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Siddiqi DA, Miraj F, Munir M, Naz N, Shaikh AF, Khan AW, Dossa S, Nadeem I, Hargraves MJ, Urban J, Shah MT, Chandir S. Integrating humanities in healthcare: a mixed-methods study for development and testing of a humanities curriculum for front-line health workers in Karachi, Pakistan. MEDICAL HUMANITIES 2024; 50:372-382. [PMID: 38238003 DOI: 10.1136/medhum-2022-012576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 08/16/2024]
Abstract
Lady health workers (LHWs) provide lifesaving maternal and child health services to >60% of Pakistan's population but are poorly compensated and overburdened. Moreover, LHWs' training does not incorporate efforts to nurture attributes necessary for equitable and holistic healthcare delivery. We developed an interdisciplinary humanities curriculum, deriving its strengths from local art and literature, to enhance character virtues such as empathy and connection, interpersonal communication skills, compassion and purpose among LHWs. We tested the curriculum's feasibility and impact to enhance character strengths among LHWs.We conducted a multiphase mixed-methods pilot study in two towns of Karachi, Pakistan. We delivered the humanities curriculum to 48 LHWs via 12 weekly sessions, from 15 June to 2 September 2021. We developed a multiconstruct character strength survey that was administered preintervention and postintervention to assess the impact of the training. In-depth interviews were conducted with a subset of randomly selected participating LHWs.Of 48 participants, 47 (98%) completed the training, and 34 (71%) attended all 12 sessions. Scores for all outcomes increased between baseline and endline, with highest increase (10.0 points, 95% CI 2.91 to 17.02; p=0.006) observed for empathy/connection. LHWs provided positive feedback on the training and its impact in terms of improving their confidence, empathy/connection and ability to communicate with clients. Participants also rated the sessions highly in terms of the content's usefulness (mean: 9.7/10; SD: 0.16), the success of the sessions (mean: 9.7/10; SD: 0.17) and overall satisfaction (mean: 8.2/10; SD: 3.3).A humanities-based training for front-line health workers is a feasible intervention with demonstrated impact of nurturing key character strengths, notably empathy/connection and interpersonal communication. Evidence from this study highlights the value of a humanities-based training, grounded in local literature and cultural values, that can ultimately translate to improved well-being of LHWs thus contributing to better health outcomes among the populations they serve.
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Huang SS, Lin YF, Huang AY, Lin JY, Yang YY, Lin SM, Lin WY, Huang PH, Chen TY, Yang SJH, Lirng JF, Chen CH. Using machine learning to identify key subject categories predicting the pre-clerkship and clerkship performance: 8-year cohort study. J Chin Med Assoc 2024; 87:609-614. [PMID: 38648194 DOI: 10.1097/jcma.0000000000001097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Medical students need to build a solid foundation of knowledge to become physicians. Clerkship is often considered the first transition point, and clerkship performance is essential for their development. We hope to identify subjects that could predict the clerkship performance, thus helping medical students learn more efficiently to achieve high clerkship performance. METHODS This cohort study collected background and academic data from medical students who graduated between 2011 and 2019. Prediction models were developed by machine learning techniques to identify the affecting features in predicting the pre-clerkship performance and clerkship performance. Following serial processes of data collection, data preprocessing before machine learning, and techniques and performance of machine learning, different machine learning models were trained and validated using the 10-fold cross-validation method. RESULTS Thirteen subjects from the pre-med stage and 10 subjects from the basic medical science stage with an area under the ROC curve (AUC) >0.7 for either pre-clerkship performance or clerkship performance were found. In each subject category, medical humanities and sociology in social science, chemistry, and physician scientist-related training in basic science, and pharmacology, immunology-microbiology, and histology in basic medical science have predictive abilities for clerkship performance above the top tertile. Using a machine learning technique based on random forest, the prediction model predicted clerkship performance with 95% accuracy and 88% AUC. CONCLUSION Clerkship performance was predicted by selected subjects or combination of different subject categories in the pre-med and basic medical science stages. The demonstrated predictive ability of subjects or categories in the medical program may facilitate students' understanding of how these subjects or categories of the medical program relate to their performance in the clerkship to enhance their preparedness for the clerkship.
