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What I have presented in this chapter is a snapshot into 15 years of creative enquiry work with medical students which shows that creative enquiry offers a learning environment of collaboration, enquiry and extended dialogue with the other and with ourselves. Through student quotes and creative work, I have sought to evidence ways in which creative enquiry can foster human flourishing alongside practitioner development work, actually two sides of the same coin – one relating to understanding the self and the vulnerability of human nature and the other to understanding of the humanity of others.

That this might lead to flourishing is endorsed by research by Satici et al. [39] into the connection between self‐compassion (a concept which essentially relates to understanding our humanity) and flourishing amongst university students [39]. Students were asked to complete questionnaires that included the flourishing scale and the self‐compassion scale. Analysis of responses found that self‐kindness (rather than self‐judgment), common humanity (versus isolation), and mindfulness (versus over identification) were positively related to flourishing [39]. Self‐kindness means being warm and understanding towards oneself in our inadequacies and failings rather than ignoring pain, or being self‐critical. Common humanity refers to understanding that we all fall short, make mistakes, feel inadequate and this can be a point of connection rather than isolation. Mindfulness is described as engaging with negative emotions in a balanced way, not suppressing or exaggerating them [39]. Creative enquiry offers an environment that invites kindness and connection in vulnerability as well the arts themselves offering other languages to gently explore emotions that might be difficult to articulate.

Lee Roze des Ordons et al. [40] explore humanity in relation to both patient care and physician wellness (similar to my concepts of practitioner development and human flourishing, respectively) through semi‐structured interviews with faculty. Five themes relating to shared humanity emerged. These all find resonance in my description of creative enquiry above. They are Whole person care – engaging with psycho‐socio‐emotional dimensions of personhood, Valuing – respect for a person's intrinsic value, Perspective taking – engaging with other perspectives and suspending judgment regarding other worldviews, Recognising universality – the shared elements of the human condition beyond professional boundaries and finally Relational focus – becoming part of another's story and reciprocally being transformed and changed through entering another's world. The authors mention the need for ‘creative imagining’ on how to embed this work in the undergraduate curriculum. What I have offered are examples of ways in which this kind of humanism is already being invited.

However, as intimated in my introduction, creative enquiry in medical education is not without its risks and application of these creative enquiry examples to medical education in general also has its limitations. Key risks in this kind of work include the risk of student exposure or difficulty in maintaining their boundaries. Careful facilitation is necessary with vulnerable leadership creating a space where our humanity and frailty are accepted and welcomed as well as respecting student privacy and holding back. For arts therapists and arts for health practitioners making space for the student voice may come more naturally than clinician educators for whom space and silence can be deeply counter‐cultural [41]. ‘Artist of the invisible’ is a term given to the art of facilitating a transformative learning group [42]. It is a helpful concept which can be applied to creative enquiry group facilitation to explain the creativity needed in order to craft a conducive group environment.

Emotional engagement can be draining and usually in each course at some point tears are shed. Research on the small group work described above found evidence of students questioning the emotional expression within the group, for example proposing more warning prior to emotional sessions e.g. where an artist/painter told his life story regarding his diagnosis and recurrence of lymphoma [8]. The group has always worked well, however, to hold a safe space and many comment on the heavier emotional sessions being the most beneficial, though not always enjoying them [8]. Also, life as a doctor is inevitably one which involves the clinician in the emotional experiences of their patients facing diseases and death. There is an emotional labour to be borne by the doctor [43].

Other challenges in this kind of work are the risk of non‐engagement. The risk is greater where students are compelled to engage in this work, but the gains may also be higher when they do (it may be the people who do not choose this work who need it the most) [44, 45]. Finally this work is time consuming and demanding for educators who may already be hard pressed. On the other hand, it can be meaningful and enriching and thereby an antidote to the risk of cynicism and burnout.

Limitations to the wider application of this work include the fact that it has all been carried out with first and second year students and it may be that disease‐centred approaches and cynicism grow in later years of the course [46]. Other limitations include the fact that students were self‐selecting in both examples, however such a large number of students were choosing creative enquiry in Example 1 that this course continues now with compulsory creative enquiry. For some students in Example 2, the group work was not their first choice, but where they have written about this, it is to make the point that they were grateful for being placed on this course.

How courses or creative enquiry options are framed for students is important. The work detailed above has all been framed within the practitioner development focus – what would happen if they were optional courses for human flourishing. This is being piloted locally in a different context – for MSc students including those studying on ‘Creative arts and mental health’ MSc. It has resulted in a small but engaged group of students taking part. We also launched a lockdown creative enquiry group called ’Interpretive voices’ in April 2020 spanning medical students, clinicians and academics. This was a space for connection, interpretation and engagement with lived experience and working practice across isolation and disciplinary boundaries. The belief is that flourishing may arise by connecting with ‘what is’ rather than instructions to ‘do better’ (eat well, sleep well).

Transferability of the models as presented above may be limited given the resource and time implications; however the creative enquiry essence of space, silence, creative engagement and vulnerable leadership can be introduced in so many ways across the curriculum. Recently a new creative enquiry prize has been initiated locally which invites students to engage creatively and face the climate crisis we are finding ourselves in. This may facilitate dialogue and engagement rather than suppressing the fears and challenges of our times. Other options might include inviting students on placement or as part of a professionalism or flourishing programme to share lived experience and dialogue through a chosen poem or image. The metaphors work powerfully to deepen and personalise reflection [6].

Future research is needed in order to extend our understanding of the contribution creative enquiry can make towards flourishing in medical education, the challenges of embedding and facilitating this work including educator development, and the potential for arts for health or arts therapist engagement in the curriculum. Understanding the challenges as well as impact of creative enquiry programmes on medical culture and the hidden curriculum could act as a catalyst towards more widespread change.

In summary, there is a growing picture in medical education and in clinical practice of stress and burnout. Though there are many possible underlying reasons for this, I have focussed here on features such as the depersonalisation and competition embodied within the undergraduate hidden curriculum, juxtaposed with the emotional burden and complexity of clinical practice. Through medical student engagement in creative enquiry I have found that given the right learning context medical students can engage in different ways of knowing and learning. Where there is a creative and trusting learning environment students share more of their ideas, stories and beliefs. This may lead to rich dialogue, connection and, for some, transformation and growth thereby potentially contributing to eudaimonic flourishing.

Through in‐depth practice and research this chapter offers some core constructs to educators interested in developing their human flourishing programmes through creative enquiry. They can be summarised with the acronym VVV , that is Vulnerable leadership, Valuing and Voice . Vulnerable leadership involves the facilitator presenting themselves as human acknowledging the inevitability of our individual inadequacies and collective failings. Valuing means inviting awareness of the intrinsic value and shared humanity of both the other and ourselves, whether student, patient or health care professional. Finally Voice relates to personal ways of knowing and exploring lived experience, inviting boundary work for the facilitator and students – what to share or keep private, the personal and professional boundaries between patient and future doctor and working across cognitive and emotional boundaries.

In summary, ‘people matter’. Creative enquiry practiced as detailed in this chapter, honours the importance for the health care professional of our relationship with ourselves as well as that of the other.