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Published online by Cambridge University Press: 02 June 2020
Viewing difficulty as an opportunity for learning runs counter to the common view of difficulty as a source of frustration and confusion. The aim of this article is to focus on the idea of difficulty as a stepping-off point for learning. The literature on difficulty in reading texts, and its impact on thinking and the interpretive process, serve as a foundation for the use of poetry in healthcare ethics education. Because of its complexity and strangeness compared to the usual scientific and clinical texts health science students encounter, poetry is an excellent means to achieve the aim of thinking through difficulties in ethics. Specific examples of teaching and learning strategies for turning difficulty into opportunities for learning are presented, including the difficulty paper and the triple mark-up method. Both methods require students to examine their process of working through difficulties, reflect on how they make sense of difficult texts and then share their process and interpretations in a collaborative manner with peers. The importance of framing difficulties as a public, visible, collaborative process rather than a personal process is emphasized. Working together to hypothesize reasons for difficulty and map out plans to come to terms with difficulty are equally relevant for reading text as they are for reading complex ethical situations. Finally, I argue that transference of this kind of personal and collaborative learning about difficulties benefits interprofessional clinical practice, particularly when dealing with ethical issues.
The aim of this section is to expand and accelerate advances in methods of teaching bioethics.
1. Salvatori, MR, Donahue, P. The Elements (and Pleasures) of Difficulty. New York, NY: Pearson Longman; 2005:7.Google Scholar
2. Newkirk, T, Heaney, S. Looking for trouble: A way to unmask our readings. College English 1984;46(8):756–66.CrossRefGoogle Scholar
3. Salvatori, MR. Difficulty: The great educational divide. In: Hutchings, P, ed. Opening Lines: Approaches to the Scholarship of Teaching and Learning, Menlo Park, CA: The Carnegie Foundation for the Advancement of Teaching; 2000:81–93.Google Scholar
4. Rosenblatt, LM. The Reader, the Text, the Poem: The Transactional Theory of the Literary Work. Carbondale and Edwardsville, IL: Southern Illinois University Press; 1978.Google Scholar
5. Adams, H. The difficulty of difficulty. In: Purves, AC, ed. The Idea of Difficulty in Literature, Albany, NY: State University of New York Press; 1991:23–50.Google Scholar
6. Elam, HR. The difficulty of reading. In: Purves, AC, ed. The Idea of Difficulty in Literature, Albany, NY: State University of New York Press; 1991:73–89.Google Scholar
7. Hynds, S. Questions of difficulties in literary readings. In: Purves, AC, ed. The Idea of Difficulty in Literature, Albany, NY: State University of New York Press; 1991:117–39.Google Scholar
8. Nystrand, M. Marking it hard: Curriculum and instruction as factors in the difficulty of literature. In: Purves, AC, ed. The Idea of Difficulty in Literature, Albany, NY: State University of New York Press; 1991:141–56.Google Scholar
9. Purves, AC. Indeterminate texts, responsive readers, and the idea of difficulty in literature. In: Purves, AC, ed. The Idea of Difficulty in Literature, Albany, NY: State University of New York Press; 1991:157–70.Google Scholar
10. Monte, S. Difficulty and modern poetry. Literature Compass 2007;4(4):1133–57. doi: 10.1111/j.1741-4113.2007.00466.x.CrossRefGoogle Scholar
11. See note 8, Nystrand 1991, at 142.
12. See note 9, Purves 1991, at 2.
13. See note 4, Rosenblatt 1978, at 14.
14. See note 4, Rosenblatt 1978, at 81.
15. See note 1, Salvatori, Donahue 2005, at xvii.
16. Montgomery, K. How to be a doctor: The place of poetry in medical education. Second Opinion, 1991;16(March):64–78.Google Scholar
17. See note 3, Salvatori 2000, at 84.
18. See note 1, Salvatori, Donahue 2005, at xi.
19. See note 1, Salvatori, Donahue 2005, at 2.
20. Halpern, DF, Hakel, MD. Applying the science of teaching and learning to the university and beyond: Teaching for long-term retention and transfer. Change 2003;35(4):36–41.CrossRefGoogle Scholar
21. Locklin, BS. Learning from our mistakes: Difficulty and insight in the literature classroom. The Journal of the Midwest Modern Language Association, 2018;46(1):57.Google Scholar
