Context and aims: Many musicians suffer for their art, and health is often compromised during training. The Health Promotion in Schools of Music (HPSM) project has recommended that health education should be included in core curricula, although few such courses have been evaluated to date. The aim of the study was to design, implement and evaluate a compulsory health education course at a UK conservatoire of music.Methods: The course design was informed by a critical appraisal of the literature on musicians' health problems and their management, existing health education courses for musicians, and the HPSM recommendations. It was delivered by a team of appropriately-qualified tutors over 5 months to 104 first-year undergraduate students, and evaluated by means of questionnaires at the beginning and end of the course. Thirty-three students who had been in their first year the year before the course was introduced served as a control group, completing the questionnaire on one occasion only. Items concerned: hearing and use of hearing protection; primary outcomes including perceived knowledge and importance of the topics taught on the course; and secondary outcomes including physical and psychological health and health-promoting behaviors. The content of the essays written by the first-year students as part of their course assessment served as a guide to the topics they found most interesting and relevant.Results: Comparatively few respondents reported using hearing protection when practicing alone, although there was some evidence of hearing loss, tinnitus, and hyperacusis. Perceived knowledge of the topics on the course, and awareness of the risks to health associated with performing music, increased, as did self-efficacy; otherwise, there were negative effects on secondary outcomes, and few differences between the intervention and control groups. The topics most frequently covered in students' essays were managing music performance anxiety, and life skills and behavior change techniques.Conclusion: There is considerable scope for improving music students' physical and psychological health and health-related behaviors through health education, and persuading senior managers, educators and students themselves that health education can contribute to performance enhancement.

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Reflective practice takes on a particular shape in classical music. The aim of this chapter is to identify some elements of classical music that distinguish it from other genres of music, and to consider how these elements may affect the kind of reflection in which classical musicians—and classical musicians-in-the-making—engage. The chapter, which is partly based on student practice diaries and interviews with professional musicians, argues that the distinguishing elements of classical music performance are a focus on interpretation, interest in following the composer’s intentions, concern about excessive demonstration of the performer’s ego, and a respect for the printed score as the ultimate repository of truth about the work. These elements seem to encourage musicians to frame their choices either with little acknowledgement of their own agency or in terms that reflect some tension between what they feel and what they perceive as the composer’s intentions. Much work remains to be done on the ways in which these self-abnegations or uncertainties play out, but by bringing their underlying ideologies to the surface young performers in particular could fruitfully harness as well as challenge them.

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