The research, led by Sujal Manohar and Eden Noah Gelgoot with colleagues including Alex Walker, Nora McCarthy and Margaret S. Chisolm, set out to answer a question that has lingered around arts and humanities initiatives in medicine: how exactly do these activities enable learning and reflection? While the value of the arts and humanities in medical education has been increasingly recognized in recent years, with the potential to cultivate important clinical attributes, much of the literature has focused on outcomes rather than process. Less is known about how a processfolio actually functions as a vehicle for learning, and even less about the individual, lived experiences of the learners who create one. The Johns Hopkins team designed their study to close that gap, treating the students not as subjects to be measured but as narrators of their own educational journey.

Methodologically, the study took a deliberately qualitative approach. The researchers employed a cross-sectional design anchored in Interpretative Phenomenological Analysis, or IPA, a methodological framework that aims to uncover how individuals make sense of their personal and social world. IPA is well suited to questions of lived experience because it asks researchers to engage in a double hermeneutic: participants are interpreting their own experiences, and the researchers are then interpreting those interpretations. In this case, the data came from three sources. First, the researchers analyzed the completed processfolios themselves, the summative course artefacts in which students had assembled their work. Second, they examined the students’ final written reflections. Third, they conducted individual semi-structured interviews with each participant, allowing them to elaborate on what the processfolio had meant to them.

The sample was small but remarkably complete. All five fourth-year medical students who finished the museum-based course chose to participate in the research study. That total participation is significant in qualitative research of this kind, because it means the findings capture the full cohort rather than a self-selected fragment of it. It also reflects the voluntary, trust-based nature of the study, which was reviewed by the Johns Hopkins University Institutional Review Board and deemed exempt research under reference number IRB00365270. Because the study was classified as exempt, the institutional review board determined that it did not include informed consent procedures or fall under specific guidelines for research with human subjects. The exemption also signals the educational, non-interventional character of the work: the researchers were studying artefacts and reflections that already existed as part of the course.

From their analysis, the researchers distilled four Group Experiential Themes, the shared patterns of meaning that emerged across the five participants’ accounts. The first theme, contemplating the journey of reflection, growth and insight, speaks to the processfolio’s core function: it makes learning visible over time. Rather than submitting a single polished product at the end of a course, students accumulate artefacts that trace how their thinking evolved week by week. Looking back across that accumulation, participants could see their own intellectual and emotional trajectory in a way that conventional assessments rarely allow. The processfolio became, in effect, a mirror held up to the learning process itself, letting students contemplate not just what they had learned but how they had learned it.

The second theme, exploring personal and emotional growth, points to a dimension of medical training that is often squeezed out by the demands of scientific coursework. Medical students are routinely taught to compartmentalize emotion, yet the capacity to recognize and process one’s own emotional responses is increasingly understood as central to physician wellbeing and patient care. In the museum-based course, engagement with art opened a space where emotional responses were not only permitted but expected to be examined. The processfolio gave students a private, structured repository for that examination, and the act of assembling it encouraged them to connect their experiences in the gallery to their emerging identities as physicians. Participants reflected on their development as medical students and future physicians, a conclusion the authors highlight as central to the study’s purpose.

The third theme is perhaps the most clinically resonant: communicating in clinical contexts, with attention to the importance and complexity of both verbal and non-verbal communication. Art museums are, in a sense, laboratories of observation. Standing before a painting or sculpture, students must describe what they see, tolerate ambiguity, and recognize that others may perceive the same object differently. These are precisely the skills that translate to the bedside, where a physician’s reading of a patient’s posture, expression and silence can matter as much as any laboratory value. The processfolio documented this translation, capturing how students moved from describing artworks to thinking about how they describe patients, and how much of clinical communication happens without words at all.

The fourth theme, acknowledging the complex history of medicine and advocating for better practices, reveals a critical, even activist dimension of the experience. Museums and medicine share entangled histories, and engagement with artistic and historical material prompted students to confront uncomfortable truths about how their profession has treated patients, particularly those from marginalized communities. Rather than treating the arts and humanities as a decorative supplement to clinical training, this theme shows them functioning as a lens for professional critique. Students did not simply absorb the history of medicine; they interrogated it, and the processfolio preserved that interrogation as a record of their evolving ethical commitments. The authors frame this as learners advocating for better practices, a striking outcome for a course that takes place far from any hospital ward.

