Planting Sequoias: Developing Identities of Membership and Love of Neighbor through Moral Communities in PA Education
Ethan Stonerook, MS, MMS, PA-C, Lauren Eyadiel, MS, MMS, PA-C, CCC-SLP, FHFSA, and Brian Peacock, MMS, PA-C, Wake Forest University School of Medicine, Department of PA Studies, Winston-Salem, NC
The Wake Forest PA Program aims to form clinicians equipped as lifelong learners guided by intrinsic commitments to excellent clinical reasoning and practically wise engagement at the bedside and in their particular community. Given the pluralistic nature of our student body, we are challenged to develop language, structures, curricula, and local cultures which form strong moral frameworks in our students. The warp and woof of our effort centers on two core courses during students’ preclinical education and one course in the clinical year.
In the first of these, Clinical Reasoning and Inquiry Based Learning, students meet thrice weekly with seven peers and a faculty facilitator to work through multidimensional domains of learning and decision making to address clinical, sociopolitical, economic, cultural, and religious aspects of a patient’s illness experience. The second of these core courses, Being a PA, aims to develop empathic clinicians with deep capacities for listening, tolerating ambiguity, and wise engagement across cultural differences. Sessions consists of narrative medicine practices, interviews with patients and clinicians, communication workshops, community engagement, and didactic lectures. Finally, in Preparing Future Professionals, clinical year students meet together quarterly in small groups with a faculty facilitator. Here, students share “parallel charts”; visual or performance art, or creative writing centered on a single patient by whom they were affected in particularly emotional or challenging ways.
Until now, these three courses have formed small groups through random or ad hoc selection. Cohesion among students and between students and faculty is “hit or miss”. Increasingly, we see lacking coherence or longevity of community in our students; perhaps a deterioration in flourishing overall. In response, we propose a pilot for developing students’ sense of community identity, habits of close attention, love of neighbor, and practices of reflection on and refinement of moral habits of knowing and being.
Our paper has three primary goals; 1) to describe the curricular content and structure of these three core courses, 2) describe a pilot model of moral community formation, aimed toward fostering small moral communities among students and faculty with goals of developing habits of close attention, love of and for neighbor, and reflection/refinement on moral development within longitudinal small groups, and 3) describe the mixed methods assessment we plan to perform with our incoming class (matriculating June, 2024).
While this paper will describe the structures and content already built into our curriculum, the primary focus of the paper will be describing the underlying theory informing small group formation and practice, schedules and objectives for navigating the pre-existing curriculum within these communities, and challenges and approaches to explicitly naming and engaging religious and non-religious sources of moral identity as students grow into professional clinicians. Primary sources of content will be drawn from the philosophies of St. Augustine’s Ordered Loves, Dr. Martin Luther King’s reflections on agape love, Iris Murdoch’s discussions of a just and loving gaze, Simone Weil’s reflections on bearing witness to suffering, and Wendell Berry’s literary commitments to the particularities of place and community, among others.
Our primary measurements of this pilot will include qualitative assessments directed at assessing overall satisfaction with the pilot program as well as the PA Program as a whole, student sense of belonging, love of learning, contributory and unitive love of neighbor, and personal identification with explicit religious or other moral frameworks. Quantitative measures will include student flourishing, tolerance of ambiguity, love of neighbor, social support and isolation, and empathy.
As our three core courses described herein are unique in PA education, this pilot program and our assessment thereof will serve as a model for moral and community identity formation in physician assistant education, will set the stage for longitudinal measurement and program improvement, and will challenge common contemporary efforts toward individuated personal and professional development or wellness.
In the first of these, Clinical Reasoning and Inquiry Based Learning, students meet thrice weekly with seven peers and a faculty facilitator to work through multidimensional domains of learning and decision making to address clinical, sociopolitical, economic, cultural, and religious aspects of a patient’s illness experience. The second of these core courses, Being a PA, aims to develop empathic clinicians with deep capacities for listening, tolerating ambiguity, and wise engagement across cultural differences. Sessions consists of narrative medicine practices, interviews with patients and clinicians, communication workshops, community engagement, and didactic lectures. Finally, in Preparing Future Professionals, clinical year students meet together quarterly in small groups with a faculty facilitator. Here, students share “parallel charts”; visual or performance art, or creative writing centered on a single patient by whom they were affected in particularly emotional or challenging ways.
Until now, these three courses have formed small groups through random or ad hoc selection. Cohesion among students and between students and faculty is “hit or miss”. Increasingly, we see lacking coherence or longevity of community in our students; perhaps a deterioration in flourishing overall. In response, we propose a pilot for developing students’ sense of community identity, habits of close attention, love of neighbor, and practices of reflection on and refinement of moral habits of knowing and being.
Our paper has three primary goals; 1) to describe the curricular content and structure of these three core courses, 2) describe a pilot model of moral community formation, aimed toward fostering small moral communities among students and faculty with goals of developing habits of close attention, love of and for neighbor, and reflection/refinement on moral development within longitudinal small groups, and 3) describe the mixed methods assessment we plan to perform with our incoming class (matriculating June, 2024).
While this paper will describe the structures and content already built into our curriculum, the primary focus of the paper will be describing the underlying theory informing small group formation and practice, schedules and objectives for navigating the pre-existing curriculum within these communities, and challenges and approaches to explicitly naming and engaging religious and non-religious sources of moral identity as students grow into professional clinicians. Primary sources of content will be drawn from the philosophies of St. Augustine’s Ordered Loves, Dr. Martin Luther King’s reflections on agape love, Iris Murdoch’s discussions of a just and loving gaze, Simone Weil’s reflections on bearing witness to suffering, and Wendell Berry’s literary commitments to the particularities of place and community, among others.
Our primary measurements of this pilot will include qualitative assessments directed at assessing overall satisfaction with the pilot program as well as the PA Program as a whole, student sense of belonging, love of learning, contributory and unitive love of neighbor, and personal identification with explicit religious or other moral frameworks. Quantitative measures will include student flourishing, tolerance of ambiguity, love of neighbor, social support and isolation, and empathy.
As our three core courses described herein are unique in PA education, this pilot program and our assessment thereof will serve as a model for moral and community identity formation in physician assistant education, will set the stage for longitudinal measurement and program improvement, and will challenge common contemporary efforts toward individuated personal and professional development or wellness.