoch University, Western Australia.
Mars, S. G. (2010). The Politics of Addiction: Medical Conflict & Drug Dependence in England since the 1960s. Science, Technology & Medicine in Modern History. California: AIAA.
Moro, M. R. (2018). Keynote Lecture: Transcultural issues for children and parents in a changing world. Cultural Crossings of Care: an appeal to the medical humanities. Institute of Health & Society, Faculty of Medicine, University of Oslo, Norway. 27th October 2018.
MacIntyre, S., & Petticrew, M. (2000). Good intentions and received wisdom are not enough. J Epidemiol Community Health, 54, 802-803.
Maginnis, C. (2018). A discussion of professional identity development in nursing students. Journal of Perspectives in Applied Academic Practice, 6(1), 91-97.
Martin, A. J., Beska, B. J., Wood, G., Wyatt, N., Codd, A., Vance, G., & Burford, B. (2018). Widening interest, widening participation: factors influencing school students’ aspirations to study medicine. BMC Medical Education, 18:117.
Miller, M. N., Mcgowan, R., Quillen, J. H. (2000). The painful truth: Physicians are not invincible. South Med Journal, 93(10).
National Collaborating Centre for Determinants of Health. (2014). Let’s talk: Moving upstream. Antigonish, NS: National Collaborating Centre for Determinants of Health, St. Francis Xavier University.
O’Mahony, S. (2016). The way we die now. London: Head of Zeus.
Palmer, P. (2017). The Courage to Teach. Exploring the inner landscape of a teacher’s life. San Francisco: John Wiley & Sons.
Paradis E. (2018). https://twitter.com/ep_qc/status/1011690403739914240 26th June; 12:19pm @ep_qc
Paul IA. (2018). https://twitter.com/Dr_Dymphna/status/1011700084575219713 26th June; 12:57 @Dr_Dymphna
Petersen, A., & Lupton, D. (2000). The New Public Health – Health and Self in the Age of Risk. London: Sage Publications.
Piff, P. K., & Moskowitz, J. P. (2017). The Class-Compassion Gap: How Socioeconomic Factors Influence Compassion. In E. Seppala, E. Simon-Thomas, S. L. Brown, M. C. Worline, C. D. Cameron & J. R. Doty (Eds.) The Oxford handbook of Compassion Science (pp. 317-330). New York: Oxford University Press.
Reeves, E. (2015). A synthesis of the literature on Trauma Informed Care. Issues in Mental Health Nursing, 36(9), 698-709.
Sacks, O. (1985). The man who mistook his wife for a hat. Duckworth: London.
Schwenk, T. L., Davis L., & Wimsatt L. A. (2010). Depression, stigma and suicidal ideation in medical students. JAMA, 304(11), 1181-1190.
Sharma, M., Pinto, A. D., Kumagai, A. K. (2018). Teaching the social determinants of health: A path to equity or a road to nowhere? Academic Medicine, 93(1); 25-30.
Sinclair, S. (1997). Making Doctors: An Institutional Apprenticeship. Oxford: Berg.
Spikins, P. (2017). Prehistoric origins: the compassion of far distant strangers. In P. Gilbert (Ed.), Compassion: Concepts, Research and Applications (pp. 16-30). London: Routledge.
Waddington, K. (2016). The compassion gap in UK universities. International Practice Development Journal, 6(1). https://www.fons.org/Resources/Documents/Journal/Vol6No1/IPDJ_0601_10.pdf
Waddington, K. (2017). Creating conditions for compassion. In P. Gibbs (Ed.), The Pedagogy of Compassion at the Heart of Higher Education (pp. 49-70). London: Springer.
Walsh, D., McCartney, G., Collins, C., Taulbut, M., Batty, G. D. (2016). History, politics and vulnerability: explaining excess mortality. Glasgow Centre for Population Health. https://www.gcph.co.uk/publications/635_history_politics_and_vulnerability_explaining_excess_mortality
Ward, S., & Outram, S. (2016). Medicine: in need of culture change. Internal Medicine Journal, 112-116.
White, M., Adams, J., & Heywood, P. (2009). How and why do interventions that increase health overall widen inequalities within populations? In S. J. Babones, (Ed.), Social Inequality and public health (pp. 65-81). The Policy Press: Bristol.
White, R. (2017). Compassion in Philosophy and Education. In P. Gibbs (Ed.), The Pedagogy of Compassion at the Heart of Higher Education (pp. 19-33). London: Springer.
Whitmarsh, I., Jones, D. S. (2010). What’s the use of race? Modern governance & the biology of difference. London: MIT Press.
Wright Mills, C. (2000). The Sociological imagination: Fortieth Anniversary Edition. Oxford: Oxford University Press.
Worline, M. C., & Dutton, J. E. (2017). Awakening Compassion at Work. Oakland, CA: Berrett-Koehler Publishers, Inc.
Zisook, S., Young, I., Doran, N., Downs, N., Hadley A., Kirby B., McGuire, T., Moutier, C., Norcross, W., & Tiamson-Kassab, M. (2016). Suicidal Ideation Among Students and Physicians at a U.S. Medical School: A Healer Education, Assessment and Referral (HEAR) Program Report. OMEGA—Journal of Death and Dying 74(1), 35–61.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
Journal of Perspectives in Applied Academic Practice has made best effort to ensure accuracy of the contents of this journal, however makes no claims to the authenticity and completeness of the articles published. Authors are responsible for ensuring copyright clearance for any images, tables etc which are supplied from an outside source.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported License.