The study is candid about its limitations and about the fact that the processfolio is not a frictionless tool. Learners shared challenges related to its use, an acknowledgment that matters for educators considering adoption. A processfolio demands sustained reflective labor across a course, and students accustomed to the metrics of biomedical assessment may find the open-ended, self-documenting format unfamiliar or burdensome. The authors also emphasize that the research was conducted at a single institution with a small sample size, which constrains how far the findings can be generalized. Five students at one medical school cannot speak for all learners everywhere, and the authors explicitly call for future research in this area to test and extend what they observed.

Even with those caveats, the study offers a rare, granular look inside an arts and humanities intervention that is often praised in the abstract but seldom examined from the learner’s point of view. By combining analysis of the processfolios and written reflections with in-depth interviews, and by interpreting that material through the lens of Interpretative Phenomenological Analysis, the researchers have shown how a single pedagogical artefact can carry a student through contemplation of their own growth, exploration of their emotional life, refinement of their communicative instincts and confrontation with their profession’s history. The work was published open access on 1 October 2026, received on 11 April and accepted on 10 September of that year, with Manohar and Gelgoot serving as co-first authors. Chisolm’s contribution was supported through her direction of the Paul McHugh Program for Human Flourishing at Johns Hopkins. As medical schools worldwide continue to weave the arts and humanities into their curricula, this study suggests that the humble processfolio, a folder of artefacts and reflections assembled over four weeks in a museum, may be one of the most quietly powerful instruments for shaping the physicians of tomorrow.

Subject of Research: Use of processfolios in arts and humanities-based museum education for reflective learning in medical students

Article Title: Exploring the use of processfolios in a museum-based course for medical students

Article References: Manohar, S., Gelgoot, E. N., Walker, A., McCarthy, N., & Chisolm, M. S. (2026). Exploring the use of processfolios in a museum-based course for medical students. BMC Medical Education. https://doi.org/10.1186/s12909-026-10394-5

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10394-5

Keywords: medical education, arts and humanities, processfolio, museum-based education, reflection, Interpretative Phenomenological Analysis, medical humanities, qualitative research, Johns Hopkins, experiential education, pedagogy, communication skills

The dataset, compiled by Csaba Szilagyi of Rush University and Johns Hopkins Medicine and Patricia K. Palmer of Emory University’s Woodruff Health Sciences Center, captures survey responses from 274 Clinical Pastoral Education students at baseline, along with pre- and post-training longitudinal data from 196 of those students. The participants were interns and residents enrolled at 29 centers accredited by ACPE, the standard-setting body for pastoral education formerly known as the Association for Clinical Pastoral Education. Data collection took place between 2020 and 2022, a period that spanned the COVID-19 pandemic and placed unprecedented emotional strain on healthcare environments of every kind.

What makes the resource scientifically valuable is its dual focus on two constructs that researchers consider core professional competencies for chaplains. The first is emotional intelligence, the capacity to perceive, understand, manage, and use emotions in oneself and others. The second is counseling self-efficacy, a trainee’s belief in their own ability to carry out the concrete activities of counseling, from building rapport to managing difficult conversations. Both constructs have been studied extensively in nurses, physicians, psychologists, and social workers, but comparable large-scale evidence in chaplaincy has been conspicuously absent, leaving educators without a solid empirical foundation for judging whether their experiential training model actually works.

To measure emotional intelligence, the researchers used the Schutte Self-Report Emotional Intelligence Test, a widely deployed self-report instrument that assesses traits such as emotion perception, emotion regulation, and the utilization of feelings in problem solving. Counseling self-efficacy was measured with the Counselor Activity Self-Efficacy Scales, which break the counseling role into specific task domains and ask respondents to rate their confidence in each. By pairing these two validated instruments across multiple time points, the dataset allows researchers to examine not just snapshots of ability but trajectories of change over the course of training, the kind of longitudinal design that single-site studies of chaplaincy education have rarely achieved.

