"It's okay to feel!": How a music-based pedagogical activity fosters medical students' emotional development

Emotions are an intrinsic part of medicine. However, formal medical curricula fall short in addressing the role of emotions in medicine, and the hidden curriculum often promotes emotional detachment as a core component of medical professionalism. In this study, we addressed the following research question: what are the mechanisms through which a music-based pedagogy grounded in emotion regulation (EmtR) nurtures medical students' emotional development?

In this cross-sectional, qualitative study, we performed a reflexive thematic analysis with an inductive approach grounded in the constructionist paradigm. The pedagogical activity comprehended four encounters, and music listening sessions were used to evoke emotions. The encounters were conceptualized to address emotion expression, identification, regulation and the impact of emotions in clinical care. We recruited 25 participants (21 students and 4 facilitators) from three Brazilian medical schools who took part in semi-structured interviews in 2020 and 2021.

Our analysis resulted in four co-constructed themes explaining the mechanisms through which the music-based pedagogical activity nurtured students' emotional development: (a) Creating a safe and pleasant environment - music listening facilitated emotional expression in a safe, democratic and supportive environment; (b) Facilitating Emotional Connections - shared emotional experiences during collective music listening strengthened connections among students and facilitators, showing how the same experience may evoke different emotional responses; (c) Providing opportunities to engage with EmtR strategies - students reflected on the impact of emotions on their personal and professional development, experiencing and simulating different EmtR mechanisms; and (d) Naturalizing Emotions in Medicine - students reported that music facilitated reflection on the role of emotions in medicine and helped them integrate their emotional selves into their professional roles, valuing emotions as essential to being a doctor.

This study clarifies the mechanisms through which music-based pedagogical interventions can nurture medical students' emotional development, contributing to a broader understanding of how the arts may counteract the culture of emotional detachment in medicine.