2013. Vol.4, No.6A, 49-52
Published Online June 2013 in SciRes (http://www.scirp.org/journal/ce) http://dx.doi.org/10.4236/ce.2013.46A009
Copyright © 2013 SciRes. 49
The Sound of Music: Transforming Medical Students into
Marco Aurelio Janaudis1, Michelle Fleming2, Pablo González Blasco1
1SOBRAMFA Medical Education and Humanism, Sao Paulo, B razil
2Stellenbosch University, Stellenbosch, South Africa
Received April 26th, 2013; revise d M a y 28th, 2013; accepted June 4th, 2013
Copyright © 2013 Marco Aurelio Janaudis et al. This is an open access article distributed under the Creative
Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium,
provided the original work is properly cited.
There is a growing focus on the introduction of courses in humanities in medical education. Music is not a
widely-used tool in medical education. It has unique features that make it an excellent educational re-
source for the possibility to express emotions. Within minutes, topics of interest in learning medicine,
such as loss, compassion, sorrow, and solidarity can be identified and used in pedagogical processes. Mu-
sic—like other art forms—can deal with the emotional universe of the student. Promoting a reflective at-
titude within an academic discipline requires the creation of space to make it formal. The Public Health
Department of Jundiai Medical School (Sao Paulo, Brazil) offers a special course on family medicine core
values, led by a SOBRAMFA Medical Education & Humanism faculty member. The process of under-
standing a student’s experience has allowed for the unveiling of a phenomenon that encompasses the stu-
dent’s inner world as he/she attends to his/her medical training. The music is played on the outside reso-
nates with the story and emotions of the student. Students realize that the pace imposed by the medical
school does not allow them to reflect on either their own lives or their formation. The musical 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 could not remember. These feelings are
presented in themes that organize the affective experience of students, mobilized by the music. Several
themes have emerged, such as the search for the self; family; vocational doubts; relationships with peers,
professors, and patients. The findings of the experience of the music spectrum come in, offering numer-
ous 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 music—this form of human knowledge of
affective tone—also becomes educational force, because the teaching process is not limited to transmis-
sion of content. Instead, more importantly, it implies that the teacher in development processes of mean-
ing and significance enable the learner to reflect and transform the everyday practice, especially in medi-
cine, where the interpersonal relationship is the basis for the full realization of future professional action.
Keywords: Medical Student; Music; Humanism; Qualitative Research
The Strength of the Songs
Current medical practice is challenged by a highly technical
and rapidly-changing environment that requires the professional
to be adaptive and proficient while maintaining a caring, hu-
manistic approach with patients. Such a balance, however, can
be challenging for students to maintain and for educators to
promote. Emerging technology tends to monopolize student
attention and learning efforts, often at the expense of other
important aspects of medicine (Calman, 1988; Schellenberg,
Humanism is a critical trait for developing future physicians
who are committed to understanding and caring for their pa-
tients. Educators must provide ways for their students to reflect
on the human dimension of doctoring and to foster develop-
ment of critical-thinking skills (Blasco, 2001).
There is a growing focus on the introduction of courses in the
humanities in medical education. The humanities are educa-
tional resources for developing future physicians’ humanism.
Although literature, films, and poetry are often used to teach
humanism, the educational possibilities of music have been less
explored and rarely incorporated into a medical curriculum
Music, like other art forms, can deal with the emotional uni-
verse of the student. Promoting a reflective attitude within an
academic discipline requires the creation of space to make it
formal (Janaudis, 2011). Out of all the arts, music probably has
the strongest connection to human emotions. It has unique fea-
tures which, while present singly in other artistic media, are
combined in music. Unlike literature, music’s emotive power is
not necessarily dependent on language. Themes such as com-
passion and human dignity, as well as sadness and loss, are
commonly explored in music, and weighty topics are often
distilled into a few minutes in songs (Newell, 2003).
Finally, in contrast to the other arts, music teaches us how to
listen. It is the perfect medium to learn how to listen not only to
M. A. JANAUDIS ET AL.
a patient’s words but also to what lies behind those words by
noticing cadence, volume, inflection, and tone (Newell, 2003).
Describing the Scenario and the Musical
The Public Health Department of Jundiai Medical School
(Sao Paulo, Brazil) offers a special course on family medicine
core values led by a SOBRAMFA Medical Education &
Humanism faculty member. It is a required clerkship for final
year medical students, divided into small groups (15 students in
each group), taking up a total of one day a week and lasting for
nine weeks. This special course started four years ago, and 300
students have been involved so far.
The teaching format consists of two half day sessions each
week. In one session, students see patients, and in the other,
they have discussions regarding those values required for ex-
cellence in docto r i ng .
Incorporation of music arose organically when, one day dur-
ing the first session of the course, a faculty member played a
song that he realized could clarify some perspectives about the
doctor-patient relationship. Students were surprised, and the
ensuing discussion was particularly insightful. From that day on,
music was often incorporated by the teacher and by the students
themselves to enlighten their own reflections. They decided to
integrate “the sound of music” into the teaching scenarios.
