Medical Humanities Education Research Articles

Mapping the Landscape of Medical Humanities Education: Trends and Insights.

Medical humanities education is an integral component of medical education. However, the current landscape of research on medical humanities education remains incomplete. The purpose of this study is to identify the trends in research on medical humanities education and provide a global overview of the field by analysing various aspects such as sources, authors, literature, and keywords. The aim is to offer insights and recommendations for the future development of medical humanities education. This research utilised bibliometric tools such as VOSviewer, CiteSpace, SciMAT, and the R software package biblioshiny to analyse literature sources, authors, documents, and keywords. This systematic review methodology allowed for a comprehensive examination of the field. Additionally, the study investigated international collaborations and scientific outputs, shedding light on the global landscape of medical humanities education research. The study included a total of 403 articles published between January 1980 and December 2023 from the Web of Science (WoS) database. The field of medical humanities education experienced an annual growth rate of 9.08% in literature output from 1980 to 2023, indicating its increasing prominence and scholarly interest over time. The research topics within this field have evolved in response to societal and medical developments. Core research themes that have consistently garnered attention from researchers include empathy, ethics, and narrative medicine, reflecting their significance and ongoing relevance in the field. These shifts in research hotspots signify the dynamic nature of the field, adapting to evolving contexts and emerging research domains. By embracing cross-cultural perspectives and fostering interdisciplinary collaborations, stakeholders in medical humanities education can collectively enrich the field, promote inclusivity, and enhance the overall educational experience for healthcare professionals.

The Potential of Artificial Intelligence Tools for Reducing Uncertainty in Medicine and Directions for Medical Education.

In the field of medicine, uncertainty is inherent. Physicians are asked to make decisions on a daily basis without complete certainty, whether it is in understanding the patient's problem, performing the physical examination, interpreting the findings of diagnostic tests, or proposing a management plan. The reasons for this uncertainty are widespread, including the lack of knowledge about the patient, individual physician limitations, and the limited predictive power of objective diagnostic tools. This uncertainty poses significant problems in providing competent patient care. Research efforts and teaching are attempts to reduce uncertainty that have now become inherent to medicine. Despite this, uncertainty is rampant. Artificial intelligence (AI) tools, which are being rapidly developed and integrated into practice, may change the way we navigate uncertainty. In their strongest forms, AI tools may have the ability to improve data collection on diseases, patient beliefs, values, and preferences, thereby allowing more time for physician-patient communication. By using methods not previously considered, these tools hold the potential to reduce the uncertainty in medicine, such as those arising due to the lack of clinical information and provider skill and bias. Despite this possibility, there has been considerable resistance to the implementation of AI tools in medical practice. In this viewpoint article, we discuss the impact of AI on medical uncertainty and discuss practical approaches to teaching the use of AI tools in medical schools and residency training programs, including AI ethics, real-world skills, and technological aptitude.

Gender and Sexuality Awareness in Medical Education and Practice: Mixed Methods Study.

The integration of gender and sexuality awareness in health care is increasingly recognized as vital for patient outcomes. Despite this, there is a notable lack of comprehensive data on the current state of physicians' training and perceptions in these areas, leading to a gap in targeted educational interventions and optimal health care delivery. The study's aim was to explore the experiences and perceptions of attending and resident physicians regarding the inclusion of gender and sexuality content in medical school curricula and professional practice in Israel. This cross-sectional survey targeted a diverse group of physicians across various specializations and experience levels. Distributed through Israeli Medical Associations and professional networks, it included sections on experiences with gender and sexuality content, perceptions of knowledge, the impact of medical school curricula on professional capabilities, and views on integrating gender medicine in medical education. Descriptive and correlational analyses, along with gender-based and medical status-based comparisons, were used, complemented, and enhanced by qualitative analysis of participants' replies. The survey, encompassing 189 respondents, revealed low-to-moderate exposure to gender and sexuality content in medical school curricula, with a similar perception of preparedness. A need for more comprehensive training was widely recognized. The majority valued training in these areas for enhancing professional capabilities, identifying 10 essential gender-related knowledge areas. The preference for integrating gender medicine throughout medical education was significant. Gender-based analysis indicated variations in exposure and perceptions. The study highlights a crucial need for the inclusion of gender and sexuality awareness in medical education and practice. It suggests the necessity for curriculum development, targeted training programs, policy advocacy, mentorship initiatives, and research to evaluate the effectiveness of these interventions. The findings serve as a foundation for future directions in medical education, aiming for a more inclusive, aware, and prepared medical workforce.

