Threshold Concepts in a Literary Magazine Produced by Health Care Students

Area of Science:

• Medical Education
• Arts and Humanities in Medicine
• Professional Identity Development

Background:

• Progress Notes is a literary magazine showcasing creative works by US healthcare students.
• Published since 2016, it features poetry, fiction, reflection, and artwork from students at the Uniformed Services University of the Health Sciences (USUHS).

Purpose of the Study:

• To identify and understand the prevalent themes and perspectives within the published works.
• To explore how these creative expressions reflect the evolving professional identity of future physicians.

Main Methods:

• Qualitative thematic analysis was employed by two independent researchers to examine written and visual works.
• Codes were developed, refined into themes, and consensus was reached through discussion, with a third researcher verifying accuracy.

Main Results:

• Eight themes emerged from written works: vocation, death, failure/resilience, emotional restraint, patient personhood, patient approach, military physicians, and personal realization.
• Artwork themes included death, comradeship/aloneness, vocation/quest, and competence.
• Analysis identified threshold concepts such as 'I am a healer,' 'I can deal with ambiguity,' and 'The patient is the focus.'

Conclusions:

• Creative writing and art offer a valuable platform for healthcare students to grapple with the core principles of medical practice.
• The identified themes and threshold concepts signify a profound ontological shift in students' professional identity as physicians.
• A student-edited literary magazine serves as a crucial forum for exploring the complexities of physicianhood.