Teaching Resilience and Whole Person Care to Future Doctors: An Interdisciplinary Approach
Zane Yi, PhD, Associate Dean & Associate Professor, School of Religion, Loma Linda University; Saul Barcelo, PhD, Assistant Professor & Director, Center for Whole Person Care, School of Religion, Loma Linda University; Jessica Chen, PhD, Fuller Seminary; and Amy Hayton, MD, Associate Dean, Physician Formation & Wholeness, Loma Linda University School of Medicine
Loma Linda University (LLU) is a Christian health sciences institution in the Inland Empire of Southern California. In the last few years, the medical school curriculum has gone through an exciting transformation to deepen students’ personal integration of LLU’s emphasis on and approach to “whole person care.”
Medical education is shifting and must continue to be responsive to the needs of each generation. Whole- person development of student physicians and supporting their resilience requires understanding and attending to who they are in their social, theological, and cultural contexts. The goal of medical curriculum has shifted from teaching comprehensive knowledge to the development of adaptive expertise, much of which relies on the healthy brain, body, and spirit of the practitioner. The recent curriculum revision at LLU School of Medicine included a greater focus on the formation of the resilient adaptive learner, a process that necessitated the development of a three-year longitudinal resilience and whole-person care curriculum. In order to do this, the School of Medicine has partnered with both religion and marriage and family therapy faculty to design and co-instruct curriculum that spans the four years of medical education.
Foundational to the new curriculum design is LIFE communities, groups of nine students paired with a physician faculty mentor that, for three years, engage in curricular discussion groups, labs, clinical skills, team-based learning and clinical rotations together. The mission of these groups is to facilitate the development of safe, significant relationships and foster a sense of community with faculty and peers while as students develop their unique professional identity, sense of purpose, and self-efficacy rooted in faith. In the first two years, physician mentors make clinical correlations related to various topics covered in a class called Christian Physician Formation, also leading their groups in deeper discussion. In the third-year, physician mentors lead a reflection session once every clerkship, allowing students to wrestle with and make meaning from their clinical experiences. Students in the first three years of their training are also required to meet individually with their community mentor twice per year for coaching. In sum, LIFE Communities allow space for students from differing backgrounds, beliefs and experiences to learn professional communication skills, teamwork and support each other on their own journeys to becoming whole-persons.
The second component of shaping the students’ resilience is deepening their self-awareness as it relates to mental and relationship health. Every fall, students get a chance to take a confidential mental health assessment so that they know if they might be at risk for depression, anxiety, or burnout and can reach out for support to a network of mental health providers that understand the medical student experience. They also learn about how to have difficult conversations, understand their own interpersonal triggers, explore the dynamics from their families-of-origin, recognize cognitive distortions, and reduce the impact of their own implicit biases. Through the open and public sharing that LIFE Community mentors offer on each of these topics, they reduce stigma around mental health issues and model courage, a growth mindset and resilience.
The third distinguishing feature of this curriculum is the integration of topics and issues that are covered with Christian Scripture, theology, and practice. Students read and discuss stories of Jesus’ teaching and healing ministry as recorded in the Gospels and his practice of various spiritual disciplines such as prayer, solitude, and rest. Students engage with pastors/chaplains and theologians from the School of Religion, along with their physician mentors, on topics such as vocation, humans being made in God’s image (and the implications of this for ethics), God’s presence in and response to suffering, the delivery of spiritual care, and the prophetic view of justice. Students are given a chance to respond and demonstrate their learning through discussion boards, reflective writing, and regular small group discussions. The third year of medical school allows for integration of these topics into the student’s clinical experiences.
This integration of community life, mental health, self and relational awareness, and Christian faith has led to some initial positive outcomes. In surveys, compared to previous years, students have indicated that they feel less alone as students, have someone they can reach out to in case of crisis, have accessed mental health resources more frequently and consistently, and rate their resilience skills as improving from year to year. In addition, the physician mentors report this aspect of their job the most fulfilling, appreciating the comradery of other like-minded physicians from different specialties, as well as gaining new skills and knowledge about topics that have been presented. Many have said that their own levels of personal burnout have been greatly improved from being involved with LIFE communities.
