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The limits of narrative: medical student resistance to confronting inequality and oppression in literature and beyond.

机译：叙事的局限性：医学生对面对不平等和文学及其他方面的压迫的抵抗。

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Introduction Upon designing and implementing a literature course on family values for Year 4 medical students, we found that while the supposed benefits of literary inquiry were to lead students to a deeper understanding of difficult issues such as illness and violence in the family, many of our students were unable to engage critically with the course material. This, we believe, was a result of their resistance to confronting issues such as inequality and oppression. This paper is an attempt to theorise student resistance to difficult, unruly subjects they encounter in a literature class, particularly those surrounding race, gender, social class and sexual identity. Methods We modify some of the expansive claims made by narrative medicine and put forth a new pedagogical and curricular approach to the uses of literature in medical education. Results We found that many students resisted course material and corresponding discussions, especially those related to sexual identity and non-traditional family values, male-female relationships and white racism. Discussion To reduce student resistance, we pose a more critical approach to narrative inquiry in medical settings that may deepen students' willingness to imagine what it is like to be someone who is suffering, and to work against oppressive social structures that sustain such suffering. Thus, we recommend moving narrative inquiry beyond a focus on the self and the patient in that individualised, circumscribed relationship and into a collective process involving the social, political, cultural and economic conditions that affect health and well-being.
机译：简介在为四年级医学生设计和实施了有关家庭价值观的文学课程之后，我们发现，尽管文学探究的假定好处是使学生对家庭疾病和暴力等棘手问题有更深入的了解，但我们中的许多人学生无法批判地使用课程材料。我们认为，这是他们抵制不平等和压迫等问题的结果。本文试图将学生对在文学课上遇到的困难，不守规矩的学科（特别是围绕种族，性别，社会阶层和性认同的学科）的抵制理论化。方法我们修改了一些叙事医学的广泛主张，并针对医学教育中文献的使用提出了一种新的教学法和课程方法。结果我们发现，许多学生抵制课程材料和相应的讨论，尤其是那些与性认同和非传统家庭价值观，男女关系和白人种族主义有关的讨论。讨论为了减少学生的抵触情绪，我们在医学环境中提出了一种更为关键的叙事方法，可以加深学生的意愿，让他们想象成为一个受苦者的感觉，并与承受这种苦难的压迫性社会结构作斗争。因此，我们建议将叙事性调查的重点从个人和患者之间的个性化，界限分明的关系转移到涉及影响健康和福祉的社会，政治，文化和经济状况的集体过程中。

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