Mandalas as a window into the wellbeing of medical students

Abstract

Background and aims: The creation of mandalas, or art made in reference to a circle, has been used for therapy and for increasing self-awareness and achieving general wellness. The aim of this qualitative study was to explore how creating mandalas in a medical humanities programme might provide medical students with an opportunity for reflection on their current psychological state. We specifically sought to identify common mandala patterns, which may provide insight into the concerns and well-being of the students. Methods: All third year medical students at The University of Hong Kong over two academic years (n=241) participated in art-making workshops to explore their self-awareness of their own emotional state. Under the guidance of an art therapist, students created a mandala in response to the question ‘How am I right now?’ completed an accompanying piece of reflective writing, engaged in group discussion and finally participated in a debriefing. We analysed the mandalas according to themes as described in a Jungian-based framework, the ‘Great Round’ where each pattern is associated with various states of consciousness. We further conducted a similar thematic analysis of the students’ writings. Results: 74.7% (n=180/241) of student allowed their work to be included in the study. It appeared that students struggled with integrating conflicting perspectives as they attempted to reconcile their professional identity as doctors-to-be. They also expressed psycho-social concerns including navigating difficult emotions, requiring nurturance, handling endings, contemplating existential concerns and managing stress. Conclusions: Mandala making as a reflective activity provided insight into evolving professional identity and the psychological state of students, which may help medical educators as they nurture the development and well-being of our future doctors. We suggest using mandala making as a means for medical students to reflect on their emotional state and to achieve psychological balance.