Illuminating the Pediatric Clerkship: Visual Art Reflections from Medical Students

Abstract

Reflection exercises via group discussion or written essays are gaining in popularity in medical student education to facilitate development of professionalism, humanism, emotional intelligence, and empathy. However, implementation is limited by clerkship time constraints. Little is known about the impact of non-verbal reflections on trainee experiences. Identifying “bright spots”, or areas of success, is a solution-focused method of approaching challenges that is a useful strategy to address complex problems requiring behavioral, social and technical changes.

Objectives: Evaluate the impact of a visual art based reflection exercise and group sharing on third year medical students’ self reported feelings of: 1) Connection with their peers and patients; 2) Satisfaction with their overall third year clerkship experience.

Description of Innovation: 22 third year medical students participated in a 30 min reflection exercise in-person facilitated by faculty between August to October 2024. Midway through their 4-week long pediatric inpatient rotation, each group of 6 to 8 students were instructed to spend 10 minutes drawing a picture of a personally joyful memory from their pediatric clerkship. The students next took turns sharing their drawing with the group, explaining why this moment was joyful, and what actions they might undertake to experience similar feelings in the future. At the end of their 4-week rotation, students completed a survey rating their feelings of connection with their peers and patients as well as their change in overall perception of their third year experience before and after the exercise using a Likert scale 1->4 (1= very negatively, 4=very positively). Results analyzed with paired T-test.

Evaluation of Innovation: Students’ mean score of their overall perception of their third year medical student experience after the reflection activity increased (mean 3.22->3.39, p=0.04). The activity made students feel more engaged and connected with both their classmates and their patients (mean score 3.17 and 3.09 respectively). Students rated agreement with the statement “The activity enabled me to identify new specific behaviors, strategies, perspectives or attitudes that I will incorporate in the future as a medical student or future physician” with a mean score of 3.22. When comparing the practice of reflection through drawing versus written essays, 21 of 22 students stated a preference for drawing. Reasons cited included ease of expression, increased sense of engagement, and increased enjoyment.

Discussion/Key Message: A reflection activity using visual art as a medium of expression to identify bright spots was effective in improving the perception of the clerkship experience, increasing students’ feelings of engagement/connectedness with their peers and patients, and enabling students to identify professional behaviors that yield a sense of personal fulfillment in the clinical area. Thematic analysis of student drawings and bright spots identified is ongoing.