|
|
SHORT COMMUNICATION |
|
|
|
Year : 2016 | Volume
: 48
| Issue : 7 | Page : 61-64 |
|
Poetry in teaching pharmacology: Exploring the possibilities
Juhi Kalra1, Satendra Singh2, Dinesh Badyal3, Purnima Barua4, Taruna Sharma1, Dinesh Chandra Dhasmana1, Tejinder Singh5
1 Department of Pharmacology, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India 2 Department of Physiology, UCMS, New Delhi, India 3 Department of Pharmacology, Christian Medical College, Ludhiana, Punjab, India 4 Department of Microbiology, Jorhat Medical College and Hospital, Assam, India 5 Department of Paediatrics, Christian Medical College, Ludhiana, Punjab, India
Date of Submission | 22-Sep-2016 |
Date of Acceptance | 05-Oct-2016 |
Date of Web Publication | 2-Nov-2016 |
Correspondence Address: Juhi Kalra Department of Pharmacology, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0253-7613.193325
Objectives: To explore poetry as a tool for active learning in linking knowledge and affective domains and to find if correlating learning with imagination can be used in “assessment for learning.” Materials and Methods: After taking a conventional lecture on Asthma, a creative writing assignment in the form of poetry writing was given to the students. Different triggers were given to the students to channelize their thought pattern in a given direction that was linked to specific areas of academic relevance. Students were asked to reflect on this learning experience and the faculty was asked to evaluate the student assignment on a 5-point Likert scale. Results: Most student groups scored well in the “overall assessment” of creative assignments and were rated as good or fair by the faculty. Students reflections were very informative and revealed that more than 90% of the students liked the exercise and many were too exuberant and liberal with emotional reactions that breathed positive. Around 5% students found the exercise average and another 5% found it very childish. Conclusion: Poetry writing turned out to be like a simulation exercise that linked academic knowledge, creativity, and the affective domain in an assumed scenario, rehearsed in free locales of mind. The metaphorical transition embedded in its subtle creation helped assess deeper understanding of the subject and the logical sequence of thought pattern. Key message: Poetry writing is like a simulation exercise that links academic knowledge, creativity and the affective domain in an assumed scenario, rehearsed in free locales of mind in the teaching of pharmacology. The richness of these student-generated creative projects indicates a need for reflective learning activities to be combined with subjective experiences, early in training.
Keywords: Creativity, humanities, medical, poetry in education, undergraduate
How to cite this article: Kalra J, Singh S, Badyal D, Barua P, Sharma T, Dhasmana DC, Singh T. Poetry in teaching pharmacology: Exploring the possibilities. Indian J Pharmacol 2016;48, Suppl S1:61-4 |
How to cite this URL: Kalra J, Singh S, Badyal D, Barua P, Sharma T, Dhasmana DC, Singh T. Poetry in teaching pharmacology: Exploring the possibilities. Indian J Pharmacol [serial online] 2016 [cited 2023 Sep 22];48, Suppl S1:61-4. Available from: https://www.ijp-online.com/text.asp?2016/48/7/61/193325 |
Poetry writing can be a good exercise for the students. It is a reflection of their ability to correlate learning with real-life situations in a methodological sequence. Conventional methods sometimes may fail linking all in a single thread, but poetry complements as well as supplements the learning, making learning more holistic. Hence, it is a flexible tool in the hands of academicians and clinicians alike.[1],[2],[3]
Poetry gives more freedom of expression as it is free from norms, codes, and conventions that often govern the structured learning pattern. It is here that it gives a whiff of relief, a freedom for in-depth exploration to those who wish to use language and verses as a media for expressing.[4] These tasks not only enable students to understand some of the varied real life applications of classroom teaching but also act as a reinforcer to establish a new memory circuit.[5],[6],[7]
Students often find problems in memorizing pharmacology as they find that facts often evaporate with the wink of the eye. The hard facts that need to be memorized appear monotonous after a while and the attention span waivers. Engaging students in activities that involve students in group activities and inspire both creativity and recall, at the same time, as in poetry writing, can help generate more interest in the subject.[5],[6] If we give interesting cues and initiate active search soon after the lecture or teaching–learning activity, the context in the cues thus designed can shift focus from passive to active learning and lead to meaningful learning of relevant facts that may otherwise be soon forgotten. Hence, this study was done with the aim to encourage active learning among students through introduction of creative writing assignments during the formative assessment.
