Medical Humanities Course Research Articles

A culturally competent approach to teach humanities in international medical school: potential frameworks and lessons learned

Background: This paper describes the development of a culturally competent medical humanities course for second and third-year medical students at the ethnically diverse College of Medicine at Qatar University. First taught in 2016, the elective seminar “Medicine and the Arts” was restructured in 2017 to cultivate an appreciation of the symbiotic relationship between medicine, art, and humanities, and to foster cultural competence among the students.Methods: Results and tips are based on our experiences and past reports.Results: In designing a course for students immersed in an Arab-Muslim context, we encountered two challenges: the discipline’s privileging of a predominantly Western canon of arts and humanities, and the largely Euro-American-centric and unilateral framing of concepts e.g., the doctor-patient relationship, patient-centered approach, patient experiences, and meanings of health and illness. To circumvent these challenges, we followed the Purnell Model for Cultural Competence, adopted the interdisciplinary approach, and employed an intersectionality framework to build and deliver a culturally competent course exploring the nexus of arts, humanities, and medicine.In addition to these tips on which frameworks to adopt and how to structure the course, we recommend a visual literacy workshop to help them develop the ability to recognize and understand ideas conveyed through art. Furthermore, we recommend deep conversations about artistic portrayals of medicine from different cultural contexts as tools for developing cultural awareness. Lastly, we recommend that these discussions adopt a student-centered approach, where students inform about their experiences and their own health and illness determinants, in order to develop their knowledge and practice of holism and patient centered approach, and other issues related to humanities and social sciences. Conclusions:Adopting and implementing a culturally competent approach to medical education, alongside interdisciplinary and intersectionality concepts, are potential conceptual frameworks to structure a course that uses art to inform about medical humanities.

Training the eye, virtually: adapting an art in medicine curriculum for on-line learning

Training the Eye: Improving the Art of Physical Diagnosis is an elective fine art-based medical humanities course at Harvard Medical School held at the Museum of Fine Arts, Boston that aims to improve skills of observation. Due to COVID-19, this curriculum was converted from in-person to a virtual format for the first time in 2020. Students enrolled in the course prior to the pandemic and completed one session in person before transitioning unexpectedly to nine remote sessions through Zoom. Students were surveyed anonymously and TAs and faculty were interviewed regarding their perceptions of the strengths, weaknesses and future preferences of the virtual arts education at the course completion. Strengths identified in the virtual platform were being able to include participants irrespective of their location, incorporating most relevant artwork from any collection, harnessing virtual tools for enhanced art viewing, time-efficiency, and having a private, safe space for engaging in this type of learning. However, the experience in the galleries and the social interactions therein were noted to be impossible to fully recapitulate. Personal connections of the class were felt to be diminished and convenience increased. Both advantages (e.g., increased reach relative to types and locations of art works) and disadvantages (e.g., intimacy and connectivity promoted by in-gallery setting) of teaching arts-based medical humanities virtually were identified. A hybrid model may be able reap the benefits of both formats when it is safe to host such courses in person. Parallel lessons may be applicable to optimizing telemedicine encounters.

Impact of a Pandemic and Remote Learning on Team Development and Elements of Compassion in Prospective Medical Students Taking a Medical Humanities Course.

Introduction: We reported previously that when teams of students reflect on readings about communication, unconscious bias, and service-learning, their critical reflection, implicit bias mitigation, empathy, and compassionate behavior all increase. However, would these gains occur when intimate classroom settings, in-person team meetings, and direct interactions with people served were lost owing to the COVID-19 pandemic and remote learning? Methods: Before an online Medical Humanities course began in August 2020 and following the course in December 2020, 61 prospective medical students (54.1% female) completed reliable surveys of their reflective capacity (RC) and cognitive empathy (compassion). Students also completed surveys about their implicit biases and team community service in December 2020. Results: Both RC and empathy scores increased in students after they reflected on difficulties in communication, unconscious biases, and team service-learning experiences in the course. In written reflections, they reported how their compassionate behavior also grew owing to bias mitigation. Most students concurred that “unconscious bias might affect some of (their) clinical decisions or behaviors as a healthcare professional” and vowed to remain aware of these biases in clinical settings. Conclusions: Compared to previous years, the pandemic and remote learning had minimal effects on the benefits of our Medical Humanities course.