Bearing witness: Medical education and reflecting on the Holocaust then and now.

Despite advocacy from the Association of American Medical Colleges (AAMC) and The Lancet Commission on medicine, Nazism, and the Holocaust, Holocaust education is lacking in medical education. To address this gap, students at Geisinger Commonwealth School of Medicine (GCSOM) viewed an Association of American Medical College (AAMC) webinar about medicine during the Holocaust as part of the required curriculum for first year medical students introduced in 2022. As part of their doctoring course, Physician and Patient Centered Care (PPCC), students viewed the AAMC webinar "The legacy of the role of medicine during the Holocaust and its contemporary relevance" and participated in two structured reflections: a written reflection on how webinar topics inform students' professional development and a verbal reflection on learning from the Holocaust to develop a sense of moral courage, advocacy, and activism in medicine. Researchers conducted qualitative analysis of written reflections and analyzed session surveys to determine key themes and impact of the session. Of the 108 enrolled in PPCC, 59 (54.6%) completed a post session Likert scale survey assessing the impact of the webinar on their personal and professional development. As an average, respondents moderately agreed that the webinar impacted their personal and professional development, with 91% slightly, moderately, or strongly agreeing. Additionally, thematic analysis of required written reflections indicated a majority of students (62.5%) identified the need for additional medical humanities education about the Holocaust and its relevance to medicine. Holocaust education encourages medical students to bear witness to past medical atrocities and critically assess the profession and their personal-professional growth. Continued structured integration of the Holocaust in medical education supports critical self-reflection and the development of morally courageous physicians who endorse and practice social accountability in medicine.

When Play Reveals the Ache: Introducing Co-constructive Patient Simulation for Narrative Practitioners in Medical Education.

Despite the ubiquity of healthcare simulation and the humanities in medical education, the two domains of learning remain unintegrated. The stories suffused within healthcare simulation have thus remained unshaped by the developments of narrative medicine and the health humanities. Healthcare simulation, in turn, has yet to utilize concepts like co-construction and narrative competence to enrich learners' understanding of patient experience alongside their clinical competencies. To create a conceptual bridge between these two fields (including narrative-based inquiry more broadly), we redescribe narrative competence via Ronald Heifetz's distinction of "technical" and "adaptive" challenges outlined in his adaptive leadership model. Heifetz, we argue, enriches learners' self-understanding of the unique demands of cultivating narrative competence, which can be both elucidated on the page and tested within the charged yet supportive simulation environment. We introduce Co-constructive Patient Simulation (CCPS) to demonstrate how working with simulated patients can support narrative work by drawing on the clinical vicissitudes of learners in the formulation and enactment of case studies. The three movements of CCPS-resensing, retelling, and retooling-told through learner experiences, describe the affinities and divergences between narrative medicine's sequence of attention, representation, and affiliation; Montello's three forms of narrative competence (departure, performance, change), and Heifetz's three steps (observe, interpret, and intervene) of adaptive leadership.

Development and implementation of the Capstone Program on integrating career exploration and medical humanities at a medical school in Korea.

