Enhancing self-awareness in medical students: an overview of teaching approaches.

Self-awareness is an individual's tendency to pay attention to his or her own emotions, attitudes, and behavior in response to specific situations. In the case of physicians, self-awareness is their insight into how their emotional makeup influences patient care. Conceivably, such insight may improve doctors' professional performance. The authors review published approaches aimed at enhancing the self-awareness of medical students and draw attention to some problems in these approaches that call for further research. Published teaching programs of self-awareness may be classified as direct or indirect. The primary objective of direct programs is to promote students' insight into their own feelings and attitudes by classroom instruction or small-group discussions, during which students share with their peers their emotional responses to various clinical experiences. The primary objective of indirect approaches is to teach clinical skills, such as patient interviewing, patient counseling, and self-assessment. It has been claimed that these programs also enhance self-awareness by drawing students' attention to differences between students' assessment of their own performance and the assessments of their instructors and patients. Both types of programs should be given consideration for inclusion into the medical curriculum. However, since presently available evidence does not allow educators to identify an optimal teaching program, more study is needed concerning the effectiveness of the various approaches to teaching self-awareness. Specifically, an effort should be made to ascertain that the benefit of the direct approaches exceeds their cost in terms of time, teacher training, and-possibly-student embarrassment.