Enhancing medical students' proficiency in coping with chronic health conditions - accounts of a poetic approach to learning in type 2 diabetes clinical simulation.

BACKGROUND: Managing Type 2 Diabetes Mellitus in Primary Health Care requires not only clinical accuracy but also humanistic and reflective capacities. Simulation-based education that integrates theatrical and humanistic elements may foster these competencies. This study explores how a clinical simulation module shaped medical students' awareness of their role in chronic care, drawing on Balint's psychodynamic perspective and Aristotelian poetics.

METHODS: A qualitative study was conducted during a T2DM simulation module with fourth-year medical students. Eighteen simulation sessions were observed, and ten in-depth interviews were carried out with students who acted as simulated doctors. Data from field notes and transcripts were analyzed using Clinical-Qualitative Content Analysis. Balint's concepts informed the reading of relational dynamics, while Aristotelian poetics offered a framework to interpret the symbolic and affective expressions emerging from the learning process.

RESULTS: Students reported emotional resistance, anxiety, and fear of judgment when engaging with the simulation. These tensions were interpreted through Balintian ideas such as the doctor's self as a therapeutic instrument, the role of collegiality, and the psychodynamics of group learning. Three thematic axes emerged: availability to assume the medical role, precision in clinical reasoning, and group support or rivalry. These were further mapped onto poetic forms - tragic, comic, and epic - illuminating symbolic dimensions of professional identity formation.

CONCLUSIONS: Combining Balint's psychodynamic insights with poetic-symbolic interpretation in simulation may offer educators a humanizing and reflective strategy to support medical students in developing relational and clinical competencies for PHC.