This study aimed to implement and evaluate the outcomes, perceptions, and satisfaction of the Capstone Program developed at the Catholic University of Korea, which integrates career exploration and medical humanities. This study was conducted with fourth-year medical students from 2017 to 2019. First, the study analyzed the trends in the results of Capstone Projects conducted by students as part of their career exploration, where they independently explored areas of interest and selected topics. Second, it qualitatively analyzed the content of individual reports in which students reflected on their experiences from a "medical humanities perspective" through the Capstone Program. Third, it examined students' perceptions and satisfaction with the Capstone Program. The analysis revealed that students chose research topics from a wide range of fields, including basic medicine, clinical medicine, global healthcare, and integrated healthcare systems and innovation. The students reported positive perceptions of their career exploration and research experiences through the Capstone Program, particularly valuing sessions like "Meetings with Seniors" within the conference framework. Students indicated that the Capstone Program enhanced their ability to think introspectively from a humanities perspective, deepening their understanding of their roles and responsibilities as medical professionals. The Capstone Program provides a significant opportunity for medical students to explore their career paths and engage in introspective reflection from the viewpoint of medical humanities and social sciences. Thus, the integration of programs like capstone into the broader medical curriculum, focusing on career guidance and the reinforcement of medical humanities education, is imperative.

“To be culturally competent is to be willing to learn about the differences and to acknowledge them”- a qualitative study on Polish medical students’ attitudes towards cross-cultural competence development

BackgroundChanges in Polish demographic data with a growing number of culturally and linguistically diverse patients stipulate new directions in medical education to prepare future physicians to work effectively across cultures. However, little is known about Polish medical students’ willingness to gain cross-cultural knowledge and skills, desire to get engaged in interactions with patients from diverse cultural backgrounds, expectations and needs concerning cross-cultural training as well as challenges they face in the path to cultural competence.MethodsTherefore, in this study, we conducted and thematically analysed fifteen semi-structured interviews with medical students to broaden our understanding of medical students’ perception of cross-cultural competence enhancement.ResultsThe conducted thematic analysis allowed for the development of four themes, which showed that Polish medical students perceived skills and knowledge necessary to facilitate culturally congruent care as indispensable to form quality patient-doctor relations, believed that lack of cultural sensitivity may lead to dangerous stereotype formation and insufficient competence may be the source of stress and anxiety resulting in confusion and lack of confidence. Finally, numerous suggestions have been made by participants on how to improve their cross-cultural competence. Students emphasized, however, the role of medical education with active and experiential learning methods, including simulation-based training, in the process of equipping them with the knowledge and skills necessary to provide best quality care to culturally diverse patients.ConclusionsOur analysis indicated that Polish medical students seem to hold positive attitudes towards cultural competence development and view it as an important component of physician professionalism.

Arts and Humanities in Medical Education: Current and Future

No abstract available

The humanization of medical education: publications review

The humanization of medical education is targeted at integration of humanitarian values and approaches into system of education of medical personnel to improve their professional and personal training. This process includes education in medical ethics, development of communication skills, stress management and implementation of humanitarian disciplines into the curriculum. The humanization contributes into formation of empathy, responsibility and professionalism in future physicians that helps to better understand and consider psychological, social and emotional needs of patients. The problems of including humanitarian sciences into medical education are associated with lack of systematic approach, adequate curricula and qualified lecturers. To optimize process, it is necessary to focus on education of ideals and beliefs, development of integrated curricula and enhancement of humanitarian component of education.

Exploring medical humanities from heterogeneous focus groups: A thematic analysis.

