title: Relationship of creative projects in anatomy to medical student professionalism, test performance and stress: an exploratory study.
abstract: BACKGROUND
  The anatomy course offers important opportunities to develop professionalism at an early stage in medical education. It is an academically significant course that also engenders stress in some students.
  
  
  METHODS
  Over a three-year period, 115 of 297 students completed creative projects. Thirty-four project completers and 47 non-completers consented to participate in the study. Projects were analyzed for professionalism themes using grounded theory. A subset of project completers and non-completers were interviewed to determine their views about the stress of anatomy and medical school, as well as the value of the creative projects. We also compared test performance of project completers and non-completers.
  
  
  RESULTS
  Projects completed early in the course often expressed ambivalence about anatomy, whereas later projects showed more gratitude and sense of awe. Project completers tended to report greater stress than noncompleters, but stated that doing projects reduced stress and caused them to develop a richer appreciation for anatomy and medicine. Project completers performed significantly lower than non-completers on the first written exam (pre-project). Differences between groups on individual exams after both the first and second creative project were nonsignificant.
  
  
  CONCLUSIONS
  For some students, creative projects may offer a useful way of reflecting on various aspects of professionalism while helping them to manage stress.
authors.affiliation: Department of Family Medicine, University of California Irvine Bldg 200, Rte 81, Medical Center, 101 City Dr, South, Orange, CA 92868, USA. jfshapir@uci.edu
authors.forename: Johanna
authors.initials: J
authors.lastname: Shapiro
authors.forename: Vincent P
authors.initials: VP
authors.lastname: Nguyen
authors.forename: Sarah
authors.initials: S
authors.lastname: Mourra
authors.forename: John R
authors.initials: JR
authors.lastname: Boker
authors.forename: Marianne
authors.initials: M
authors.lastname: Ross
authors.forename: Trung M
authors.initials: TM
authors.lastname: Thai
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Leonard
mesh_terms: D000715:Anatomy / Q000193:education*; D002102:Cadaver; D002140:California; D015331:Cohort Studies; D003162:Competency-Based Education; D003405:Creativity; D004504:Education, Medical, Undergraduate / Q000379:methods*; D004521:Educational Measurement; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D011361:Professional Competence; D013315:Stress, Psychological; D013337:Students, Medical / Q000523:psychology* / Q000706:statistics & numerical data; D013732:Test Anxiety Scale; D055815:Young Adult