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）近期已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近距离接触，以及对超越躯体症状的各类问题进行照护，而这类内容通常是医学生尚未接触过的领域。摄影叙事法（Photovoice, PV）是一种多维度工具，可支撑教学、科研与推广三项核心工作。当作为教学工具应用时，通常以学生为参与者、教师为引导者。学生受邀拍摄照片，并围绕影像进行叙事，为其赋予特定语境下的意义与解读。 经验报告：我们邀请一组学生以"医学生视角下的姑息医学"为主题撰写文稿。本次实践通过12次每周开展的对话圈活动推进，活动中会用到此前发放给学生的音乐、视频与文本等素材。每名学生独立完成一份摄影叙事作品。学生们提交的摄影叙事作品自发被划分为三类：姑息医学照护的家庭亲历、实践场景中的专业照护经历，以及以更具概念性的方式对主题进行的阐释。 讨论：尽管本次实践的主题与所采用的方法均存在局限与难点，但整体体验反馈极佳。这不仅体现在学生的学习收获上，更体现在小组内部形成了紧密联结，全体成员均对本学期开展的这项实践表达了由衷的感谢。 结论：基于每位学生经独立思考后产出的9份摄影叙事作品可见，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独特的方式受到该主题的触动。摄影叙事作品的创作，能够以兼具个人性与人文性的方式，呈现对同一主题的多元观点，换言之，即展现三年级医学生眼中的姑息医学认知。