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Affiliation(s)
- Shiau-Shian Huang
- Department of Medical Education, Clinical Innovation Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Yu-Fan Lin
- Department of Medical Education, Clinical Innovation Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Anna YuQing Huang
- Department of Computer Science and Information Engineering, National Central University, Taoyuan, Taiwan, ROC
| | - Ji-Yang Lin
- Department of Computer Science and Information Engineering, National Central University, Taoyuan, Taiwan, ROC
| | - Ying-Ying Yang
- Department of Medical Education, Clinical Innovation Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Sheng-Min Lin
- Department of Medical Education, Clinical Innovation Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Wen-Yu Lin
- Department of Medical Education, Clinical Innovation Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Pin-Hsiang Huang
- Department of Medical Education, Clinical Innovation Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Tzu-Yao Chen
- Department of Computer Science and Information Engineering, National Central University, Taoyuan, Taiwan, ROC
| | - Stephen J H Yang
- Department of Computer Science and Information Engineering, National Central University, Taoyuan, Taiwan, ROC
| | - Jiing-Feng Lirng
- Department of Medical Education, Clinical Innovation Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Chen-Huan Chen
- Department of Medical Education, Clinical Innovation Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
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Sarraf-Yazdi S, Pisupati A, Goh CK, Ong YT, Toh YR, Goh SPL, Krishna LKR. A scoping review and theory-informed conceptual model of professional identity formation in medical education. MEDICAL EDUCATION 2024. [PMID: 38597258 DOI: 10.1111/medu.15399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/12/2024] [Accepted: 03/18/2024] [Indexed: 04/11/2024]
Abstract
INTRODUCTION Professional identity formation (PIF) is a central tenet of effective medical education. However, efforts to support, assess and study PIF are hindered by unclear definitions and conceptualisations of what it means to 'think, act, and feel like a physician'. Gaps in understanding PIF, and by extension, its support mechanisms, can predispose individuals towards disengaged or unprofessional conduct and institutions towards short-sighted or reactionary responses to systemic issues. METHODS A Systematic Evidence-Based Approach-guided systematic scoping review of PIF theories was conducted related to medical students, trainees and practising doctors, published between 1 January 2000 and 31 December 2021 in PubMed, Embase, ERIC and Scopus databases. RESULTS A total of 2441 abstracts were reviewed, 607 full-text articles evaluated and 204 articles included. The domains identified were understanding PIF through the lens of pivotal theories and characterising PIF by delineating the underlying factors that influence it and processes that define it. CONCLUSIONS Based on regnant theories and frameworks related to self-concepts of identity and personhood, the relationships between key PIF influences, processes and outcomes were examined. A theory-backed integrated conceptual model was proposed to delineate the interconnected relationships among these, aiming to untangle some of the complexities inherent to PIF, to shed light on existing practices and to identify shortcomings in our understanding so as to develop mechanisms in support of its multifaceted, interlinked components.