Combining Ethics Inquiry and Clinical Experience in a Premedical Health Care Ethics Internship.

The professional formation of physicians begins in the premedical years, and educators are now recommending that medical ethics and humanities courses be considered essential components to becoming a physician rather than elective prerequisites for medical school admission. As a result, questions have arisen about how to teach students ethical reasoning skills before their professional training, as they have limited opportunities now to develop these skills and the related competencies in a real-world medical context. The authors describe Santa Clara University's Health Care Ethics Internship (HCEI), an undergraduate college experience that emphasizes ethical inquiry and immerses students in health care settings to foster deep learning. The HCEI includes mentored clinical rotations integrated with classroom inquiry into ethical theory, structured reflection, and professional development considerations. A survey of former students (academic years 2001-2002 to 2017-2018) explored their perceptions of these program components and the impact of the experience on their preprofessional readiness, career choice, and professional capabilities. Of 185 former students who could be contacted, 89 (48.1%) completed the survey. Students reported that the HCEI: (1) assisted them in gaining admission to medical school, (2) had a positive influence on their career decisions, (3) increased their professional capabilities, (4) helped them develop preprofessional competencies, (5) gave them knowledge and experience they used in their personal and professional ethical decision making, and (6) increased their moral sensitivity and ethical responsibility. Integrating clinical rotations into ethics education exposes premedical students to real-world ethical questions, helps them develop a nuanced understanding of a health care career, and prepares them for the medical school admissions process. Other universities should consider implementing a similar program to prime their students for continued professional and moral development during medical school and residency.

Medical Undergraduates' Perceptions on Medical Humanities Course in Nepal.

Medical humanities is taught in medical schools in the western countries, partly to address the lack of compassion within healthcare. It seeks to develop understanding of human experiences relating to disease, disability and death, through humanities, arts and social sciences. In 2018, Patan Academy of Health Sciences Nepal introduced an eight-week medical humanities course for new medical students. This study aims to evaluate the course from the student participants' view, exploring their perceptions and experiences. A mixed method study was used to assess the perceptions of 65 students who completed a semi-structured survey, comprising eight items, with five point- Likert scale and three open response questions. Quantitative data was analysed with results expressed as mean, standard deviation and percentage. Qualitative data was coded and analysed thematically. The students' perception of the course was strongly positive where 98.5% agreed or strongly agreed it was enjoyable and interesting (items 1,2) and should be continued (item 9). 97% agreed or strongly agreed it made them think differently (item 5) and 96.9% that it was relevant to future careers (item 6). 96.9% agreed or strongly agreed the course helped them understand doctor's caring roles (item 10) and 92.3% believed it will make them better doctors (item 11). Three themes emerged from open response questions related to perceptions- enjoyable and interesting, positive personal impact and valuable and important. The students had positive perceptions of the medical humanities course, recognizing its' impact, importance and its value in medical education. Its expansion in the undergraduate curriculum should be considered.

A PRACTICAL STUDY ON THE CONSTRUCTION OF HIGH-QUALITY MEDICAL HUMANITIES GOLD COURSE UNDER INTERNET BACKGROUND

With the development of the Internet, modern educational technology has brought about great changes in educational ideas and methods. Medical humanities course is an important part of medical curriculum. How to give full play to the advantages of the Internet and promote the quality of medical humanities courses is related to the training quality of modern medical talents. From the perspective of the advantages of Internet background, teaching design and teaching form, this paper discusses how to build internet medical humanities course, which aims to improve the quality of medical humanities course construction.

“Booster Shots” of Humanism at Bedside Teaching

I. INTRODUCTION Most medical education programmes in Taiwan accept students upon high school graduation. Medical education used to consist of seven years with the last year being an internship. Since 2013, medical students have graduated at the end of six years, and the internship has been moved to a postgraduate year. In both formats, students have been offered medical humanities courses in the “pre-med” phase, i.e. the first two years of medical school. From the third year onward, however, students rarely have exposure to subjects related to humanism, other than courses on medical ethics and some problem-based learning case discussions. Moreover, medical students have had very little exposure to humanities in high school. Such limited exposure to humanities during medical school can have detrimental effects on cultivating humanistic physicians in Taiwan.

