Amid the lightning-fast changes and challenges in today’s healthcare climate, high standards of professionalism and wise decision making are expected of medical practitioners.
While medical education traditionally focuses on gaining knowledge and building skills, the Geisel School of Medicine is also committed to developing a learning environment that furthers the holistic character development necessary for medical students to flourish in medical school, their professional careers, and life.
Roshini Pinto-Powell, MD, director of Geisel’s preclinical On Doctoring curriculum, has spent the past several years studying character education, and why it’s essential for medical students.
Collaborating with Geisel colleagues in foundational courses, and the Office of Student Life, she created and implemented a pilot curriculum focused on teaching character development—Building Wisdom and Flourishing—that began last fall in the first year On Doctoring course and will continue in a four-year arc across the medical school’s curriculum.
Defined as the sum of the moral and mental qualities which distinguish an individual, character is shaped in part by temperament, decisions, and habits that are formed over a lifetime and not easily altered. It is part of who we are, and it shapes our capacity to flourish.
Not typically discussed in medical school, character education differs from acquiring knowledge—it relies on self-reflection, discussion, and deep thinking.
Building Wisdom and Flourishing
At the start, Pinto-Powell shared with her students what she learned about the character-related intellectual virtues of critical thinking, lifelong learning, and moral virtues necessary to be a successful physician, such as compassion and kindness. She also uses poetry to discuss ethical issues and talked about the value of leaning into the arts and humanities as a basis for reflection. “T. S. Eliot said, ‘we have the experience, but we miss the meaning,’” she says. “Without reflection, we miss life’s meaning and the same is true for medical education.”
Character is not static, she explains. “This curriculum is about preparing our students to succeed in this work which needs ongoing attention, and by working on our character we are building the lifelong professional values that lead to flourishing.”
Phase one includes a mix of brief large group presentations and small group discussions and reflective writing focused on a variety of readings and complex discussion topics such as difficult conversations and wise negotiation, the wisdom of servant leadership, and whether the values of humanism and professionalism are in conflict.
Photos by Kurt Wehde
“I enjoy reflective writing. It’s nice to step away from the science and approach medicine through a different lens—one just as important as it fosters personal growth,” says Garrison Verner MED’28.
According to Pinto-Powell, we can endlessly talk about these topics, but reflective writing reveals the unseen which leads to character development and wise decision making. In one writing session, she asked students to think and write about the virtues a physician needs—the exercise not only revealed the necessary virtues but hopefully unveiled each student’s individual struggles of how to navigate these.
“Everyone wants to flourish no matter their path. We flourish when we make wise decisions in our daily life—for ourselves, for our patients, our learners, our colleagues, and our communities” she says.
Student Reflections
This curriculum also gives Geisel students a lifelong advantage by encouraging them to think about things that they may not otherwise think about rather than settling on one-fits-all solutions.
“For me, reflective writing gives you time to pause from the pace of medical school to try to figure out how everything is connected—from the patients you are seeing to your classes to all of the conversations you are having,” says first-year student Milan S. MED’28.
“In the professional development seminars, we are asked to consider different perspectives and moral principles while solving ethical questions. Solving complex problems always includes variables in human relationships, and this is a good way to think about those nuances,” he adds.
The seminars’ strength lies in scenarios depicting ethical conundrums that are robust and not contrived. “I am generally skeptical of ethical workshops and find people usually say what they think they should, rather than what they think—that isn’t the case here,” says Dara Cuffe MED’28.
"It's hard to come up with challenging situations that elicit bimodal responses and people with clinical experience are attuned to social norms,” she says. “To find scenarios where all of our experiences lead to different answers was helpful in growing my perspective."
The relevance of these scenarios may take many years of practice before encountered, but when they are, Geisel-trained physicians will draw on what they learned to look beyond the obvious.