Medical humanities has evolved to encompass a multidisciplinary approach, integrating humanities, social sciences, and arts into medical education and practice. Despite its flourishing development, the definition of medical humanities still requires refinement to be inclusive of various cultures and regions. This study aimed to explore perceptions among students, physicians, and nurses, with a focus on the definition, learning, and implementation of medical humanities. We conducted four heterogeneous focus groups, comprising 4th-year and 6th-year medical students, physicians (including three medical humanities educators), and nurses. Data collection utilized semi-structured guiding questions, followed by thematic analysis. The transcripts were manually analyzed in their original Mandarin, and participant names were anonymized to ensure that the authors remained unaware of the participants' identities throughout the study. The analysis identified three themes and 16 subthemes. Theme 1, "Medical Humanities Properties," included four subthemes: variety, evolvement, clinical relevancy, and the value of humaneness. Theme 2, "Medical Humanities Contents," comprised seven subthemes: self-cultivation, communication, empathy, cultural competence, medical ethics and law, embodiment, and one subtheme open for interpretation in varying circumstances. Theme 3, "Medical Humanities Cultivation," included five subthemes: personal growth, curriculum, multimedia, clinical experience, and metacognition. Our study introduces a three-layered framework of medical humanities, emphasizing the field's dynamic nature and the critical role of experiential learning in developing key competencies such as empathy, awareness, and communication. This framework incorporates the concept of "self-cultivation" from Eastern philosophy, accentuating the significance of well-being for health-care professionals. The research not only enriches medical humanities education and practice by incorporating Eastern perspectives but also deepens the overall understanding of humanity in health care.

An evaluation of the West of Scotland in-programme Chief Resident role

BackgroundPostgraduate leadership education is an evolving field. Locally we have an established ‘Chief Residency’ programme where centres have two to four senior trainees completing leadership duties alongside clinical workload, supported by local directors of medical education. This is twinned with a 4-day central training programme and peer-support network. MethodsTo assess perspectives of the CR role, we adopted a qualitative case-study design using an electronic questionnaire delivered to previous chief residents between 2020 and 2023. Results were analysed using thematic analysis. ResultsTrainees valued involvement within quality improvement and trainee support, demonstrating successful multi-departmental projects. Leadership education was viewed ubiquitously positively but participants felt further work is needed to address role legitimacy locally. A proposed solution was junior doctor leadership teams to address workload and emotional challenges. ConclusionThis model provides further evidence of the value in investing in trainee leadership positions, demonstrating organisational impact. Future work will research hospital peer leadership teams.

Investigation of clinical medicine undergraduates’ recognition of narrative medicine

BackgroundNarrative Medicine (NM), a contemporary medical concept proposed in the 21st century, emphasizes the use of narrative as a literary form in medicine. This study aims to explore the understanding about NM and willingness to learn NM among medical students in our hospital.MethodsA questionnaire survey was conducted among 130 students at Xiangya Medical College of Central South University.ResultsThe findings revealed that a small percentage of students (3.1%) were familiar with narrative medicine and its training methods. Knowledge about the treatment skills (77.7%) and core content (55.4%) of narrative medicine was limited among the students. Despite this, a majority (63.1%) expressed a lack of interest in further understanding and learning about narrative medicine. Surprisingly, the survey indicated that students possessed a high level of narrative literacy, even without formal training in narrative medicine. Additionally, over half of the surveyed students (61.5%) believed that narrative medicine could benefit their clinical practice.ConclusionsThis study serves as a preliminary basis for the future development of narrative medicine education in China. It highlights the need to prioritize medical humanities education and provide medical students with more opportunities to access information on narrative medicine. By doing so, we can strive to enhance the visibility and promote the integration of narrative medicine into medical humanities education in China.

Medical students’ perceptions of integrating social media into a narrative medicine programme for 5th-year clerkship in Taiwan: a descriptive qualitative study

BackgroundThe growing demands in integrating digital pedagogies in learning (e.g., social media) contribute to disrupting many fields, including the medical humanities education. However, the strengths and barriers behind social media and medical humanities context are blurred and contradictive. We examined the perceptions of integrating social media – Facebook – into a narrative medicine (NM) programme for 5th -year clerkship in Taiwan.MethodsWe used purposive sampling to recruit participants. Sixteen medical students (Female/Male: 7/9) participated in four group interviews. Semi-structured focus group interviews were conducted to explore students’ perceptions and experiences of the social media integrated into the NM programme. We analysed the data using a descriptive thematic analysis with a team-based approach. Data were managed and coded using ATLAS.ti version 9.0.ResultsWe identified six main themes: (1) Positive experiences of social media integration; (2) Negative experiences of social media integration; (3) Barriers on writing and sharing NM stories in social media; (4) Barriers on reading NM stories in social media; (5) Barriers on reacting contents in social media; (6) Suggestions for future improvement.ConclusionsThe study revealed the strengths and barriers from medical students’ perceptions, when integrating social media into a NM programme. It is important to match students’ experiences, barriers, and perceptions towards learning. Understanding participants’ suggestions for future improvement are also crucial. With this knowledge, we might better develop the social media integration systems that achieve our desired outcomes based on the medical humanities education curricula.