Who's Your Enemy?: Incorporating Stories of Trauma into a Medical Humanities Course.

This article discusses the theoretical and practical experiment of creating, promoting and co-teaching a medical humanities course: Medicine, War and the Arts at a School of Medicine in the United States from the viewpoint of the students who took the class. Specifically, it analyses how three themes emerged in students’ responses to the oral, literary and visual stories of war and trauma in the course and how they revealed the subjective and ambivalent nature of all medical encounters with patients. The conclusion is that actively encouraging students to view the role of the physician through the lens of historical and contemporary trauma enables them to contemplate the difficult question, “Who’s Your Enemy?” when caring for the sick and themselves.

Fostering Empathy, Implicit Bias Mitigation, and Compassionate Behavior in a Medical Humanities Course.

Increases in compassionate behavior improve patient outcomes and reduce burnout among healthcare professionals. We predicted that selecting and performing service-learning projects by teams of prospective medical students in a Medical Humanities course would foster students’ compassion by raising their reflective capacity, empathy, and unconscious bias mitigation. In class, we discussed difficulties in communication and implicit bias. In this observational study, teams wrote individual and team critical reflections on these class discussions and their service-learning experiences, and we analyzed these reflections for dissonance, self-examination, bias mitigation, dissonance reconciliation, and compassionate behavior. Thirty-two students (53% female) completed the Reflective Practice Questionnaire and the Jefferson Scale of Empathy before the course in August 2019 and after it in December 2019. In December, students were surveyed concerning their attitudes toward team service-learning projects and unconscious bias. The students reported changes in their behavior to mitigate biases and become more compassionate, and their reflective capacity and empathy grew in association with discussions and team service-learning experiences in the course. Virtually all students agreed with the statement “Unconscious bias might affect some of my clinical decisions or behaviors as a healthcare professional,” and they worked to control such biases in interactions with the people they were serving.

To examine the associations between medical students\u2019 conceptions of learning, strategies to learning, and learning outcome in a medical humanities course

BackgroundBy learning medical humanities, medical students are expected to shift from handling the diseases only to seeing a whole sick person. Therefore, understanding medical students’ learning process and outcomes of medical humanities becomes an essential issue of medical education. Few studies have been conducted to explore factors surrounding medical students’ learning process and outcomes of medical humanities. The objectives were: (1) to investigate the relationships between medical students’ conceptions of learning and strategies to learning; and (2) to examine the relationships between students’ strategies to learning and learning outcomes for medical humanities.MethodsWe used the modified Approaches to Learning Medicine (mALM) questionnaire and Conceptions of Learning Medicine (COLM) questionnaire to measure the medical students’ strategies to learning and conceptions of learning respectively. The learning outcome of medical humanities was measured using students’ weighted grade in a medical humanities course. The confirmatory factor analysis (CFA) was used to validate the COLM and mALM questionnaires, in which construct validity and reliability were assessed. Pearson’s correlation was used to examine the relationships among the factors of COLM, mALM, and the weighted grade. Path analysis using structural equation modeling technique (SEM) was employed to estimate the structural relationships among the COLM, mALM, and the weighted grade.ResultsTwo hundred and seventy-five first-year medical students consented to participate in this study. The participants adopting surface strategies to learning were more likely to have unsatisfactory learning outcome (β = − 0.14, p = .04). The basic-level conception of “Preparing for Testing” was negatively (β = − 0.19, p < .01) associated with deep strategies of learning, and positively (β = 0.48, p < .01) associated with surface strategies of learning (β = 0.50, p < .01). The basic-level conception of “Skills Acquisition” was positively associated with deep strategies of learning (β = 0.23, p < .01).ConclusionMedical educators should wisely employ teaching strategies to increase students’ engagement with deep and self-directed learning strategies, and to avoid using surface learning strategies in the medical humanities course in order to achieve better learning outcomes.