The longitudinal structure is particularly rich for residents, the more advanced tier of CPE trainees. For this group the dataset includes not only pre-training and post-training assessments but also a mid-residency measurement, creating a three-point trajectory that can reveal whether gains in emotional intelligence and self-efficacy accumulate steadily, plateau, or accelerate at particular stages of supervised clinical practice. Alongside the quantitative scores, the dataset records demographic and educational information for each participant, enabling analyses of how factors such as age, gender, prior education, and religious background relate to baseline competencies and to the amount of growth trainees experience.

Perhaps the most distinctive component is qualitative. The dataset preserves open-ended responses in which students described what they perceived as facilitators and barriers to the development of their emotional intelligence during training. These free-text accounts offer a ground-level view of how experiential education actually operates: which supervisory practices, clinical encounters, and peer group processes trainees credit with sharpening their emotional awareness, and which structural obstacles, from heavy patient loads to limited feedback, they identify as impediments. Combined with the validated scale scores, this mixed structure supports both statistical modeling and thematic analysis within a single coherent resource.

The parent study behind the dataset was designed to answer three questions that have lingered in the pastoral psychology literature: whether emotional intelligence and counseling self-efficacy change from the start to the end of CPE, what the baseline distributions of these capacities look like across a broad, geographically dispersed sample, and how demographic and educational factors shape both. Because the data were gathered across 29 accredited centers rather than a single institution, the sample captures the heterogeneity of real-world CPE programs, which vary in size, setting, patient population, and educational philosophy. That breadth matters enormously for anyone hoping to generalize findings to the profession as a whole, and the authors note that, to date, this stands among the largest multicenter datasets in CPE research.

The potential applications extend well beyond chaplaincy itself. Researchers studying emotional intelligence and self-efficacy development in comparable healthcare professions, including nursing, medicine, social work, and clinical psychology, can use the dataset as a comparison benchmark for other trainee populations. Educational scientists interested in experiential learning more broadly may find in it a rare opportunity to model competency growth in a profession where learning happens primarily through supervised encounter with real patients rather than through classroom instruction. And because the data are being shared openly, the resource lowers the barrier to entry for smaller research teams who lack the infrastructure to mount their own multisite data collection efforts.

The project also offers a case study in responsible research conduct. The study was reviewed by the Johns Hopkins Medicine Institutional Review Board, which determined that formal ethical approval was waived because the research qualified for exemption under the U.S. Department of Health and Human Services Common Rule, with survey data recorded without identifiable personal information and posing no more than minimal risk. Informed consent was obtained from all participants, and the work was funded by the Foundation for ACPE. The authors acknowledge collaboration with Paul Galchutt, Dr. Kristin Langstraat, and Dr. George Fitchett, along with the ACPE Certified Educators who supported data collection and the students who took part.

For a field that has long relied on small, single-site studies and anecdotal accounts of transformation, the arrival of a large, validated, longitudinal, multicenter dataset marks a genuine inflection point. It gives chaplaincy educators, for the first time, the statistical power to ask whether the experiential model at the heart of their profession demonstrably builds the emotional competencies it promises, and it gives the broader psychological sciences a new window into how human beings learn to do some of the most emotionally demanding work in healthcare. As hospitals increasingly recognize spiritual care as an integral component of patient-centered medicine, evidence about how that care workforce is trained has never mattered more.

Subject of Research: A multicenter longitudinal dataset measuring emotional intelligence and counseling self-efficacy in clinical pastoral education students at U.S. healthcare training centers.

Article Title: Multicenter dataset describing emotional intelligence and counseling self-efficacy among clinical pastoral education students in healthcare settings

Article References: Szilagyi, C., & Palmer, P. K. (2026). Multicenter dataset describing emotional intelligence and counseling self-efficacy among clinical pastoral education students in healthcare settings. Discover Psychology. https://doi.org/10.1007/s44202-026-00905-2

Image Credits: AI Generated

DOI: 10.1007/s44202-026-00905-2

Keywords: emotional intelligence, counseling self-efficacy, clinical pastoral education, healthcare chaplaincy, ACPE, Schutte Self-Report Emotional Intelligence Test, Counselor Activity Self-Efficacy Scales, longitudinal dataset, pastoral psychology, experiential education, trainee competency, open data