» Materials and Methods | |  |
The study was undertaken after taking due ethical clearance from the Institutional Ethical Committee. The teaching hours allotted to the Department of Pharmacology in the annual MBBS calendar of the institute were utilized for this purpose. Asthma was initially taught in two interactive lectures. Creative writing scenarios were then prepared, validated, and pilot-tested through E-mail group discussion. Necessary modifications were made after validation.
One-hundred and twenty students participated in the study. The students were divided into small groups of 10 each, and poetry writing assignments were given in the form of creative writing scenarios/triggers.[8] A total of six triggers were used as shown in [Table 1]. Each trigger was allotted to two groups of ten students each. The assignments were assessed on a 5-point Likert scale to derive an overall impression, based on three major criteria which were validated through E-mail discussions.
Students were informally sensitized toward reflection writing and asked to write reflections in a given printed format of “What Happened”, “So What,” and “What next”. Poetry writing was followed by sensitizing students on how to write reflections where students reflected on the entire learning experience.
» Results | |  |
Poetry writing added some color and fun to the exhaustive learning challenges and brought about a climate of change. Six different triggers were used to give direction to the student imagination [Table 1]. These triggers were aimed at focusing on different areas of concern not only in Pharmacology but also in linking it with etiopathogenesis as in trigger 1, therapeutics and special drug delivery systems as in trigger 2 and 3, adverse drug effects, drug toxicity, and drug–drug interactions as in trigger 4 and 5, and status asthmatics as in Trigger 6. The cue, “It was spring time, the flowers were blooming, Teddy bear, the rug, mite, Food” was used with an intent to see how students link allergic response with therapeutic options.
Faculty assessment and feedback revealed that ~70% faculty rated the poetry as good and ~30% as fair on a 5-point Likert scale (Excellent, Good, Can’t say, Fair, and Poor), based on three point criteria which were used for the overall assessment. This three-point criterion took into consideration the points as follows: (1) Clarity on the given topic and the written communication of the same, (2) extent of understanding of the topic by the student, (3) basic concept grabbed based on lecture objectives. Students’ emotional reactions were mostly positive as was evident in their reflections where they wrote “poetry was fun”, “I liked the creative way of teaching”, “helped me a lot to learn and recollect”. However, 5% of students reported the entire exercise as kiddish, another 5% found the exercise average, and two students found it exhaustive [Table 2] as evident in the statement “Helped memorize better, but exhaustive”. All data were qualitatively analyzed.