Current Status and Improvement Strategies for Medical Humanities Education in Medical Schools

With the increasing demand for humanistic qualities in the healthcare industry, the importance of medical humanities education in cultivating high-quality medical talents is continuously growing. Medical humanities education not only involves the study of medical knowledge but more importantly, focuses on cultivating students' compassion, ethical perspectives, communication skills, and sense of social responsibility. However, there are some challenges faced by medical schools in implementing humanities education, such as insufficient educational resources, unreasonable course settings, and a lack of effective practical teaching. In view of this, this paper aims to analyze the current status of medical humanities education and propose improvement strategies based on this analysis, in order to promote the development of medical humanities education and better meet the comprehensive quality requirements of medical talents demanded by society.

Development of a Medical Humanities Course Based on Design Thinking and Medical Students’ Perceptions

Amid the increasing interest in medical humanities education, this study developed a medical humanities course that utilized design thinking to foster creative thinking, problem-solving, and collaboration skills that pre-medical students should possess. The course’s efficacy was assessed by evaluating improvements in core design thinking skills. The present study was conducted among 83 first-year medical students after planning and implementing a design thinking course. The reflection journals written by students along the course of the class were examined using the template analysis technique to evaluate the effectiveness of the class. The study’s primary findings showed the successful development of step-by-step medical humanities education content utilizing design thinking and its practical implementation in a class. Moreover, the course improved students’ core design thinking skills effectively, and in a balanced way. These results illustrate the effective application of design thinking in medical school through a medical humanities course. These findings indicate that a medical humanities course can help medical students showcase their abilities to collaborate and solve problems in the real world. This paper suggests the need for further research to develop a curriculum that integrates design thinking and investigate the relationship between medical students’ core competencies and design thinking-based courses.

Patient-physician interaction education in Korea: a systematic review.

Patient-physician interaction (PPI) is an important area in medical education, but in-depth discussions on the content of the outcome of patient-doctor education are rare. Therefore, in this study, we will systematically analyze the research on PPI education in Korea. In this study, papers searched with keywords related to PPI education from Korea's academic journal service were targeted according to a systematic literature analysis method. The scope of the study was to include papers published in academic journals that are candidates for Korea Citation Index registration, excluding dissertations, research reports, posters, conference presentations, books, and internet materials. The content included papers targeting medical education and medical school students was set as the range. As a result of the analysis, although communication between PPI has many positive effects in the PPI in medical education at medical schools, obstacles do occur, and various ways to overcome them were suggested. Therefore, although medical interview training between patients and doctors in medical schools is necessary, it was analyzed as being based on overseas research or lacking in specific content. The core of PPI education appears to be medical interviews, and it seems necessary to discuss whether empathy or patient-centered medical care are appropriate as the main principles of PPI education in Korea. Therefore, education on the patient-doctor relationship is an important element in medical humanities and medical humanities education, and it is expected that research and education on this will progress more actively.

Program director longevity in emergency medicine residencies: A 40-year analysis.

