Humanistic Domains Research Articles

The 7 Elements Communication Rating Form for Teaching and Assessing Medical Communication Competency.

Medical communication skills are a critical component of clinical medicine and patient satisfaction.Communication skills are difficult to teach and evaluate, necessitating tools that are effective and efficient. This study presents and validates the 7 Elements Communication Rating Form (7E-CRF), a streamlined, dual-purpose, evidence-based medical communication checklist that functions as a teaching and assessment tool. A 14-item teaching and assessment tool is described and validated using face, concurrent, and predictive validity indices.The study was conducted with 661 medical students from the West Virginia School of Osteopathic Medicine (WVSOM).Student performance was assessed in year 1 labs, year 2 labs, and year 2 and year 3 objective structured clinical examination (OSCE).These internal indices were compared with student performance on the Humanistic Domain of the Comprehensive Osteopathic Medical Licensing Examination (COMLEX) Level 2-Performance Evaluation (PE), a licensure exam previously taken in years 3 or 4 of osteopathic medical schools. The evidence of interrater reliability and predictive validity is strong. Data from the 7E-CRF is compared to performance on the COMLEX Level 2-PE, Humanistic Domain. The 7E-CRF can identify students who are at a 10-fold increased risk of failure on the COMLEX Level 2-PE Humanistic Domain. Conclusions:The 7E-CRF integrates instruction and assessment, based on a national and international model. The simplicity, foundation in professional consensus, ease of use, and predictive efficacy make the 7E-CRF a highly valuable instrument for medical schools in teaching and evaluating competency in medical communication skills.

The Impact and Feasibility of a Student-led Program to Connect Patients and Caregivers via Synchronous Audiovisual Technology During Restricted Visitation Policies.

During the SARS-CoV-2 pandemic, hospital visitation restrictions hindered patients' access to vital social support. This study explores the impact and feasibility of a student-led program facilitating audiovisual communication between inpatient rehabilitation patients and their caregivers. The study design employed a prospective observational approach, and convenience sampling enrolled 99 participants, including 33 patients, 33 caregivers, and 33 medical students. From September 2021 to March 2022, eligible patients admitted to an inpatient rehabilitation hospital identified a caregiver and participated in a 30-minute audiovisual call organized by a medical student. Post-visit surveys via RedCap were completed by all participants and covered limitations in video calls, program benefits, comfort levels in video conferencing, and overall program ratings. The study adopted a quantitative research paradigm for data analysis. Statistical analysis utilized pairwise McNemar's and Wilcoxon's test for inter-group comparison. Patients, caregivers, and medical students all reported positive outcomes in program offerings including providing social support, decreasing feelings of isolation, and providing a feeling of connection. Patients rated the program 4.82 ± 0.47 on a Likert scale, with 97% recommending it to others, even beyond visitation restrictions. The most common diagnosis among patients was stroke (30%), highlighting the program's potential applicability across diverse patient populations. Caregivers rated the program 4.59 ± 0.87 and expressed a desire for its continuation post-restrictions (80%). Medical students (81%) recommended the program, citing benefits in reducing social isolation and gaining clinical experience. No statistical differences were observed between groups in emotional and humanistic domains. This study highlights the potential for programs to utilize technology to address social isolation in the healthcare setting. When public health restrictions occur, medical educators should consider opportunities to support and foster innovation for student-led programs. Further research should explore broader impacts on healthcare outcomes and medical education.

The Importance of Humanistic Dimension in Managing Rohingya Refugees in the Indonesian Western Province of Aceh

One of the reasons Rohingya refugees were saved from the sea in the Province of Aceh is based on humanity; nevertheless, the stakeholder management on the ground tends to ,dismiss the importance of the humanistic dimension. It includes challenges of the state in providing assistance, the limitation for resettlement, job opportunity prohibition, limited development of skills, and partnership challenges in the field. This paper addresses the practical implementation of managing refugees at the local level towards the six domains of the humanistic dimension through the Spider Web configuration. It allowed relevant stakeholders in the province to analyze their challenges, address their limitations and measure their practical action in locally managing Rohingya refugees. The result showed that the most important humanistic domain in managing refugees was a partnership with stakeholders followed by the resettlement process. At the same time, the region considered labor opportunity, not an important humanistic dimension. The paper further discussed the possibility of a partnership with non-state actors, particularly private sectors, to provide skills and training development and job opportunities for the future Rohingya self of reliance.

