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.