The musical learning experience has been running for the
past four years. Some songs have been identified as useful re-
sources for evoking attitudes about daily be havior, feelings and
values (love, compassion, jealousy, empathy, forgiveness and
revenge, understanding, communication), and they stimulate
self-examination and disclosure of emotional responses. The
songs act as triggers to foster discussion among learners be-
cause they identify with characters in the songs and use them to
represent their own reality. Through the discussion, the partici-
pants give feedback on the songs and generate new themes for
discussion, as well as suggesting other songs to use. Some of
the songs are listed in Table 1.
In the past, some student groups have been asked to write
about their experiences at the end of the special course. Some
students who attended the course agreed to participate in out-
lining a brief research project designed in a qualitative manner,
through a group discussion and interviews. The interviews were
taped, transcribed and then interpreted according to the herme-
neutic perspective (Janaudis, 2011).
“I See the Light!”, “I Gotta Feeling.”
Students talked about many facets of the experience, includ-
ing how it affected their perspectives on culture, fear, expecta-
tions about the future, and balancing work with family. There
was much more than medicine, there was “life”. Songs led stu-
dents to be emotionally open and disclose their feelings. Some
feedback about the unique opportunity for emotional openness
was as follows:
“In this experience, we were able to discuss issues we can’t
talk about during medical instruction, since there is no time, no
room for that.”
“The experience was very positive but at the same time
leaves me quite sad: I realize how much I was able to think,
reflect on these things, and now it sounds like I lost all that
since I began medical school.”
“The experience was a great surprise. We learned more than
just the subject, we learned life manners. We started to look at
each other like f riends, not competitors.”
The music-related teaching experience also fostered students’
reflections about themselves, and their future professional roles:
“There is nothing more natural than music; art imitates life,
correct? What happens today is that we don’t have time in our
lives, and our eyes remain too tired to see. So we forget a sense
for details. Reflection with music helped us to understand:
there were the lyrics, its poetry, music. All related to our own
life; music gives us the opportunity to reflect a bit on who we
“Before entering the medical school, I used to reflect a lot.
With this experience, I got back that wonderful feeling. I real-
ized that ‘medicine’ was taking the main part of my life, and I
had no time to reflect. That’s a contradiction: good doctors
need to be reflective.”
An interesting situation arose with one group. Although the
students build their small groups based on their preferences for
Some songs used in our e d ucational experience with medical st udents.
SONG SINGER PLAY THE SONG
Suspicious Minds Elvis Presley http://www.youtube.com/watch?v=hohl44WZUWg&feature=related
One Metallica http://www.youtube.com/watch?v=JDbQ53Q0tyM&feature=related
The News ack Jonhson http://www.youtube.com/watch?v=0HhrjJxnLyo&feature=related
Nos Bailes da V id a Milton Nascimento http://letras.terra.com.br/milton-nascimento/47438/
Bola de Meia, Bola de Gude Milton Nascimento http://letras.terra.com.br/milton-nascimento/102443/
Alma Zélia Duncan http://letras.terra.com.br/zelia-duncan/43887/
Estrada Nova Oswaldo Monte negro http://letras.terra.com.br/oswaldo-montenegro/189353/
Ciranda da B ailarina Adriana Calcanhoto http://letras.terra.com.br/adriana-calcanhotto/ 102206/
La Bilirrubina Juan Luiz Guerra http://letras.terra.com.br /j u an-luis-guerra/163411/
Copyright © 2013 SciRes.
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,
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
Copyright © 2013 SciRes. 51
M. A. JANAUDIS ET AL.
music—this form of human knowledge of affective tone—also
becomes an educational force, because the process of teaching
is not limited to transmission of content. More importantly, it
implies that the teacher in development processes of meaning
and significance enable the learner to reflect and transform the
everyday practice, especially in medicine, where the interper-
sonal relationship is the basis for the full realization of future
Blasco, P. G. (2001). Literature and movies for medical students. Fam-
ily Medicine, 33, 426-428.
Blasco, P. G., Moreto, G., & Levites, M. R. (2005). Teaching humani-
ties through opera: Leading medical students to reflective attitudes.
Family Medicine, 37, 18-20.
Calman, K. C., Downey, R. S., Duthie, M., et al. (1988). Literature and
medicine: A short course for medical students. Medical Education,
22, 265-269. doi:10.1111/j.1365-2923.1988.tb00752.x
James, M. (1969). Suspicious Mi nds, song by Elvis Presley.
Janaudis, M. A. (2011) A música como instrumento de reflexão para o
estudante de Medicina [tese]. São Paulo: Faculdade de Medicina.
URL (last checked 14 April 2013).
Newell, G. C., & Hanes, D. J. (2003). Listening to music: The case for
its use in teaching medical humanism. Academic Medicine, 78, 714-
Schellenberg, E. G. (2001) Music and nonmusical abilities. Annals of
the New York Academy of Sciences , 930, 355-371.
The Carpenters (1973) Sing, song by Carpenters.
Copyright © 2013 SciRes.