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Affiliation(s)
| | - Anushka Pisupati
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
| | - Chloe Keyi Goh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
| | - Yun Ting Ong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
| | - You Ru Toh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
| | - Suzanne Pei Lin Goh
- Duke-NUS Medical School, National University of Singapore, Singapore
- KK Women's and Children Hospital, Singapore
| | - Lalit Kumar Radha Krishna
- Duke-NUS Medical School, National University of Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
- Palliative Care Institute Liverpool, Academic Palliative and End of Life Care Centre, United Kingdom Cancer Research Centre, University of Liverpool, Liverpool, UK
- Centre for Biomedical Ethics, National University of Singapore, Singapore, Singapore
- Palliative Care Centre for Excellence in Research and Education, Singapore
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Ahmed K, Patel A, Lingard L. Exploring the experiences of Canadian medical students with a background in the arts and humanities. CANADIAN MEDICAL EDUCATION JOURNAL 2024; 15:6-14. [PMID: 38528890 PMCID: PMC10961114 DOI: 10.36834/cmej.77005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
Background Arts and Humanities (A/H) training is a powerful strategy to help medical students develop key competencies which align with the CanMEDS roles that Canadian physicians are expected to embody. Students with backgrounds in A/H may enter medical school with the skills and dispositions that A/H training provides. This paper explores the varied experiences of medical students with prior A/H backgrounds, with an emphasis on how they navigate relationships with their student cohorts and participate in undergraduate medical training environments. Methods Descriptive qualitative research methodology was used to conduct and analyze semi-structured interviews exploring the perspectives of Canadian medical students with either a A/H degree or training in A/H (n = 13). Domains such as identity, integration of interests, and challenges in maintaining A/H interests during medical training were explored. Results Participants described their A/H identity as intertwined with their identity as medical trainees and described their sense of interconnection between the disciplines. Challenges included imposter syndrome and difficulties in relating with peers from science backgrounds. Participants described returning to their A/H interests as a tool for wellness amidst medical training. Conclusions Medical students with a background in A/H training describe this background as offering both affordances and challenges for their sense of identity, belonging, and wellness. These students offer an untapped resource: they come with dispositions of value to medicine, and they perceive a positive, hidden A/H curriculum that supports their maintenance of these dispositions during training. Understanding more about these hidden treasures could help foster the development of well-rounded and humanistic physicians in the entire medical class.
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Affiliation(s)
- Khadija Ahmed
- Undergraduate Medical Education, Schulich School of Medicine & Dentistry, Western University, Ontario, Canada
| | - Arjun Patel
- Undergraduate Medical Education, Schulich School of Medicine & Dentistry, Western University, Ontario, Canada
| | - Lorelei Lingard
- Department of Medicine, CERI, Schulich School of Medicine & Dentistry, Western University, Ontario, Canada
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Eno C, Piemonte N, Michalec B, Adams CA, Budesheim T, Felix K, Hack J, Jensen G, Leavelle T, Smith J. Forming Physicians: Evaluating the Opportunities and Benefits of Structured Integration of Humanities and Ethics into Medical Education. THE JOURNAL OF MEDICAL HUMANITIES 2023; 44:503-531. [PMID: 37526858 PMCID: PMC10733221 DOI: 10.1007/s10912-023-09812-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/18/2023] [Indexed: 08/02/2023]
Abstract
This paper offers a novel, qualitative approach to evaluating the outcomes of integrating humanities and ethics into a newly revised pre-clerkship medical education curriculum. The authors set out to evaluate medical students' perceptions, learning outcomes, and growth in identity development. Led by a team of interdisciplinary scholars, this qualitative project examines multiple sources of student experience and perception data, including student essays, end-of-year surveys, and semi-structured interviews with students. Data were analyzed using deductive and inductive processes to identify key categories and recurring themes. Results suggest that students not only engaged with the curricular content and met the stated learning objectives but also acknowledged their experience in the humanities and ethics curriculum as an opportunity to reflect, expand their perceptions of medicine (and what it means to be "in" medicine), connect with their classmates, and further cultivate their personal and professional identities. Results of this qualitative study show how and in what ways the ethics and humanities curriculum motivates students past surface-level memorization of factual knowledge and encourages thoughtful analysis and evaluation about how the course material relates to and influences their thinking and how they see themselves as future doctors. The comprehensive qualitative approach reflects a holistic model for evaluating the integration of humanities and ethics into the pre-clerkship medical education curriculum. Future research should examine if this approach provides a protective factor against the demonstrated ethical erosion and empathy decrease during clinical training.