“I’m sure that there is something healing in the writing process”

The University of Southern Denmark has introduced a mandatory course in Narrative Medicine into the curriculum of undergraduate medical students. It is part of a trajectory called ‘Human First’, which aims to improve the students’ empathic abilities by teaching them narrative competencies to draw on in their future clinical encounters as medical doctors. Although, theoretical accounts seem to make a strong case for the utility and value of educational interventions, such as courses in narrative medicine or medical humanities, there has been a lack of empirical studies providing evidence to support such accounts – especially those focusing on the long-term effects and impact on patient care. Our systematic literature search and review of empirical studies regarding the effects of teaching close reading of fictional texts and creative writing to medical and health care students, tentatively confirmed previous indications of positive effects. Larger, multi-site and more rigorous studies that assess the long-term impacts of these educational interventions and adjust for local variations are, however, still in short supply. Finally, we present critical reflections on whether empathy and similar phenomena are at all measurable and discuss the possibility of meaningfully evaluating the utility of curricular interventions such as narrative medicine courses.

‘Human First’: Teaching close reading and creative writing to medical students

The University of Southern Denmark has introduced a mandatory course in Narrative Medicine into the curriculum of undergraduate medical students. It is part of a trajectory called ‘Human First’, which aims to improve the students’ empathic abilities by teaching them narrative competencies to draw on in their future clinical encounters as medical doctors. Although, theoretical accounts seem to make a strong case for the utility and value of educational interventions, such as courses in narrative medicine or medical humanities, there has been a lack of empirical studies providing evidence to support such accounts – especially those focusing on the long-term effects and impact on patient care. Our systematic literature search and review of empirical studies regarding the effects of teaching close reading of fictional texts and creative writing to medical and health care students, tentatively confirmed previous indications of positive effects. Larger, multi-site and more rigorous studies that assess the long-term impacts of these educational interventions and adjust for local variations are, however, still in short supply. Finally, we present critical reflections on whether empathy and similar phenomena are at all measurable and discuss the possibility of meaningfully evaluating the utility of curricular interventions such as narrative medicine courses.

Burn Fragment, and: Mounting

Burn Fragment, and: Mounting Laurie Clements Lambeth (bio) Burn Fragment Still the flesh insists: thumbcap hard hat new little pileup of cells proud flesh mound uninflatedcrimson blister singed singing signaling pain but also the event of burning that I cannot rememberWhen: fresh new enough last night?How: dinner? What did did I we ohplates warmed over no flame no great heatHow can flesh remember what the mind has lost?One hand holds the other thumb over thumb tracing circlesand lines as though pacing to bring it backthrough the barrier splitting wound from its shaping moment shape from eventthat particular now from becoming a then his easy morning whisper: Candle— streams back last night’s power cut the matchflame climbing its short wooden routedull wick to thumb. I waited watched as it lit at both ends then water and water— [End Page 113] Mounting In order to risewithout assistanceit is best to facebackward, stirrup turnedto accommodate your turn as you mount,starting by shoulder,back turned to danger(thick head of teeth, hoof,motion’s potential), facing the haunches,and beyond, the past.Hitch the left leg, footanchored in stirruphigher than your waist, clutch a hank of maneand reins with one hand,the saddle’s cantlewith the next, and turn,right leg now all spring, a new beast bouncingon one leg (or five,you a mere danglingmass attached to thismonster silhouette), bounce three times and leap—whirl through air to faceforward now, at lastseated, reins gathered.As easy as breath. I’m not sure, years nowout of the saddle, [End Page 114] if I could still hikemy leg high, the footfinding its stirrup. If so, would the looseleg remember howto bounce, or containthe power to raisemy body from ground to wither, from pastto future, turning?Some nights I wakento find my left kneepressed against my chest, the right one stretched long,reaching (the muscleschemically slackened)at times an unseenground, at others, sky, perpetuallymidleap, toe pointed.Directionless. Thisposition comfortsas much as it aches. [End Page 115] Laurie Clements Lambeth laurie clements lambeth is the author of the poetry collection Veil and Burn. Her poetry has most recently appeared in Poetry Magazine, Zocalo Public Square, and Nimrod, while her recent creative nonfiction has been published by Ecotone, the New York Times, and Crab Orchard Review. She teaches medical humanities courses at the University of Houston. Copyright © 2018 University of North Carolina Wilmington

Darwinian Feminism and Early Science Fiction: Angels, Amazons and Women by Patrick B. Sharp