We sought to assess trends in emergency medicine residency program director (PD) length of service over the past 40 years and evaluate relationships between duration of service and important factors such as PD start year, geographic region, and year of program initial accreditation. We retrospectively analyzed program data from the American Medical Association Graduate Medical Education Directory and Emergency Medicine Residents' Association Match database. We calculated descriptive statistics and used linear regression to assess the impact of PD start year, region, and year of program initial accreditation on PD duration of service. We gathered data on 783 unique PDs between 1983 and 2023. The overall mean ± SD PD duration of service was 6.19 ± 4.72 years (range 1-29 years). The mean duration of service by decade of start date was 6.49 years in the 1980s, 7.39 years in the 1990s, 5.92 years in the 2000s, 4.08 years in the 2010s, and 2 years in the 2020s. Both PD start year (p = 0.002) and program initial accreditation year (p = 0.001) significantly predicted duration of PD service. Region did not significantly predict duration of PD service (p = 0.225). Duration of service as a PD is decreasing in recent decades. Both PD start year and year of initial program accreditation significantly predict duration of service as PD. Future research must be done to better understand this phenomenon and uncover strategies to promote PD longevity.

Analysis of the instrumental problem of doctor-patient relationship in doctor-patient communication

Doctor-patient communication requires mutual trust, mutual respect and mutual participation of both doctors and patients. However, the current consumer society makes the doctor-patient relationship a humanized service based on exchange, and the doctor-patient relationship becomes the medium of the consumption process. Technical medicine makes the doctor-patient relationship ignore the narrative of emotion and human nature, leading to the instrumentalization of the doctor-patient relationship. To realize the doctor-patient relationship by the tool-oriented tendency, we need to transform the medical staff service concept, strengthen medical humanities education, enhance the medical students’ belief of heal the wounded and rescue the dying, guard the sacred feeling of life and the sense of mission of protecting human health.

Exploring the Possibility of Death Education through Literature from the Perspective of Medical Humanities

The purpose of this study is to examine the possibility of medical humanities from the perspective of death literature and to explore educational possibilities. In this study, the possibility of medical humanities from the perspective of death literature was considered by dividing it into the effect of death education in poetry, the effect of death education in novels, and the effect of death education in essays. As a result, the possibility of death education using poetry seems to be key to triggering the imagination related to the experiences of students through the medium of death poetry implied in symbolic language. The possibility of death education using novels seems to be meaningful in indirectly experiencing life and death by using the characteristics of transitional experience of novels and having them worry about the true meaning and value of life. The possibility of death education using essays is that they can utilize the characteristics of empathic experiences of essays. Essays contain actual events rather than fiction and are expected to be effective in education on death because they present the author's direct experience and accompanying emotions. In conclusion, this study is meaningful in suggesting the application of medical humanities education that integrates and improves the direction of death education as human-centered medicine based on clinical and medical science as a humanistic understanding of death.

Original Research: Exploring Medication Safety Practices from the Nurse's Perspective.

Medication preparation and administration are complex tasks that nurses must perform daily within today's complicated health care environment. Despite more than two decades of efforts to reduce medication errors, it's well known that such errors remain prevalent. Obtaining insight from direct care nurses may clarify where opportunities for improvement exist and guide future efforts to do so. The study purpose was to explore direct care nurses' perspectives on and experiences with medication safety practices and errors. A qualitative descriptive study was conducted among direct care nurses employed across a large health care system. Data were collected using semistructured interview questions with participants in focus groups and one-on-one meetings and were analyzed using qualitative direct content analysis. A total of 21 direct care nurses participated. Four major themes emerged that impact the medication safety practices of and errors by nurses: the care environment, nurse competency, system influences, and the error paradigm. These themes were often interrelated. Most participants depicted chaotic environments, heavy nursing workloads, and distractions and interruptions as increasing the risk of medication errors. Many seemed unsure about what an error was or could be. The complexity of medication safety practices makes it difficult to implement improvement strategies. Understanding the perspectives and experiences of direct care nurses is imperative to implementing such strategies effectively. Based on the study findings, potential solutions should include actively addressing environmental barriers to safe medication practices, ensuring more robust medication management education and training (including guidance regarding the definition of medication errors and the importance of reporting), and revising policies and procedures with input from direct care nurses.