Hope to inspire

A new study highlights the impact of OUWB’s Study Trip to Auschwitz on medical students while also validating calls for greater inclusion of such content in education for all health professions.

“The Impact of a Study Trip to Auschwitz: Place-based Learning for Bioethics Education and Professional Identity Formation” recently was published in the Cambridge Quarterly of Healthcare Ethics.

Lead author was Maxwell Li, M.D., OUWB ’24. Co-authors were Ramona Stamatin, M.D., OUWB ’24, Jason Wasserman, Ph.D., Dean’s Distinguished Professor, Department of Foundational Medical Studies, and Hedy Wald, Ph.D., clinical professor, Family Medicine, Warren Alpert Medical School of Brown University. (Wasserman and Wald serve as co-directors of OUWB’s Study Trip to Auschwitz.)

The study includes feedback from medical students who went on the inaugural OUWB Study Trip to Auschwitz in 2022.

Li, currently in a preliminary year of residency at University of California, Riverside, says the findings are clear: The future physicians who went on the study trip were heavily impacted by physically being in the place where so many lessons about humanism are to be learned.

“The hope is to inspire more medical schools to include the Holocaust and medicine in their curricula,” says Li. “A lot of the learnings and teachings are relevant today…we need to focus on humanism as much as possible.”

‘A true program evaluation’

The OUWB Study Trip to Auschwitz is entirely donor-funded and includes a pre-trip curriculum, a seven-day trip to Krakow and Oswiecim (the location of Auschwitz-Birkenau) in Poland, and a post-trip workshop where students prepare presentations to share their experiences and insights with the broader community.

This includes other medical students; faculty, staff, and students across the university; schools and other organizations throughout southeast Michigan; and at both national and international forums.

The pre-trip curriculum includes three modules focused on general Holocaust history, an introduction to the history of medicine during the Holocaust, reflective writing and professional identity formation, and required multiple postings to a discussion board reflecting on various module components as well as the students’ expectations related to their upcoming study trip.

The trip itself includes tours of historic sites and museums in Krakow followed by educational tours of Auschwitz I and II (Birkenau) in Oswiecim. Students also attend lectures by Auschwitz historians and participate in three reflective writing sessions, as well as one discussion session on the relevance of the Holocaust to contemporary medicine.

Upon return, students discuss and reflect upon the trip experience during a seven-week seminar and develop projects and presentations for sharing what they learned at a symposium dinner as well as with the community groups at the medical school, health system, the broader university, and at regional and national conferences.

Understanding the long-term impact of the study trip was the idea of Wasserman.

“We really wanted a true program evaluation,” he says.

Reflective writing sessions are an integral part of the OUWB Study Trip to Auschwitz.

‘A very relevant topic’

Wasserman says it was intentional to have the evaluation led by someone who hadn’t been on the trip.

“I think it’s really hard to conduct a program evaluation of something you’ve been so intimately connected with,” he says.

That meant Wasserman and Wald were out as leads, as well as any students who had traveled to Poland for the study trip.

Li stepped up to do it through OUWB’s Embark program, a four-year longitudinal curriculum that consists of structured coursework in research design and implementation, scholarly presentation, and more.

“It’s a very relevant topic that isn’t taught enough so I thought it was a really good idea to jump on it,” he says.

The evaluation relied on written reflections and semi-structured open-ended interviews with a goal of identifying key themes as patterns.

Prompts for the written reflections included: reflecting on moral failures and atrocities of Nazi physicians and the medical-scientific establishment and its relevance for one’s professional identity formation; how resistance and resilience stories resonated with one’s own sense of moral courage within challenging contemporary health care; and reflecting on what participants were taking forward from the experience.

Post-trip interviews were conducted with 13 of the 19 student participants in late 2022.

Li and Stamatin conducted all interviews and analyses. Wasserman and Wald reviewed and provided further commentary on the results to deepen interpretation with additional information about the experience. The study was approved by the Institutional Review Board at Oakland University.

Hope to inspire

According to the study, analysis of the interview transcripts and reflective writings yielded four core themes:

1. Gaining a greater understanding of the relationship of bioethics and atrocities of the Holocaust.
2. Recognizing moral courage and social awareness as part of professional identity formation, particularly considering the concern that such atrocities could happen again.
3. Developing a deeper appreciation for the roles played by dehumanization and medical power during the Holocaust and their contemporary manifestations.
4. The power of presence and experiential learning for bioethics and humanism education and professional identity formation.

Wasserman says the themes that emerged are consistent with the overall intent of the study trip.

“The themes touch on the core problems of dehumanization and the consequences of that…(and) on core issues of bioethics, which I’m obviously glad to see as a bioethics professor,” he says.

Wasserman notes that another theme he was pleased to see addresses the notions of personal responsibility and professional identity.

“That gets into the question of ‘What kind of professional do I want to be?’” he says. “Part of the core hope is that this study trip changes how the students view themselves as professional physicians and what their responsibilities are.”

By publishing the paper, Wasserman says the co-authors have several goals.

First, the hope is to raise awareness of OUWB’s program.

“We’re doing something special here and this is one way to let people in the field know about it,” he says.

The second goal is to raise awareness about the benefits of critical place-based learning.

“This is the idea that being there confers a kind of experiential learning that can’t be duplicated in the classroom,” says Wasserman.

He also hopes that the published paper encourages other schools to look at their own Holocaust and medical education programs.

“Even more broadly, I hope the paper inspires more creative approaches to ethics and humanities education that are rooted in critical place-based pedagogies,” he says. “And I would be pleased to see this paper contribute to a growing sense that we need to do more of that.”