Cloaking as a Community: Re-imagining the White Coat Ceremony With a Medical School Learning Community

Abstract

The Johns Hopkins School of Medicine’s Learning Community–White Coat Ceremony (LC-WCC) is held each spring as a learning community (LC) event. Learning communities (LCs) connect people to learn and work across boundaries to achieve a shared goal. The LC-WCC invites first-year students to collaborate with school leaders, define the class professional values, and innovate with community members. Class-elected student leaders recruit peers to join committees to plan and lead several aspects of the ceremony, including a class-nominated speaker, a personal statements presentation, a patient inclusion presentation, a class-authored statement of values, and artistic performances. Student cloaking is performed by LC advisors in their LC small groups. A 2015 post-LC-WCC survey asking students to compare experiences of a traditional Stethoscope Ceremony (SC) with the LC-WCC found that the latter significantly increased students’ sense of accomplishment (38% vs 68%, P < .001), sense of connection to the school (59% vs 82%, P < .001), to classmates (71% vs 93%, P < .001), and to the event (42% vs 76%, P < .001). Cloaking as a community is an effective way for a medical school LC to instill a greater sense of community and student leadership in this milestone celebration of humanistic values in medicine.

Thoughts at a White Coat Ceremony

“…Dr. Arnold P. Gold held his first White Coat Ceremony four years after that [1]. White Coat Ceremonies have spread throughout US medical schools and even internationally [2,3], largely through the support of the foundation established by Dr. Gold, his family and his colleagues [3]. I confess that when I first heard of these events sometime in the mid to late 1990s, the idea of presenting a white coat to entering medical students in a ceremony so that they would understand that they are beginning their entry into a profession, reminded me of an old Monty Python sketch.…”

“…It has also been suggested that the White Coat Ceremony is a defensive action by the medical profession, symbolizing a claim of entitlement in a world where physician leadership of healthcare is challenged [7]. Perhaps reflecting these perceived conflicts is a model in which a "profession-entry" ceremony is held early in the first year followed by a later "humanistic" ceremony including individual statements of values, a high level of student engagement, and artistic performances [2]. Most White Coat Ceremonies include recitation of some sort of commitment or oath: the meaning and appropriateness of such recitations has also been debated [8,9].…”