Abstract
For nearly four decades, researchers have explored the integration of arts and humanities content into health professions education (HPE). However, enduring controversies regarding the purpose, efficacy, and implementation of humanities initiatives suggest that the timing and context of trainees’ exposure to such content is a key, but seldom considered, factor. To better understand the affordances of introducing humanities-based health curriculum prior to the HPE admissions gateway, we conducted a qualitative instrumental case study with participants from Canada’s first Health Humanities baccalaureate program. Fully anonymized transcripts from semi-structured interviews (n = 11) and focus groups (n = 14) underwent an open-coding procedure for thematic narrative analysis to reveal three major temporal domains of described experience (i.e., prior to, during, and following their participation in a 12-week semester-long “Introduction to Health Humanities” course). Our findings demonstrate that perceptions of arts- and humanities content in health education are generated well in advance of HPE admission. Among other findings, we define a new concept—epistemological multicompetence—to describe participants’ emergent capability to toggle between (and advocate for the role of) multiple disciplines, arts and humanities particularly, in health-related teaching and learning at the pre-professional level. Improved coordination of baccalaureate and HPE curricula may therefore enhance the development of capabilities associated with arts and humanities, including: epistemological multicompetence, aesthetic sensibility, and other sought-after qualities in HPE candidates. In conclusion, attending to the pre-professional admissions gateway presents a new, capabilities-driven approach to enhancing both the implementation and critical understanding of arts and humanities’ purpose, role, and effects across the “life course” of health professions education.
Highlights
For nearly four decades, researchers have investigated the integration of arts and humanities content into undergraduate, graduate, post-graduate, and continuing medical and health professions education (HPE) more broadly
Our findings show that the role and significance of the arts and humanities in health are aligned with the realization of central human capabilities; advocating for the role of the arts and humanities with regard to this principle, rather than the struggling, and not altogether convincing terms of “empathy training” or “compassion,” fundamentally reframes the arts as a practical, secular, and democratic goal for HPE and the baccalaureate programs it draws from
Teaching and learning Health Humanities at the baccalaureate level is a critical moment in professional development, because attitudes towards arts and humanities are more malleable and subject to external conditions that may enhance—or diminish—perceptions of their value
Summary
Researchers have investigated the integration of arts and humanities content into undergraduate, graduate, post-graduate, and continuing medical and health professions education (HPE) more broadly. Associated with “soft” skills relevant to clinical practice, arts and humanities disciplines (which may involve history, philosophy, literary studies, and fine arts, to name a few; for brevity, we will refer to “humanities” throughout this article) can be generally described as prioritizing aesthetics, social experiences, and interpretive methods over the quantitative modes of investigation more typical to empirically-oriented STEM subjects (such as biology, chemistry, and physics) (Becher and Trowler 2001; Marra and Palmer 2008) Despite these promising—and frequently idealized—claims, there is still no settled consensus regarding the purpose, role, efficacy, or optimal implementation of arts- and humanities-based content in the HPE context (Williams 2019; McFarland et al 2018). “Rather than beg off the need to measure these teaching efforts,” Charon (2010) concludes, “teachers in the humanities can embrace the demanding task of delineating how medicine changes when fortified by narrative competence and humanities-derived skills.” (p. 935) And so the debate continues, as the studies, commentaries, and publications proliferate: how can practitioners better articulate how humanitiesbased clinical education mitigates critical issues at the individual and institutional level of health care—wicked problems that include physician burnout prevention and management, professionalism, and supporting patient-centered health care? (Gillis 2008; Shapiro et al 2009; Doukas et al 2012, 2015; Jones et al 2017; Gillies 2018; Mangione et al 2018)
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