22. See note 7, Hynds 1991, at 117.
23. Kumagai, AK, Wear, D. “Making strange”: A role for the humanities in medical education. Academic Medicine, 2014;89(7):973–7.CrossRefGoogle Scholar
24. Darbyshire, P.Understanding caring through arts and humanities: A medical/nursing humanities approach to promoting alternative experiences of thinking and learning. Journal of Advanced Nursing 1994;19:856–63.CrossRefGoogle Scholar
25. Holmes, V, Gregory, D. Writing poetry: A way of knowing nursing. Journal of Advanced Nursing 1998;28(6):1191–4.CrossRefGoogle ScholarPubMed
26. Hatem, D, Ferrara, E. Becoming a doctor: Fostering humane caregivers through creative writing. Patient Education and Counseling 2001;45:13–22.CrossRefGoogle ScholarPubMed
27. Grant, VJ. Making room for medical humanities. Journal of Medical Humanities 2002;28:45–8.CrossRefGoogle ScholarPubMed
28. Shapiro, J, Rucker, L. Can poetry make better doctors? Teaching the humanities and arts to medical students and residents at the University of California, Irvine, College of Medicine. Academic Medicine 2003;78(10):953–7.CrossRefGoogle Scholar
29. Shapiro, J, Rucker, L, Beck, J. Training the clinical eye and mind: Using the arts to develop medical students’ observational skills. Medical Education 2006;40:263–8.CrossRefGoogle Scholar
30. Delaney, C, Gaunt, H. “I left the museum somewhat changed”: Visual arts and health ethics education. Cambridge Quarterly of Healthcare Ethics 2018;27(3):511–24. doi:10.1017/S0963180117000913.CrossRefGoogle Scholar
31. Hunter, KM, Charon, R, Coulehan, JL. The study of literature in medical education. Academic Medicine 1995;70(3):787–94.Google Scholar
32. Charon, R. Narrative medicine: Attention, representation, affiliation. Narrative 2005;13(3):261–70.CrossRefGoogle Scholar
33. Raingruber, B. Assigning poetry reading as a way of introducing students to qualitative analysis. Journal of Advanced Nursing 2009;1753–61.CrossRefGoogle Scholar
34. Foster, W, Freeman, F. Poetry in general medical practice education: Perceptions of learners. Family Medicine 2008;25(4):294–303.Google ScholarPubMed
35. See note 4, Rosenblatt 1978, at 23.
36. See note 6, Elam 1991, at 83.
37. See note 10, Monte 2007, at 1145.
38. See note 4, Rosenblatt 1978, at 25.
39. Carper, B. Fundamental patterns of knowing in nursing. Advances in Nursing Science 1978;1(1):13–23.CrossRefGoogle Scholar
40. See note 16, Montgomery 1991, at 66.
41. Bao, L, Redish, EF. Educational assessment and underlying models of cognition. In: Becker, WE, Andrews, ML, eds. The Scholarship of Teaching and Learning in Higher Education: Contributions of Research Universities, Bloomington, IN: Indiana University Press; 2004:221–64.Google Scholar
42. See note 20, Halpern, Hakel 2003, at 40.
43. See note 20, Halpern, Hakel 2003, at 41.
44. See note 2, Newkirk, Heaney 1984, at 756–66.
45. See note 3, Salvatori 2000.
46. See note 1, Salvatori, Donahue 2005.
47. See note 2, Newkirk, Heaney 1984, at 756.
48. See note 1, Salvatori, Donahue 2005, at xviii.
49. Dewey, J. How We Think, Boston, MA: D.C. Heath; 1933:108–9.Google Scholar
50. See note 21, Locklin 2018, at 57.
51. See note 1, Salvatori, Donahue 2005, at 10.
52. Creighton University, Master of Science in Health Care Ethics Program, Creighton University 2018; available at https://gradschool.creighton.edu/program/health-care-ethics-ms (last accessed 13 Sept 2018).Google Scholar
53. LeVasseur, J. boy, Danny. In Davis, C, Schaefer, J, eds. Between the Heartbeats. Iowa City, IA: University of Iowa Press; 1995:106.Google Scholar
54. Caston, A. The good we do. Prairie Schooner 2002;76(2):27–8.Google Scholar
55. Schmitt, P. Thanksgiving: Visiting my brother on the ward. Bellevue Literary Review 2006;6:90–1.Google Scholar
56. Hazen-Hammond, S. Let me breathe. The Healing Muse: A Journal of Literary & Visual Arts 2008;8(1):14.Google Scholar
57. Mitchell, P. Redesigning the practice of medicine. Pulse: Voices from the Heart of Medicine – The First Year. New York, NY: Change in Healthcare Publishing; 2008:9.Google Scholar
58. Haddad, A. Shine a light here, dig deeper over there: Integrating the health humanities in online bioethics education. In: Banner, O, Carlin, N, Cole, T, eds. Teaching Health Humanities. New York, NY: Oxford University Press; 2019:75–88.Google Scholar
59. See note 55, Schmitt 2006, at 90–1.
60. See note 54, Caston 2002, at 27-28.
61. See note 4, Rosenblatt 1978, at 60.
62. See note 55, Schmitt 2006, at 90–1.
63. Bishop, J. Creating narratives in the clinical encounter. Medical Humanities Review 2000;14(1):10–23.Google ScholarPubMed
64. See note 56 Hazen-Hammond 2008, at 14.
65. See note 57, Mitchell 2008, at 9.
66. See note 5, Adams 1991, at 47.
67. Interprofessional Education Collaborative. Core competencies for interprofessional collaborative practice. Washington, DC: Interprofessional Education Collaborative; 2016.Google Scholar
68. See note 9, Purves 1991, at 161.
69. See note 3, Salvatori 2000, at 85.
70. Milligan, E. Narrative matters (but not exclusively) in bioethics education. Journal of Bioethical Inquiry 2012;9(4):508.CrossRefGoogle Scholar