From skillful to empathic: evaluating shifts in medical students' perceptions of surgeons through a combined patient as teacher and arts-based reflection program




Introduction: The purpose of this study was to identify whether the incorporation of a combined Patient as teacher (PAT) and arts-based reflection (ABR) program during a surgical clerkship rotation could influence more humanistic perceptions of surgeons, using an innovative evaluation approach.

Methods: A novel, single question evaluation tool was created. Third year medical-students were asked to “list the top 5 attributes of a surgeon, in order of perceived importance” both before and after their surgical clerkship rotations and participation in the PAT/ABR program. Attributes identified by students were coded as either “humanistic” or “non-humanistic,” which were then analyzed using generalized linear regression models under a Bayesian framework.

Results: After participation in the PAT/ABR program, the predicted probability of students ranking a humanistic characteristic as the most important attribute of a surgeon had increased by 17%, and the predicted probability of students ranking a humanistic characteristic amongst their top three attributes for a surgeon had increased by 21%.

Conclusion: This innovative evaluative method suggested the success of a combined PAT/ABR program in encouraging a humanistic perspective of surgery and this approach could potentially be explored to evaluate other humanistic education initiatives.


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Author Biographies

Gurjot K Gill, University of Toronto

Resident doctor, Department of Obstetrics and Gynaecology, Temerty Faculty of Medicine, University of Toronto, Ontario, Canada

Stella L Ng , University of Toronto

Director and Scientist, Centre for Interprofessional Education; Scientist, the Wilson Centre; and associate professor, Department of Speech-Language Pathology, University of Toronto, Toronto, Ontario, Canada.

Emilia Kangasjarvi , University of Toronto

Research and Education Coordinator with Faculty of Medicine, Centre for Faculty Development, University of Toronto at St. Michael’s Hospital, Unity Health Toronto.

Jeff Crukley, University of Toronto

Adjunct lecturer, Department of Speech-Language Pathology, University of Toronto.

Jory S Simpson, University of Toronto

Division Head of General Surgery at St. Michael’s Hospital, Director of MD Program for the Department of Surgery and director for Humanism in Surgery curriculum, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada.


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How to Cite

Gill GK, Ng SL, Kangasjarvi E, Crukley J, Simpson JS. From skillful to empathic: evaluating shifts in medical students’ perceptions of surgeons through a combined patient as teacher and arts-based reflection program. Can. Med. Ed. J [Internet]. 2023 Aug. 1 [cited 2023 Dec. 8];14(5):14-21. Available from:



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