Analysis of Medical Students’ Book Reports on Shalamov’s Kolyma Tales (1974): Would You Reveal the Truth About a Suspected Malingering Patient ?

The aim of this study was to investigate medical students’ thought processes regarding whether to reveal the truth about a suspected malingering patient by analysing their book reports on Shalamov’s Kolyma Tales (1974). Methods The participants were 47 medical students in their junior year. The book was provided a month before the classroom lecture. Students had discussions in groups of 7 and wrote book reports that included answers to 3 questions. Results Most students (39, 83.0%) answered that they had faked an illness previously, and abdominal pain (21, 53.8%) was the most frequently feigned illness. On the pre-reading questionnaire, 14 (29.8%) answered that they would reveal the truth by fair means or foul, whereas 15 (32.0%) would turn a blind eye to a malingering patient. On the post-reading questionnaire, however, 17 (36.2%) answered that they would reveal the truth, while 22 (46.8%) answered that they would turn a blind eye. It is notable that among the 18 students (38.2%) who replied that whether they would reveal the truth depended on the situation on the pre-reading questionnaire, 3 (6.3%) instead stated on the post-reading questionnaire that they would reveal the truth, while 7 (14.9%) answered that they would turn a blind eye. The remaining 8 (17.0%) did not change their mind and still replied that it depended on the situation. Conclusion It is thought that reading and discussing this story gave the students the opportunity to think about how to manage malingering patients, as portrayed in Shalamov’s Kolyma Tales (1974).