433 BOOKS IN REVIEW which audiences are shown “in graphic detail … the very real impact of inappropriate and reckless consumption” (83). She incorporates helpful film analysis into her readings and does so with verve, as in her elaboration of a scene in which clinical laboratory footage is juxtaposed with traditional film footage: “While [the doctor] watches the ‘clinical version,’ the version the audience sees is a more emotional version, a version shot on handheld camera, a version that bobs and weaves, as if filmed by a person in the crowded casino rather than by a security camera fixed to a wall” (82). The book would benefit from more sustained readings of this nature, during which Schweitzer’s style, at once approachable and insightful, comes through. Overall, Schweitzer’s monograph would work well as a reader for lowerdivision courses in film studies with a focus on disaster films or in intro-level medical humanities courses. Its tendency to gloss over critical scholarship while presenting big (if sometimes trite) ideas, while niggling to readers well versed in the topic, would make for a good primer for students just getting used to the idea that there is something more to zombies and apocalyptic plague movies than meets the eye.—Kari Nixon, Whitworth University The Descent of Woman. Patrick B. Sharp. Darwinian Feminism and Early Science Fiction: Angels, Amazons and Women. Cardiff: U of Wales P, NEW DIMENSIONS IN SCIENCE FICTION, 2018. ii+193pp. £60 hc, ebk. This well-researched and very readable study of late nineteenth- and early twentieth-century feminist responses to Darwinian evolutionary theory examines the intersections of gender, sexuality, race, and colonialism in a wide range of early speculative fiction by women. For Sharp, “Darwinian feminism” was “a formative moment in the long history of women’s SF” (173) and he sets out to trace the outlines of this moment. He opens by situating Margaret Cavendish’s A Blazing World (1666) and Mary Shelley’s Frankenstein (1818) as influential precursor texts that provide model critiques of masculinist science, but his emphasis is on later work, from nineteenthcentury feminist utopias to feminist sf published during the heyday of the pulp magazines. Sharp argues that for Darwinian feminists, “Darwin’s account of sexual selection provided the template for diagnosing the violence of patriarchal institutions that enslaved women” and “also provided an account of the possible mechanisms for their emancipation” (2). He situates Darwin’s work in the context “not only of a colonial grammar of race, but also a Victorian grammar of gender and sexuality” (7), and it is through this complex nexus that he reads women writers’ challenges to “violent Darwinian masculinity” (7), even as they worked within the plot structures and narrative strategies favored by male writers. Sharp outlines five “storytelling tactics” (9) particularly popular in early women’s sf: 1) a revisionary take on sexual selection that gives women the upper hand; 2) a privileging of the domestic sphere to which women have traditionally been confined; 3) a reorganization of the colonial gaze in order to challenge masculine aggression and hierarchy; 4) echoing Mary Shelley, a critique of the dangers of masculinist science; and 5) the representation of women through figures of the Amazon and the angel 434 SCIENCE FICTION STUDIES, VOLUME 46 (2019) “as the apex of Darwinian feminist evolution” (9-11). Sharp convincingly makes the case that science fiction is “a Darwinian genre” (1) and that evolutionary theory is a key element of sf’s scientific megatext. As part of his analytical framework, Sharp notes how systems of genres become available to writers at specific historical and cultural moments. His first two chapters, “Scientific Masculinity and its Discontents” and “Charles Darwin, Gender and the Colonial Imagination,” provide both a detailed overview of the kinds of scientific “plots” that feminist writers struggled with/against and a very useful outline of Darwin’s work, including its developments and transformations in the socio-philosophical works of Herbert Spencer and others. These opening chapters tracing the rise of the masculinist science project provide an excellent background to Sharp’s study. He pays careful attention to the scientific theories and stories that directly impacted the writing of science fiction in the late...