Examining concurrent validity between COMLEX-USA Level 2-Cognitive Evaluation and COMLEX-USA Level 2-Performance Evaluation.

The Comprehensive Osteopathic Medical Licensing Examination of the United States of America (COMLEX-USA) is a three level examination used as a pathway to licensure for students in osteopathic medical education programs. COMLEX-USA Level 2 includes a written assessment of Fundamental Clinical Sciences for Osteopathic Medical Practice (Level 2-Cognitive Evaluation [L2-CE]) delivered in a computer based format and separate performance evaluation (Level 2-Performance Evaluation [L2-PE]) administered through live encounters with standardized patients. L2-PE was designed to augment L2-CE. It is expected that the two examinations measure related yet distinct constructs. To explore the concurrent validity of L2-CE with L2-PE. First attempt test scores were obtained from the National Board of Osteopathic Medical Examiners database for 6,639 candidates who took L2-CE between June 2019 and May 2020 and matched to the students' L2-PE scores. The sample represented all colleges of osteopathic medicine and 97.5% of candidates who took L2-CE during the complete 2019-2020 test cycle. We calculated disattenuated correlations between the total score for L2-CE, the L2-CE scores for the seven competency domains (CD1 through CD7), and the L2-PE scores for the Humanistic Domain (HM) and Biomedical/Biomechanical Domain (BM). All scores were on continuous scales. Pearson correlations ranged from 0.10 to 0.88 and were all statically significant (p<0.01). L2-CE total score was most strongly correlated with CD2 (0.88) and CD3 (0.85). Pearson correlations between the L2-CE competency domain subscores ranged from 0.17 to 0.70, and correlations which included either HM or BM ranged from 0.10 to 0.34 with the strongest of those correlations being between BM and L2-CE total score (0.34) as well as between HM and BM (0.28).The largest increase between corresponding Pearson and disattenuated correlations was for pairs of scores with lower reliabilities such as CD5 and CD6, which had a Pearson correlation of 0.17 and a disattenuated correlation of 0.68. The smallest increase in correlations was observed in pairs of scores with larger reliabilities such as L2-CE total score and HM, which had a Pearson correlation of 0.23 and a disattenuated correlation of 0.28. The reliability of L2-CE was 0.87, 0.81 for HM, and 0.73 for BM. The reliabilities for the L2-CE competency domain scores ranged from 0.22 to 0.74. The small to moderate correlations between the L2-CE total score and the two L2-PE support the expectation that these examinations measure related but distinct constructs. The correlations between L2-PE and L2-CE competency domain subscores reflect the distribution of items defined by the L2-PE blueprint, providing evidence that the examinations are performing as designed. This study provides evidence supporting the validity of the blueprints for constructing COMLEX-USA Levels 2-CE and 2-PE examinations in concert with the purpose and nature of the examinations.

Adaptación de los dominios científicos, tecnológicos y humanísticos en la academia a causa del COVID-19

Los dominios universitarios son sistemas complejos de conocimientos tecnológicos, humanísticos y científicos que se integran en las instituciones de educación superior a sus saberes, cosmovisiones, a sus prácticas culturales y sociales. El objetivo del estudio es conocer los dominios científicos, tecnológicos y humanísticos de las instituciones de educación superior del Ecuador. La investigación cuenta con una metodología de enfoque cualitativo de tipo descriptivo. Una de las conclusiones es que estos aportan como ejes a la planificación estratégica institucional, y ayudan a los procesos sustantivos como es la docencia, investigación y vinculación de las instituciones hacia los diversos problemas que se pueden presentar. La pandemia de COVID-19 ha obligado a la mayoría de las instituciones educativas a la modalidad obligatoria de clases en línea. Para realizar el ajuste, las instituciones han optado por el uso de herramientas tecnológicas, donde el principal involucrado es el educador, por este motivo, los dominios se han involucrado de forma distinta.

A nova estética de R. Musil e os “estados de agregação” da alma e do intelecto

Em 1910, quatro anos depois de publicar O Jovem Törless, Musil terminou, enfim, sua difícil segunda obra (as novelas Uniões). É um período de incertezas, primeiro porque Musil duvida que suas novelas teriam o sucesso do primeiro romance, segundo, porque se preocupa com sua carreira de escritor. Nesse momento de crise ainda sorrateira, ele começa a anotar ideias sobre as relações da moral com a arte. É um assunto antigo que acompanha a reflexão estética desde Platão e Aristóteles, mas ele recebe na reflexão de Musil um novo horizonte que conecta a moral e a estética com o conhecimento científico.

