Photovoice as a tool for teaching and learning about palliative care

Abstract: Introduction: Palliative care was recently included in the undergraduate medical curriculum in Brazil, but putting its teaching into practice represents a major challenge. Palliative care involves intimate contact with suffering and caring for issues that go beyond physical symptoms, aspects generally unfamiliar to medical students. Photovoice (PV) is a multifaceted tool that can support the teaching, research and extension trinomial. In its application as a pedagogical tool, students generally act as participants and the teacher as facilitator. Students are invited to take photographs (photo) and narrate these images (voice) ascribing meaning and interpretation within a context. Experience Report: A group of students was invited to produce a manuscript with the theme “Palliative care from the point of view of a third-year medical student”. The work was developed over 12 weekly meetings in the form of conversation circles that dealt with materials previously sent to students such as music, videos and texts. Each student produced an individual PV. Photovoices prepared by the students were spontaneously divided into three groups: family experiences of palliative care, professional experiences in practice scenarios and development of the theme in a more conceptual manner. Discussion: Despite the limitations and difficulties of the theme and the methodology used, the final balance of the experience was very positive, not only in relation to student learning, but also to the creation of a strong bond within the group, which expressed deep gratitude for the work developed over the course of the semester. Conclusion: In view of the nine PVs produced, as a result of each student’s individual reflection, it is clear that each member of the group was touched in a different way by the subject, even though all the reflections were presented collectively during our meetings. The production of a PV allowed the externalization of different views on the same subject in a personal and humanistic way, in other words, the perception of palliative care in the view of a third-year medical student.

摘要：

引言：姑息医学（Palliative care）近期被纳入巴西本科医学课程，但将其教学落地实践仍是一项重大挑战。姑息医学涉及与病痛的亲密接触，以及照料超出躯体症状范畴的诸多议题，这些皆是医学生普遍较为陌生的领域。摄影发声法（Photovoice, PV）是一种多维度工具，可支撑教学、研究与社会服务三元体系的开展。将其作为教学工具应用时，学生通常作为参与者，教师则承担引导者角色。学生受邀拍摄照片并为影像配述解说，在特定语境中赋予图像意义与解读。

实践报告：一组学生受邀撰写主题为‘三年级医学生视角下的姑息医学’的手稿。该项工作通过12次每周开展的对话研讨圈形式推进，期间会研讨此前发送给学生的音乐、视频与文本等素材。每位学生均独立完成一份摄影发声作品。学生们自发将所制作的摄影发声作品划分为三类：姑息照护的家庭体验、临床场景中的专业实践经历，以及以更具概念性的方式展开的主题探讨。

讨论：尽管该主题与所采用的方法论存在局限与难点，但本次实践的整体反馈极为积极，不仅体现在学生的学习成效上，更促成了小组内部紧密的情感联结，参与者们对本学期开展的这项工作表达了深切的感激之情。

结论：基于每位学生独立反思后产出的9份摄影发声作品可见，尽管所有反思均在小组会议中集体呈现，但小组每位成员均以各自不同的方式受到该主题的触动。摄影发声作品的创作，以兼具个人性与人文性的方式外化了对同一主题的多元视角，换言之，即展现了三年级医学生眼中的姑息医学认知。