Medical humanities education in China: an exploratory cross-sectional study

BackgroundGovernmental policies in China have strengthened education in the medical humanities. Previous publications have highlighted the inadequacy of medical humanities education in China and have promoted their advancement and evaluation. Medical disputes and mistrust between doctors and patients in China have been ascribed to a paucity of proper medical humanities education at the medical student level. However, no studies to date have specifically examined the frequency, structure, and characteristics of the medical humanities curricula at all Chinese medical schools, making it difficult to draw a comprehensive understanding of its current state. We therefore aim to provide such an understanding of the current role of the medical humanities at Chinese medical schools. MethodsWe did an exploratory cross-sectional study of medical humanities education in China. We did a comprehensive web-based search of records and curricula to identify all medical humanities courses at all tier-one western medicine Chinese medical schools. In China, only tier-one colleges can offer an education in clinical medicine. All medical schools' compulsory public curricula and the schools' medical humanities curricula were included in our analyses. The primary outcome was to categorise both quantitatively and qualitatively the role of the humanities at Chinese medical schools. We categorised all course data and analysed it using SPSS (version 20). Ethical approval was obtained by the Institutional Review Board of the National Yang-Ming University. FindingsBetween July 1, 2017, and April 30, 2018, we identified 138 tier-one Chinese medical schools with compulsory public curricula, of which 93 (67%) had a medical humanities curricula. Eight medical humanities course types were identified. On average, each school offers 3·84 types of different medical humanities courses. The types of courses that are offered the most are medical psychology or clinical psychology (72 [77%] of 94), medical ethics (68 [72%]), hygienic or medical jurisprudence (56 [60%]), and doctor–patient communication (46 [49%]). Medical humanities courses account for 3–10% of the total credits medical students are required to obtain to graduate in China. The compulsory Ideological and Political Theory curriculum accounts for 6–8% of credits required to graduate. This curriculum includes Mao Zedong Thought, Modern Chinese History, Marxism, Socialism with Chinese Characteristics, and Moral Education and Law, and is required of all students, not solely medical students. InterpretationMedical humanities courses at western medical schools such as the University of Oxford and Harvard Medical School account for 15% and 25% of the total credits required to graduate, respectively. In China, medical humanities education accounts for a substantially smaller portion of the curriculum. Despite ongoing medical disputes and doctor–patient tension, only half of medical schools offer doctor–patient communication type courses. However, China's Ideological and Political Theory curriculum also has a humanistic intent, and when added with medical humanities courses, the two together account for 9–18% of the total credits required to graduate. These unique curricular components serve to support governmental priorities, including developing leaders who follow the so-called rule of law and the rule of virtue. These traits of China's medical humanities curricula match China's national political ideology. However, a more coherent longitudinal medical humanities framework specifically aimed at strengthening the patient–doctor relationship would be useful. China's endeavours to foster medical humanities education reform should be actively promoted at the research, policy, and practice level. FundingThe Republic of China Ministry of Science and Technology (grant MOST 105-2511-S-010 -002 -MY2).

Regressing or progressing: what next for the doctor–patient relationship?

Regressing or progressing: what next for the doctor–patient relationship?

More than visual literacy: art and the enhancement of tolerance for ambiguity and empathy

BackgroundComfort with ambiguity, mostly associated with the acceptance of multiple meanings, is a core characteristic of successful clinicians. Yet past studies indicate that medical students and junior physicians feel uncomfortable with ambiguity. Visual Thinking Strategies (VTS) is a pedagogic approach involving discussions of art works and deciphering the different possible meanings entailed in them. However, the contribution of art to the possible enhancement of the tolerance for ambiguity among medical students has not yet been adequately investigated. We aimed to offer a novel perspective on the effect of art, as it is experienced through VTS, on medical students’ tolerance of ambiguity and its possible relation to empathy.MethodsQuantitative method utilizing a short survey administered after an interactive VTS session conducted within mandatory medical humanities course for first-year medical students. The intervention consisted of a 90-min session in the form of a combined lecture and interactive discussions about art images. The VTS session and survey were filled by 67 students in two consecutive rounds of first-year students.Results.67% of the respondents thought that the intervention contributed to their acceptance of multiple possible meanings, 52% thought their visual observation ability was enhanced and 34% thought that their ability to feel the sufferings of other was being enhanced. Statistically significant moderate-to-high correlations were found between the contribution to ambiguity tolerance and contribution to empathy (0.528–0.744; p ≤ 0.01).ConclusionsArt may contribute especially to the development of medical students’ tolerance of ambiguity, also related to the enhancement of empathy. The potential contribution of visual art works used in VTS to the enhancement of tolerance for ambiguity and empathy is explained based on relevant literature regarding the embeddedness of ambiguity within art works, coupled with reference to John Dewey’s theory of learning. Given the situational nature of the tolerance for ambiguity in this context, VTS provides a path for enhancing ambiguity tolerance that is less conditioned by character traits. Moreover, the modest form of VTS we utilized, not requesting a significant alteration in the pre-clinical curricula, suggests that enhancing the tolerance of ambiguity and empathy among medical students may be particularly feasible.