» Discussion | |  |
New perspectives originated when students were given freedom to express and explore.[1] After having undergone the routine core training, the students were divided into small groups of 10 students each. Triggers in the form of a thought that can lead them to a given direction were given.[8] These themes acquired new colors as students painted their thought and began converting academic foci in their memories into verses. Although the effort was premature and since the students had no earlier experience in poetry writing, yet the transformation of academic theme into a real life situation made theory more viable on paper and in their hearts.[4] It triggered a memory aspect that could not have been triggered by a teacher alone. Poetry writing and preparing verses are entirely different aspects. We listen, but may not have our heart into it. Then, we create and we pour in our souls. It is this deep sense of involvement that is the beginning of greater things and creating new memory links.[9],[10] Creative writing has been earlier reported to aid internalization of information and deep understanding of concepts in science.[11],[12] When combined with active imagination, this coherent understanding has led to meaningful learning as reported in numerous ‘haikus’ written for neurodegenerative disorders by a group of undergraduate students in Massachusetts, USA.[13]
Some students also reported poetry writing kiddish. However, the term kiddish brought a sigh of relief. All childlike things are synonymous with curiosity, and if we can strike curiosity, at least we have knocked at closed door in the fond hope that the door shall open. This variation can also be attributed to student personal preferences because learning styles differ as reported earlier by Mc Naughton.[12]
Unaccustomed to these exercises, they may not have taken an instant liking. The assignment was very new and came to them as a surprise. The reason can be that the students were more prepared for a serious multiple choice or problem-based routine test and hence found poetry writing kiddish. However, as we went through their assignments, we found that they were creative, expressive and could manage to fold relevant facts and wrap them up beautifully into poetry. Poetry is an expression of creativity and exposing students to humanities can hone the skills.[14] Poems lend themselves well to an ideal integrated platform that can be used to establish a connect between empathy, clinical, psychological, and factual aspects or to a focused discussion on a single aspect of a subject.[6],[13],[15]
Sharing a poem was based on trigger-1, [Table 1], and narrated in third person. The trigger here was “It was spring time, the flowers were blooming…. Teddy bear, the rug, mite, Food”.
He had a teddy bear:
He was asthmatic
Oh! He was asthmatic
When flowers bloomed
His days were in gloom
When pollen took a yellow hue,
Bronchodilators like beta-2 sympathomimetics,
Anticholinergics and Methylxanthines
Came to his rescue
Literally, his halaat were very kharaab
While sleeping on the rug
He sneezed and sneezed
His future was, though bright
Yet again, the mite gave him a bite
Everyone blamed the canteen peanuts
And his poor teddy
For all the plight
Dr. Krantikari said, his tracheobronchial tree was hypersensitive
It harbored monsters of cough with wheeze
And hence his troubles began to increase
Doctors gave him bronchodilators, corticosteroids
And mast cell stabilizers,
First two came together, through a nebulizer
Reserving Omalizumab, as its price got higher
He coughs less and now breathes better
But misses the teddy on the rug
The teddy could not be given salbutamol
Nor even a shot of cortisol
So leaving him, sadly, the teddy went away
Wish his teddy never had to leave that way.
Poetry helped us initiate focused thinking. The mention of Omalizumab after the steroid and the bronchodilator use, in “He had a teddy bear “reflects that order of preference of drug to be chosen was well understood, and was not misplaced during rhyming.[16] There was evidence of good sequencing of thoughts as we find that steroid, bronchodilator, and omalizumab follow the mention of “hypersensitivity” in the very same verse –”Dr. Krantikari said, his tracheobronchial tree was hypersensitive”. This points toward understanding of the concept in a logical sequence and correlation intact.[12] It has been reported earlier that poetry enhances critical thinking.[17]
The second poem “Who am I” written in the first person by the student group. It was based on another trigger [trigger-3, Table 1], namely, The difficult inhaler (types).
Who am I:
Who am I
Just a small inhaler
People use me
When they can’t breathe well
They carry me in purse and pouches and whenever they travel
And also when asthma turns Lungs so frail
I have a family out there
Rotahaler, my brother
A sister nebulizer and me
My brother-Rotahaler
Dry capsules he eats
And it’s the asthma attacks he beats
Nebulizer my sister is electric
Her Misty drug solution makes
Asthmatics feel fantastic
She says; use a spacer with me for better inhalation
Because children need a lot of education
We are a difficult bunch to use
My name is MDI
And Salbutamol, Ipratropium bromide I contain
Handle me carefully for God’s grace
Use me regularly or just for episodic attacks
Candidiasis shall appear if you don’t use me well
And surely it will remind you to your sins
Embrace me; hold me when you are prone
Oh! I will comfort your breath and soul.
