M. A. JANAUDIS ET AL.
facilitating team work, the natural fatigue in addition to the
stressful environment of the previous medical school year
erodes some relationships. Students often appear overwhelmed
and can hardly talk among themselves without arguing. On the
first day of the special session, however, they found themselves
in a welcoming environment. The teacher did not start talking
about public health issues as they were expecting but instead
asked each student to introduce the colleague occupying the
next seat. This exercise demonstrated to the students that they
needed to understand each person to be able to understand the
community. They disclosed their dilemmas, motivations, and
expectations and realized (based on an Elvis song) that they
could not go on together “with suspicious minds”. They were
then ready to immerse themselves in family medicine principles
and see their patients in the community. They grasped the bot-
tom line of what family medicine is all about: to understand
ourselves in order to be able to understand our patients.
The last assignment was an amazing performance by the
student group of the song “I Gotta Feeling” (from the Black
Eyed Peas) as a tribute to our healing clerkship. It started as a
joke, inspired by Oprah. During The Oprah Show’s 24th season
kickoff party, the Harpo staff and more than 20,000 people
pulled off a massive surprise for the unsuspecting talk-show
host. The entire crowd performed a choreographed piece to the
Black Eyed Peas song. Award-winning director Michael
Gracey says the interaction between the Black Eyed Peas and
the crowd is what made the Oprah flash mob so extraordinary.
A video of this flash mob performance was sent to the stu-
dents as a “challenge”, in the form of a joke, with the group
being told that if they could recreate this performance, they
would be excused from taking the final exam. The group
worked together and copied the performance!
One question emerged from our experience with students in
this special course: Is the student burnout we observe in the last
years of medical school responsible for the lack of humanity in
their practice? These student quotes address that question:
“Today this song became our song. When we started to de-
humanize, we just listened to it and became humans again.”
“We opened that way because of the welcoming environment,
the lack of hierarchy, and the way we were treated by our supe-
riors: as colleagues. For the first time, we were appreciated as
individuals and not for what we produce.”
Understanding the Learning Process: Without
Suspicious Mind(s) (James, 1969)
The process of understanding the students’ experience al-
lowed for the unveiling of a phenomenon that encompasses
their inner world as they attend to their medical training. The
music played on the outside resonates with the story and emo-
tions of the student. The student realizes that the pace imposed
by the medical school does not allow him to reflect, whether on
his own life or in his formation. The music experience allows
students to hear their feelings and share them with the professor
and peers. They are surprised by memories and feelings that
surface that they were unaware of or that they could not re-
member. These feelings are presented in themes that organize
the affective experience of the student, mobilized by the music.
Several themes emerged as well as the search for self: family;
death; vocational doubts; relationships with peers, professors,
and patients.
Education is much more than simple training, which refers
only to the acquisition of specific skills. To educate implies the
ability to drive one’s students to reach their potential. Fostering
human skills is a major aim of medical education because these
skills are essential for clinical competence and professional
development. The use of art forms in medical education helps
to engage students, trigger reflection and empathy, and increase
cultural awareness and sensitivity.
Music has several characteristics that make it particularly
suitable for humanistic training in medicine, with the potential
for enhancing caring and compassion in students. Exposing
students to songs—followed by faculty-facilitated open discus-
sion—stresses emerging topics, stimulates reflection on the
personal and professional attitudes and values of medical stu-
dents, and proves to be a useful and enjoyable way of teaching.
Music has some practical advantages that make it an easy
tool for instructing students in humanism. It can be played in a
group setting, making it ideal for group participation. Music is
also portable and retains its effect, even in small settings. As
noted above, the emotional power of a piece of music is inde-
pendent of its length. Some of the most powerful recordings
ever made (for example Queen’s “We Will Rock You”) are
three minutes long. In addition, music is probably one of most
physical of arts, often provoking reactions such as toe-tapping
and dancing, making it easily and readily accepted by busy
residents and students (Blasco, 2005).
Music is a universal language that young students easily as-
similate. In addition, it can be a stimulus for personal and pro-
fessional development because it touches uniquely on emotions.
Emotions play a specific role in learning attitudes and behavior,
and educators cannot afford to ignore the affective domain. In
life, the most important attitudes, values, and actions are taught
through role modeling and example, a process that acts directly
on a learner’s emotions. Because feelings exist before concepts,
the affective path is a critical short-cut to the rational process of
learning. Although technical knowledge and skills can be ac-
quired through training with little in the way of a reflective
process, it is impossible to refine attitudes, acquire virtues, and
incorporate values without reflection.
The Bottom Line: Sing of Good Things Not Bad,
Sing for You and Me (The Carpenters, 1973)
Engaging learners emotionally and promoting reflection
about events they see and hear are essential elements for pro-
voking useful discussions about values and ethics. Teaching in
the affective domain (i.e., attitudes and beliefs) requires inno-
vative strategies that meet learners’ needs, and techniques that
are current and fit the students’ culture. It makes sense, there-
fore, to use music to teach emotionally-based subjects such as
the humanities and ethics (Blasco, 2005; Janaudis, 2011).
The results arise from the students’ own assessments of the
course. They have had room to reflect on their feelings, expec-
tations, and fears; even though those matters are usually in their
minds, they have never before found such a comfortable envi-
ronment for disclosing them. They share without constraint
their uncertainty, emotions, and doubts, and they picture their
future as doctors and as human beings. Ultimately, they enrich
themselves through self-knowledge.
The findings of the experience of the music spectrum come
in, offering numerous prospects for development in the context
of medical education, as noted in the themes that emerged. As
the basic experience we have of the world is emotional, the
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