Music in medical education: A critical interpretive synthesis.

INTRODUCTION: While many have championed the value of music in medical education, research specific to how and why music has been offered in medical education is sparse and there have been few attempts to synthesise the literature. METHODS: A Critical Interpretive Synthesis (CIS) of 56 texts including published articles, correspondence, abstracts and one thesis published between 1977 and 2022 was undertaken to explore the evidence basis for offering music in medical education. RESULTS: A total of 52 music-focused programmes/activities were described, encompassing both curricular and extra-curricular, receptive and participatory music activities and a wide range of musical genres. Inductive analysis of data extracted from texts revealed a variety of rationales for the use of music in medical education, which could be grouped within seven interrelated themes: well-being; supportive learning environment; affective engagement; teaching and learning; developing skills for clinical practice; humanism in medicine; and creative expression (identity). DISCUSSION: The results of this synthesis demonstrate that there remains a gap between what is claimed about the affordances of music and what has been explicitly addressed in medical education research. Despite a paucity of research in this area, the available data support that the affordances of music are 'multiple' and may not be well represented by linear models. Evidence that engagement with music is beneficial for medical students is strongest in relation to the affordances of music for well-being, facilitating a supportive learning environment, affective engagement, memorisation and creative expression (identity). That engagement with music might enhance humanism, including developing skills for clinical practice, requires further investigation. Accounting for student agency and the 'multiple' affordances of music will ensure that future teaching and research are best positioned to benefit medical students' well-being and personal and professional development.

A narrative orientation for the longitudinal integrated clerkship.

BACKGROUND: This paper follows through with findings from a longitudinal integrated curriculum (LIC) programme evaluation, which revealed that (1) experiential perspectives and (2) the integration of learning featured weakly in the programme's structure. On examination, these two areas were seen to be linked because, by granting authority to experience, we are called to follow its lead wherever it may take us. METHODS: Data was collected from students, clinicians and programme administrators using participatory mapping and discussions and analysed through four lenses, one of which was to identify what seemed to be missing or quiet. FINDINGS: Two features of the LIC model were not explicitly structurally supported in the programme: integration of learning and experiential perspectives. DISCUSSION: The authors draw on narrative medicine and visual thinking to propose a novel response to the problem, which locates the clinical educator as embodying a narrative orientation to teaching. A narrative orientation affirms the power of human experience, told through stories, to enable integrative, whole-person, big picture thinking in the medical education curriculum. Teaching ideas are scaffolded through metaphors of form, space and integration. CONCLUSION: In pursuit of an authentic integrator of learning in the LIC, we already have within our reach the power to grant human experience the authority to teach us wherever we find it and follow wherever it leads. However, its potential is yet to be realised, and this discussion throws up new questions for practical enquiry: how best to support educators to adopt a narrative orientation.