WHY USE LITERATURE?
Theoretically, using literature as a method of teaching psychiatry is aligned to two approaches to learning: experiential7 and constructivist.8
Heron defined experiential learning as 'knowledge by acquaintance' in literal or symbolic form and involving action, reflection, emotion and imagination.6
Literature is a form of experiential learning that involves symbolic experience and appeals naturally to the learner's imagination. It elicits an emotional response from the reader as they identify with characters' joys, struggles and aspirations.
Constructivism fosters learning by encouraging the discovery of meanings through the use of personal viewpoints and validation of the learning experiences through intersubjectivity or the convergence of personal meanings.7 Literature as a teaching tool presents opportunities for both personalised and intersubjective learning. Experiential learning and constructivism share the assumption that true learning is rooted in evocative learning. Unlike with the largely cognitive-oriented traditional didactic teaching, experiential or constructivist based learning methods appeal to emotions and provoke thought, and therefore achieve a higher learner level of retention long after the initial learning episode.6,9
Often, health issues are presented to students in a decontextualised manner, which can detract from student interest and learning. Fictional accounts can contextualise the symptoms and articulate the experience of suffering in a memorable manner. Further, literary works engage the reader more fully by engaging their imaginative faculties. In literary accounts, portrayals of suffering can go beyond the terms of nosological classification. This makes the description of the illness more vivid. For example, in Darkness Visible: a memoir of madness, William Styron rejects the very term 'depression' as an inadequate word for the suffering he has been through.10 He describes it as 'a true wimp of a word for such a major illness'.