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The Role of Empathy and Wisdom in Medical Practice and Pedagogy: Confronting the Hidden Curriculum

DOI: 10.1155/2013/923810

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Abstract:

The role of the virtues of empathy and wisdom in clinical practice is used to address two crises facing modern medicine—quality of care and professionalism. To that end, these virtues are initially explored individually and then collectively in terms of a synergistic relationship between them. Next, how empathy and wisdom guide and empower clinical practice, especially in terms of their synergistic relationship, is discussed vis-à-vis the two crises. The “Grand Rounds” scene from “W;t”—Margaret Edson’s 1999 Pulitzer prize-winning play—is used to illustrate how these virtues function with respect to providing quality care in a professional manner. The paper concludes with a discussion of the challenges facing the pedagogy of equipping medical students, residents, and even practicing clinicians with virtues like empathy and wisdom. 1. Introduction In a study exploring the educational experiences of medical students, Coulehan and Williams from Stony Brook University Medical Center recount the story of a first-year student who arrives on campus with a heart full of empathy to meet patients’ needs. However, by the end of the student’s medical education she is no longer enthusiastic about medicine and serving patients but turns inward in order to survive the personal hardships, if not abuse, she faces daily as a medical student. In response to a questionnaire, she writes, “I’ve become numb. So much of what I do as a student is stuff that I do not fully believe it. And rather than try to change everything that I consider wrong in the hospital or the community at large.” She confesses, “I just try to get through school in the hope that I will move on to bigger and better things when I have more control over my circumstances” [1, page 599]. Unfortunately, her story is common for many medical students. In a recent study involving the educational experiences of medical students, Michalec reports that a knowledge gap exists between students and laypersons, with detrimental consequences for students’ ability to connect with others—especially with patients. “Preclinical students… spoke not merely of having trouble communicating with laypersons because of distinctiveness of what they were learning,” writes Michalec, “but that what they were learning was also powerful and was accompanied by a level of authority, according to their instructors” [2, page 274]. He goes on to note that the outcome of the knowledge gap between medical students and laypersons was a sense of superiority on the part of the students towards others, particularly patients, who lacked such

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