In this panel, the faculty who have supported the development of this integrative curriculum—a physician, a therapist, a chaplain, and a philosopher--will reflect on their experiences, highlighting interdisciplinary pedagogical dynamics, strengths, and areas for growth and future development.
Medical education is shifting and must continue to be responsive to the needs of each generation. Whole- person development of student physicians and supporting their resilience requires understanding and attending to who they are in their social, theological, and cultural contexts. The goal of medical curriculum has shifted from teaching comprehensive knowledge to the development of adaptive expertise, much of which relies on the healthy brain, body, and spirit of the practitioner. The recent curriculum revision at LLU School of Medicine included a greater focus on the formation of the resilient adaptive learner, a process that necessitated the development of a three-year longitudinal resilience and whole-person care curriculum. In order to do this, the School of Medicine has partnered with both religion and marriage and family therapy faculty to design and co-instruct curriculum that spans the four years of medical education.
Foundational to the new curriculum design is LIFE communities, groups of nine students paired with a physician faculty mentor that, for three years, engage in curricular discussion groups, labs, clinical skills, team-based learning and clinical rotations together. The mission of these groups is to facilitate the development of safe, significant relationships and foster a sense of community with faculty and peers while as students develop their unique professional identity, sense of purpose, and self-efficacy rooted in faith. In the first two years, physician mentors make clinical correlations related to various topics covered in a class called Christian Physician Formation, also leading their groups in deeper discussion. In the third-year, physician mentors lead a reflection session once every clerkship, allowing students to wrestle with and make meaning from their clinical experiences. Students in the first three years of their training are also required to meet individually with their community mentor twice per year for coaching. In sum, LIFE Communities allow space for students from differing backgrounds, beliefs and experiences to learn professional communication skills, teamwork and support each other on their own journeys to becoming whole-persons.
The second component of shaping the students’ resilience is deepening their self-awareness as it relates to mental and relationship health. Every fall, students get a chance to take a confidential mental health assessment so that they know if they might be at risk for depression, anxiety, or burnout and can reach out for support to a network of mental health providers that understand the medical student experience. They also learn about how to have difficult conversations, understand their own interpersonal triggers, explore the dynamics from their families-of-origin, recognize cognitive distortions, and reduce the impact of their own implicit biases. Through the open and public sharing that LIFE Community mentors offer on each of these topics, they reduce stigma around mental health issues and model courage, a growth mindset and resilience.
The third distinguishing feature of this curriculum is the integration of topics and issues that are covered with Christian Scripture, theology, and practice. Students read and discuss stories of Jesus’ teaching and healing ministry as recorded in the Gospels and his practice of various spiritual disciplines such as prayer, solitude, and rest. Students engage with pastors/chaplains and theologians from the School of Religion, along with their physician mentors, on topics such as vocation, humans being made in God’s image (and the implications of this for ethics), God’s presence in and response to suffering, the delivery of spiritual care, and the prophetic view of justice. Students are given a chance to respond and demonstrate their learning through discussion boards, reflective writing, and regular small group discussions. The third year of medical school allows for integration of these topics into the student’s clinical experiences.
This integration of community life, mental health, self and relational awareness, and Christian faith has led to some initial positive outcomes. In surveys, compared to previous years, students have indicated that they feel less alone as students, have someone they can reach out to in case of crisis, have accessed mental health resources more frequently and consistently, and rate their resilience skills as improving from year to year. In addition, the physician mentors report this aspect of their job the most fulfilling, appreciating the comradery of other like-minded physicians from different specialties, as well as gaining new skills and knowledge about topics that have been presented. Many have said that their own levels of personal burnout have been greatly improved from being involved with LIFE communities.
In this panel, the faculty who have supported the development of this integrative curriculum—a physician, a therapist, a chaplain, and a philosopher--will reflect on their experiences, highlighting interdisciplinary pedagogical dynamics, strengths, and areas for growth and future development.