How Bodies Learn: A Brief Intervention Using Dance and Dialogue
Setting
Although the practice of medicine is inextricably involved with the body, medicine's inherent emphasis on cognition and mental processing means the physician's body is largely ignored as a site of learning. One consequence of this disembodiment is that residents' capacity to monitor their behaviors is compromised. In addition, the adult learning paradigm that dominates current approaches to innovation in medical education expects learners to be self-aware and actively reflect on their learning processes. Many residents have little experience engaging in such reflection. The brief intervention described in this article addresses the problem of “disembodied learning” for physicians in training with the following objectives:
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Recognize which learning strategies residents are likely to enact in response to new stimuli (eg, new clinical environment, new rotation, or new levels of responsibility).
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Analyze and articulate how medical education impacts and changes resident bodies as they learn how to perform competently as physicians.
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Practice leadership and team building through effective communication.
Intervention
The intervention consists of residents choreographing and performing a dance (think Electric Slide, not Swan Lake) as a group, followed by a facilitated dialogue linking the activity to embodied learning. The duration of the exercise is 60 to 90 minutes; with 45 to 60 minutes allocated to the dance portion, and 15 to 30 minutes for the dialogue.
This activity was designed for a cohort of family medicine residents halfway through their internship year and could be run with a cohort from any specialty, with the expectation that the dialogue portion of the activity will differ depending on the residents' experiences. The group should be around 6 to 10 dancers (everyone in the room must dance to the best of their ability—no spectators). Larger groups can be split provided there is sufficient space.
The exercise requires room for the group to move, a stereo, a contemporary song (with a brisk, walking-pace beat), and a confident facilitator to keep the group moving. The facilitator must be able to (1) count to the beat of the music, (2) keep the group moving by assisting with the addition of new steps and practicing as described below, and (3) facilitate open dialogue centered on the residents' experiences.
Instructions
Dance
(1) Announce that the goal is to choreograph, learn, and perform a dance as a group within the next hour. (2) Each member of the group devises movement for 8 counts; count out the time for them while the music is playing. (3) Build the dance; each person teaches their 8 counts; when the group feels comfortable, add the next 8 counts. Practice from the beginning as often as necessary. Continue until all the steps have been added. (4) If time permits, divide the group into 2 and have each half “perform” the dance for the others. (5) Offer a 5-minute break to rest the body before the discussion.
Dialogue
Use the guiding questions in the left column of the Table to begin the conversation. Be prepared to follow the learners' lead.
Outcomes to Date
This activity has been run annually with 4 cohorts of family medicine interns, including, on average, 6 residents, a facilitator, the program director, and 1 or 2 clinical faculty members. The setting was a required 2-day retreat, with the dance activity scheduled after lunch on the first day. The sample responses from the dialogue portion of the activity speak to its success in raising residents' awareness of their bodies' learning in the course of clinical training. For different specialties, the dialogue may reveal other insights (eg, surgery residents may focus more on physical skills training and their bodies' condition during lengthy procedures). The dance and dialogue have resulted in increased awareness of self and others, in addition to enhancing the cohesion of the group by serving as a shared memory and focal point for in-group humor, helpful self-deprecation, and appreciation of difference. In the future, it may be beneficial to elicit resident and faculty reflections on its impact both in the short-term and long-term.
Author Notes