The metaphorical element contained in these lines points toward an evolved thinking:[4]
“Candidiasis shall appear if you don’t use me well
And surely it will remind you of your sins.”
The precautions as well as the intensity of the opportunistic infection are well narrated through metaphorical diction in – ”will remind you of your sins”.
Quoting further:
“Use a spacer with me for better inhalation
Because children need a lot of education.”
Clearly mentions how spacers will need coordination and points toward difficulty in educating children regarding the correct use of inhalers. These translucent observations helped illustrate that connectivity was established between theory, its comprehension, and application.[13]
During this project, there were moments where we questioned the outcome and the utility of the entire exercise that seemed so abstract. As is true of most research, we needed to lend scores or grades to everything we did. There was a quotient of dilemma on how to assess if learning actually happened during poetry writing. Should we lend scores to poetry? And at one point of time, we did so. However, eventually, we concluded that in assessment for learning not all moments need to be treated as “decision moments”.
Another limitation of this study can arise during implementation, and hence it is imperative that the trigger must direct their creativity either toward strengthening theoretical base, or toward situations of future clinical applicability.[4]
Although the quality of writing was not rated either “excellent” or “very good” [Figure 1], yet on an average, the effort was remarkable, basic concept was grabbed and well as expressed. We found, as is true of open-ended questions, assignments such as these may pose a problem to those with a very scientific bend of mind and negligible inclination toward arts, those less accustomed to these experiments, and also who are not very expressive and lack a command over language. Besides, student preferences and learning styles differ.[13] However, objectively perceiving, we can say that considering that it was their first exposure to humanities in medical education, the effort was encouraging. The mention that “we realized learning can be fun”, “poem was awesome”, and “exhaustive” or “kiddish “for some shows a diversity in learning preferences.[4] Interestingly, positive remarks point toward the fact that attributes of affective domain were touched upon and expressed in words [Table 1] and may have acted as stress buster, as in reported earlier studies.[4] These strengths and limitations of poetry make it powerful tool, provided it is used skillfully because it is the mere skill that can help one convert disadvantages into advantages.[5] | Figure 1: Overall impression-creative writing, based on faculty feedback 71%
Click here to view |
» Conclusion | |  |
The richness of these student-generated creative projects indicates a need for reflective learning activities to be combined with subjective experiences, early in training. This shall open the window to clinical correlation. Although endeavors such as these need commitment, time, and self-motivation, once acknowledged for their potential benefits, they carry the promise to make students lifelong learners, confident, and self-reliant. However, the poetry must go on, even when rhymes are difficult for the sheer pleasure that it echoes harmony, resounds with knowledge, and changes perceptions.
Acknowledgment
I extend my sincere thanks to my faculty mentors at the Regional Centre for Foundation of Advancement of International Medical Education and Research (FAIMER), at Christian Medical College, Ludhiana, to my colleagues from CMCL-FAIMER, 2014 and 2015 batch students, and faculty from my department at Himalayan Institute of Medical Sciences (HIMS), Dehradun.
Financial Support and Sponsorship
Nil.
Conflicts of Interest
There are no conflicts of interest.