Cultivating Community-Responsive Future Healthcare Professionals: Using Service-Learning in Pre-Health Humanities Education.

This essay argues that service-learning pedagogy is an important tool in pre-health humanities education that provides benefits to the community and produces more compassionate, culturally competent, and community-responsive future healthcare professionals. Further, beginning this approach at the baccalaureate level instills democratic and collaborative values at an earlier, crucial time in the career socialization process. The discussion focuses on learning outcomes and reciprocity between the university and community in a Medical Humanities course for junior and senior premedical students, an elective in the premedical curriculum. The course includes an experiential learning element in which students shadow physicians and a service-learning component in which students complete medically-relevant service work, working with partners such as the veteran's hospital, a hospice home, and organizations that serve individuals with disabilities. We cover topics such as narrative medicine, ethics, cross-cultural medicine, patient/practitioner relationships, the human life cycle, and the illness experience, and the writing, discussion, and reflection we engage in is enriched by the real-world experiences from which the students are able to draw. The shadowing and service experiences and the classroom texts and topics combine to form a symbiosis that leads to especially meaningful teaching and learning outcomes.

The Medical Humanities Effect: a Pilot Study of Pre-Health Professions Students at the University of Rochester.

Qualitative and quantitative research on the impact of medical and health humanities teaching in baccalaureate education is sparse. This paper reviews recent studies of the impact of medical and health humanities coursework in pre-health professions education and describes a pilot study of baccalaureate students who completed semester-long medical humanities courses in the Division of Medical Humanities & Bioethics at the University of Rochester. The study format was an email survey. All participants were current or former baccalaureate students who had taken one or more courses in literature and narrative in medicine, bioethics, history of medicine, and/or visual arts and healthcare during the past four years. The survey gathered numerical data in several areas: demographic information, career plans, self-reported influence of coursework on educational and career plans, and self-reported influence of coursework on intellectual skills and abilities. It also gathered narrative commentary that elaborated on students' responses to the numerically-based questions. Notable findings from preliminary analysis of the data include higher scores of self-reported impact of the coursework on specific habits of mind and on preparedness for intended career rather than on gaining admission to future educational programs. Discussion of the results focuses on several potential future directions this type of study might take, including multi-center, longitudinal, and sequential approaches.

Different perceptions of narrative medicine between Western and Chinese medicine students

BackgroundWestern medicine is an evidence-based science, whereas Chinese medicine is more of a healing art. To date, there has been no research that has examined whether students of Western and Chinese medicine differentially engage in, or benefit from, educational activities for narrative medicine. This study fills a gap in current literature with the aim of evaluating and comparing Western and Chinese Medicine students’ perceptions of narrative medicine as an approach to learning empathy and professionalism.MethodsAn initial 10-item questionnaire with a 5-point Likert scale was developed to assess fifth-year Western medical (MS) and traditional Chinese medical (TCMS) students’ perceptions of a 4-activity narrative medicine program during a 13-week internal medicine clerkship. Exploratory factor analysis was undertaken.ResultsThe response rate was 88.6% (412/465), including 270 (65.5%) MSs and 142 (34.5%) TCMSs, with a large reliability (Cronbach alpha = 0.934). Three factors were extracted from 9 items: personal attitude, self-development/reflection, and emotional benefit, more favorable in terms of enhancement of self-development/reflection. The perceptions of narrative medicine by scores between the two groups were significantly higher in TCMSs than MSs in all 9-item questionnaire and 3 extracted factors.ConclusionsGiven the different learning cultures of medical education in which these student groups engage, this suggests that undertaking a course in Chinese medicine might enhance one’s acceptance to, and benefit from, a medical humanities course. Alternatively, Chinese medicine programmes might attract more humanities-focused students.