Relationship of Clinical Skills Performance in Medical School With COMLEX-USA Level 2-Performance Evaluation.

Osteopathic medical students are required to pass the Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) Levels 1- and 2-Cognitive Evaluation and COMLEX-USA Level 2-Performance Evaluation (PE) to graduate. Predictors of COMLEX-USA cognitive exam performance are well established, but relatively few studies have explored factors associated with performance on the Level 2-PE. To evaluate the relationship between school-based clinical competency assessments (written, simulation, and workplace evaluations) and Level 2-PE performance to ensure that these assessment efforts are effective and grounded in evidence to support student readiness. School-based performance measures for 451 first-time takers of COMLEX-USA Level 2-PE were analyzed. A series of Mann-Whitney analyses were applied to compare 3 types of clinical performance assessments against COMLEX-USA Level 2-PE pass-fail performance: (1) internal objective structured clinical examinations (OSCE; average discipline-specific OSCE score and a comprehensive OSCE); (2) national examination performance (average clinical subject Comprehensive Osteopathic Medical Achievement Test, or COMAT, scores and Comprehensive Osteopathic Medical Self-Assessment Examination, or COMSAE, Phase 2 scores); and (3) a workplace-based clinical evaluation by preceptors. Students who passed the Level 2-PE had a significantly higher average discipline-specific OSCE score, COMSAE Phase 2 performance score, average COMAT score, and individual subject COMAT scores in all subjects except Psychiatry. Students who passed the Level 2-PE humanistic domain also had significantly higher scores in the communication skill component of the school's comprehensive OSCE. Similarly, students who passed the Level 2-PE biomedical domain had significantly higher scores in the data gathering and subjective, objective, assessment, and plan documentation scores on the internal OSCE. The size of these differences (η2) was relatively small. Student performance on the competency-based preceptor evaluation showed no significant relationship with pass-fail performance on the Level 2-PE. High-stakes OSCEs aligned with the level 2-PE blueprint are effective predictors of performance and are an important way to support student readiness for the Level 2-PE. Other assessments, such as subject-based COMATs and COMSAE Phase 2, add value to school-based assessments over workplace-based assessments.

THE ESPISTEMOLOGICAL HORIZON OF NEUROSCIENCE IN HIGHER EDUCATION. EXPERIENCES OF THE STATE UNIVERSITY OF BOLIVAR

One of the problems presented by Higher Education Institutions is the lack of relevance to the problems of social, productive and cultural environments and contexts, an expression of fragmented, isolated and decontextualized management. The Academic Regime Regulation assumes the challenge of contributing to overcoming this problem, generating a proposal based on the framework of relevance proposed in article 107 of the Organic Law of Higher Education, LOES, and which is a planning based on the Called scientific, technological and humanistic domains of the Ecuadorian HEI. (Larrea, 2014) The relationship between the scientific advances in neurosciences and the processes of formation in the new millennium, due to the need to deepen the understanding of the brain and its functions, the relationship between the processes of formation, learning, personality and education are vital in As to the scientific value of neuroscientific knowledge, such as those related to emotions and cognitive processes in the stages of human development. The essence of this work raises the need to highlight the implications of neurosciences and education, in terms of training processes, precision of educational quality, professional training and future education.

Depth and Width: Culturally Sensitive Narrative Inquiry

This paper processes the choice of narrative inquiry and analysis methodologies to conduct research and accomplish optimal inquiry value, especially in the humanistic research domain. It will discuss Narrative Inquiry in context and how this can comprise both depth and width in research, attaining not merely relevant but also rigorous quality. The paper will refer particularly to the author’s doctoral research as a source of illustration to narrative inquiry embedded in a contextual framework.