» References | |  |
1. | Brown SA. Creative expression of science through poetry and other media can enrich medical and science education. Front Neurol 2015;6:3.  [ PUBMED] |
2. | Downie G. Telling: Detail and diagnosis in medical poetry. Med Humanit Rev 2002;16:9-17.  [ PUBMED] |
3. | Shapiro J, Ortiz D, Ree YY, Sarwar M. Medical students’ creative projects on a third year pediatrics clerkship: A qualitative analysis of patient-centeredness and emotional connection. BMC Med Educ 2016;16:93.  [ PUBMED] |
4. | McBain L, Donnelly S, Hilder J, O’Leary C, McKinlay E. “I wanted to communicate my feelings freely”: A descriptive study of creative responses to enhance reflection in palliative medicine education. BMC Med Educ 2015;15:180. |
5. | Shapiro SL. Poetry, mindfulness, and medicine. Fam Med 2001;33:505-6.  [ PUBMED] |
6. | Muszkat M, Barak O, Lalazar G, Mazal B, Schneider R, Levi IM, et al. The effect of medical students’ gender, ethnicity and attitude towards poetry-reading on the evaluation of a required, clinically-integrated poetry-based educational intervention. BMC Med Educ 2014;14:188.  [ PUBMED] |
7. | Roediger HL 3 rd, Butler AC. The critical role of retrieval practice in long-term retention. Trends Cogn Sci 2011;15:20-7. |
8. | Rangachari PK. Of toxic tales and poisoned pens: Melding toxicology and creative writing in an undergraduate course. Mol Interv 2010;10:336-40.  [ PUBMED] |
9. | Kuhn D, Black J, Keselman A, Kaplan D. The development of cognitive skills to support inquiry learning. Cogn Instr 2000;18:495-523. |
10. | Kornell N, Metcalfe J. Study efficacy and the region of proximal learning framework. J Exp Psychol Learn Mem Cogn 2006;32:609-22.  [ PUBMED] |
11. | Stammers TG. Healing allusions? The use of poetry in teaching medicine. Contemp Med Educ 2015;3:127-33. |
12. | Macnaughton J. The humanities in medical education: Context, outcomes and structures. Med Humanit 2000;26:23-30.  [ PUBMED] |
13. | Pollack AE, Korol DL. The use of haiku to convey complex concepts in neuroscience. J Undergrad Neurosci Educ 2013;12:A42-8.  [ PUBMED] |
14. | Dhaliwal U, Singh S, Singh N. Promoting competence in undergraduate medical students through humanities: ABCDE paradigm. Res Humanit Med Educ 2015;2. Available from: http://www.rhime.in/?p=1089. [Last cited on 2015 Jun 17]. |
15. | Windish DM, Price EG, Clever SL, Magaziner JL, Thomas PA. Teaching medical students the important connection between communication and clinical reasoning. J Gen Intern Med 2005;20:1108-13.  [ PUBMED] |
16. | Kruschke JK. Bayesian approaches to associative learning: From passive to active learning. Learn Behav 2008;36:210-26.  [ PUBMED] |
17. | Skelton JR, Macleod JA, Thomas CP. Teaching literature and medicine to medical students. Part II: Why literature and medicine? Lancet 2000;356:2001-3.  [ PUBMED] |
[Figure 1]
[Table 1], [Table 2]
This article has been cited by | 1 |
Educational Interventions for Medical Students to Improve Pharmacological Knowledge and Prescribing Skills: A Scoping Review
|
|
| Weiwei Shi, Helen Qin, Brett Vaughan, Louisa Ng | | Perspectives on Medical Education. 2023; 12(1) | | [Pubmed] | [DOI] | | 2 |
Poetry in medicine: a pedagogical tool to foster empathy among medical students and health care professionals |
|
| Anuradha Joshi, Swapnil Paralikar, Shreya Kataria, Juhi Kalra, Sheetal Harkunni, Tejinder Singh | | Journal of Poetry Therapy. 2022; : 1 | | [Pubmed] | [DOI] | | 3 |
Experiences of nursing interns with the application of knowledge and skills in drug administration: A qualitative study |
|
| Nusrat Bano, Hend Al Najjar | | Saudi Journal for Health Sciences. 2020; 9(3): 227 | | [Pubmed] | [DOI] | | 4 |
Mini-Review - Teaching Writing in the Undergraduate Neuroscience Curriculum: Its Importance and Best Practices |
|
| Sarah C. Petersen, Jennifer M. McMahon, Hewlet G. McFarlane, Christopher M. Gillen, Haruhiko Itagaki | | Neuroscience Letters. 2020; 737: 135302 | | [Pubmed] | [DOI] | |
|
 |
|
|
|
|