Experiments in Adapting to Need: Pragmatism as Orienting Perspective in Clinical Social Work

In this article I show how conceptions of pragmatism set forth in American philosophy serve as orienting perspectives for critical thinking and decision making in social work practice, providing frames of reference in efforts to engage divergent theories and methods in light of the concrete particulars of the clinical situation. I outline fundamental features of pragmatism, drawing on the seminal contributions of William James and John Dewey, and explore the ways in which organizing principles facilitate efforts to make use of ideas across multiple explanatory systems, bridging scientific and humanistic domains of understanding. I present a case report and consider the ways pragmatic approaches focus our attention on essential concerns in the clinical situation. Pragmatic formulations reaffirm framing perspectives and core values in the American social work tradition, emphasizing the importance of multiple explanatory tools; the practical outcomes of ideas in a given situation; the crucial role of collaborative interaction and experiential learning in understanding, and the focus on the individual and the human particularity of the helping process that ultimately defies categorization.

Relationships between high-stakes clinical skills exam scores and program director global competency ratings of first-year pediatric residents

BackgroundResponding to mandates from the Accreditation Council for Graduate Medical Education (ACGME) and American Osteopathic Association (AOA), residency programs have developed competency-based assessment tools. One such tool is the American College of Osteopathic Pediatricians (ACOP) program directors’ annual report. High-stakes clinical skills licensing examinations, such as the Comprehensive Osteopathic Medical Licensing Examination Level 2-Performance Evaluation (COMLEX-USA Level 2-PE), also assess competency in several clinical domains.ObjectiveThe purpose of this study is to investigate the relationships between program director competency ratings of first-year osteopathic residents in pediatrics and COMLEX-USA Level 2-PE scores from 2005 to 2009.MethodsThe sample included all 94 pediatric first-year residents who took COMLEX-USA Level 2-PE and whose training was reviewed by the ACOP for approval of training between 2005 and 2009. Program director competency ratings and COMLEX-USA Level 2-PE scores (domain and component) were merged and analyzed for relationships.ResultsBiomedical/biomechanical domain scores were positively correlated with overall program director competency ratings. Humanistic domain scores were not significantly correlated with overall program director competency ratings, but did show moderate correlation with ratings for interpersonal and communication skills. The six ACGME or seven AOA competencies assessed empirically by the ACOP program directors’ annual report could not be recovered by principal component analysis; instead, three factors were identified, accounting for 86% of the variance between competency ratings.DiscussionA few significant correlations were noted between COMLEX-USA Level 2-PE scores and program director competency ratings. Exploring relationships between different clinical skills assessments is inherently difficult because of the heterogeneity of tools used and overlap of constructs within the AOA and ACGME core competencies.

Humanities in Gross Anatomy Project: A novel humanistic learning tool at Des Moines University

Gross anatomy affords physical therapy students an opportunity to discover human morphology by intimately studying the dead. Moreover, it also exposes future physical therapists to the humanistic aspects of the profession. In 2007, anatomy faculty decided to socialize students to the humanities with a new course requirement: Humanities in Gross Anatomy Project (HuGA) Project. At the end of the course, students, either individually or as a group, submitted a project that described how they had been personally touched by the donor's gift and how the gift contributed to their professional growth and education. The submission could be in the form of a narrative, poem, song, video, etc. All students met the three grading criteria that were established; thus taking the first step in socializing themselves to the humanistic domain of their professional education. In summary, the HuGA project is a novel educational tool that formally provided physical therapy students with humanistic learning opportunities in a gross anatomy course and appeared to facilitate reflective learning. The utilization of reflection as it relates to clinical decision making and patient interaction is critical for physical therapy practice.

Global overall rating for assessing clinical competence: what does it really show?

Single-item global overall ratings are often used as a method of assessing learners' clinical competence at the end of a clerkship. The purpose of this study was to identify which aspects of clinical competence are assessed through these ratings. At the end of a clinical clerkship in primary health units, 106 Year 4 students are routinely assessed by faculty staff of three disciplines (obstetrics and gynaecology, internal medicine, paediatrics), using a single global numeric rating (on a scale of 0-10). Faculty scores across disciplines for each learner are averaged to produce a global overall rating (GOR). In this study, the same students were assessed by the same faculty staff 2 weeks later using a newly developed, more detailed form composed of 13 domains, of which six related to technical skills and seven to humanistic skills, each scored on a scale of 0-10. Scores for each domain across disciplines were averaged as global itemised ratings (GIRs). Statistical analysis included Cronbach's alpha coefficient and Pearson's correlation coefficients. Statistical significance was set at P < or = 0.05. The internal consistency of GIR items was high (alpha coefficient = 0.935). Global overall rating scores were higher than most technical domains of GIRs and lower than the humanistic domains of GIRs. The highest significant correlations were found between the GOR and the technical domains of the GIR. When faculty staff attribute a global single-item overall rating to a student's clinical competence, they tend to focus more on technical skills.

Os diferentes olhares na avaliação de alunos em estágio clínico supervisionado

To compare medical students' global itemized ratings (GIR) and real-case structured clinical assessment (RC-SCA), generated by faculty members from three different specialties (Gynecology-O&G, Internal Medicine-IM, Pediatrics-Ped). 106 Y4 learners were assessed by one faculty member from each specialty, who filled in GIR, consisting of 6 technical domains (mean score GIRt) and 7 humanistic domains (mean score GIRh), on a 0-10 scale, and resultant RC-SCA, from direct attendance observation. Statistical analyses used Cronbach coefficient, Friedman and Wilcoxon paired tests, Pearson and Spearman correlation coefficients, Euclidean distances. Significance level=5%. High internal consistency was observed in the three GIR (> 0.92). Ratings were negatively skewed. Ped scores were significantly lower than O&G and IM (median differences between 0.50 and 0.67), with low correlations between them (-0.02<R<0.48). the domains that had greater impact on the reliability of GIR were: clinical judgment (O&G and Ped), problem-solving (IM), and self-reflective skills (Ped). O&G and Ped scores showed the smallest agreement; GIRt Ped scores showed the greatest disagreement with all the other scores. The specialties have different views on how to evaluate students' skills, inspite of using similar instruments, which can be a reflection of their 'culture'. the challenge remains to minimize these differences through faculty development activities.

“The great convergence”: visionary illusion or megatrend?

Megatrends are historical nexuses which gather and focus both obvious and subtle sub‐trends as a contribution to the history of future ideas. A substantive candidate of the twenty‐first century is “convergence”. That pursuit of “the unity of all knowledge” involves the integration, synthesis and confluence of different and often opposing intellectual concepts; and of seminal research developments and academic disciplines. Three major components and sets of authors are identified and examined: the technology of theology; the increasing interconnectedness of social, political and economic forces; and the interfacing of scientific, humanistic and spiritual domains.

"Giving up maleness": Abraham Maslow, masculinity, and the boundaries of psychology.

Ian A . M . N icholsonS t. T hom as U niversityP sychology's boundaries consist of a netw ork of m ethods, categories, and institu-tional practices. S trategically important , these m arkers distinguis h the field fromcom m on sense and popular psychology . A lthough psychologists have attem pted todefine them selves in term s of natural science, gender considerations have also beenw oven into the fabric of the field. T his article exam ines psychology's genderidentity throug h a consideration of the career of A braham M aslow . T rained as anexperim entalist, M aslow is widel y know n for his attem pt to expand the discipline'sboundaries into hum anistic dom ains. H e w as convinced that psychology had be-com e too m asculine for its ow n good, yet he struggled to find a w ay to softenpsychology w ithout com pletely underm ining its rigorous foundation. H is w orkhighlights the connection betw een m asculinity and science and the difficulty ofredraw ing psychology's boundaries w ithout underm ining its credibility.In recent years, historians of psychology have becom e increasingly sensitiveto the w ays in whic h the discipline has been shaped by com petition from rivalform s of psychological know -how . L ike all academ ic disciplines, psychology hasm ade a series of claim s to a particular dom ain of expertise and , like other fields,its claim s have not gone uncontested. C om m on sense, popular psychology,spiritualism , and other academ ic fields have encroached on the discipline's claim sand threatened its professional authority, financial support, and institutionalrecognition (C oon, 1992; G ieryn, 1983; M oraw ski & H ornstein, 1991). T he fieldhas responded to these threats by constructing an intellectual and professionalboundary using the m ethods and language of natural science (B urnham , 1987;R om anyshyn, 1971; T oulm in & L eary, 1985). In so doing, psychologists haveendeavored to position them selves as objective observers of psychological naturew hile portraying their rivals as self-interested am ateurs m ired in custom andm ysticism .A lthough not entirely unsuccessful, the use of the idiom of natural science asa boundary has created difficulties for a discipline com m itted to exam ining thepsychological com plexities of hum an nature (A sh, 1992). T he pursuit of scientificobjectivity has often been done at the expense of hum an interest, and in the pastthe field has sacrificed a great deal of cultural ground to psychoanalysis, popular