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Affiliation(s)
- Cassie Eno
- Department of Medicine Education, Creighton University, 2500 California Plaza, Omaha, NE, 68178, USA.
| | - Nicole Piemonte
- Department of Medical Humanities, Creighton University, Phoenix, AZ, USA
| | - Barret Michalec
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Charise Alexander Adams
- Kingfisher Institute for the Liberal Arts and Professions, Creighton University, Omaha, NE, USA
| | - Thomas Budesheim
- Department of Psychological Science, Creighton University, Omaha, NE, USA
| | - Kaitlyn Felix
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Jess Hack
- Creighton University, Omaha, NE, USA
| | - Gail Jensen
- School of Pharmacy and Health Professions, Creighton University, Omaha, NE, USA
| | - Tracy Leavelle
- Department of History, Creighton University, Omaha, NE, USA
| | - James Smith
- Department of Medicine Education, Creighton University, 2500 California Plaza, Omaha, NE, 68178, USA
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Childress A, Lou M. Illness Narratives in Popular Music: An Untapped Resource for Medical Education. THE JOURNAL OF MEDICAL HUMANITIES 2023; 44:533-552. [PMID: 37566168 DOI: 10.1007/s10912-023-09813-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/19/2023] [Indexed: 08/12/2023]
Abstract
Illness narratives convey a person's feelings, thoughts, beliefs, and descriptions of suffering and healing as a result of physical or mental breakdown. Recognized genres include fiction, nonfiction, poetry, plays, and films. Like poets and playwrights, musicians also use their life experiences as fodder for their art. However, illness narratives as expressed through popular music are an understudied and underutilized source of insights into the experience of suffering, healing, and coping with illness, disease, and death. Greater attention to the value of music within medical education is needed to improve students' perspective-taking and communication. Like reading a good book, songs that resonate with listeners speak to shared experiences or invite them into a universe of possibilities that they had not yet imagined. In this article, we show how uncovering these themes in popular music might be integrated into medical education, thus creating a space for reflection on the nature and meaning of illness and the fragility of the human condition. We describe three kinds of illness narratives that may be found in popular music (autobiographical, biographical, and metaphorical) and show how developing skills of close listening through exposure to these narrative forms can improve patient-physician communication and expand students' moral imaginations.
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Affiliation(s)
- Andrew Childress
- Humanities Expression and Arts Lab, Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA.
| | - Monica Lou
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
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Defenbaugh N, Dickey LA, Foulke VC, Orlando JP. Storied reflections: Development of a longitudinal interdisciplinary curriculum to improve patient-provider communication. PEC INNOVATION 2023; 2:100170. [PMID: 37384161 PMCID: PMC10294085 DOI: 10.1016/j.pecinn.2023.100170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 04/08/2023] [Accepted: 05/23/2023] [Indexed: 06/30/2023]
Abstract
Objective This article details the development of an interdisciplinary graduate medical education (GME) narrative curriculum. Methods Descriptive statistics were conducted for the narrative session surveys. Two separate qualitative analyses were conducted. First, content and thematic analyses of the open-ended questions in the survey using NVIVO software occurred. Second, an inductive analysis of the participants' 54 stories was performed to identify unique themes not related to the prompt topics. Results Quantitative survey results demonstrated that 84% of learners' felt the session benefited their personal or professional sense of wellbeing and resilience, 90% of learners believed the sessions aided in their ability to listen more effectively, and 86% of learners could apply what they practiced or witnessed. Qualitative analysis of survey data showed learners focused on patient care and listening. Thematic analysis of participants' narratives revealed strong feelings and emotions, struggles with time management, increase in self- and other-awareness, and challenges managing job-life balance. Conclusion The longitudinal interdisciplinary Write-Read-Reflect narrative exchange curriculum is cost-effective, sustainable, and demonstrably valuable to learners and their program directors across multiple disciplines. Innovation The program was designed for 4 graduate programs' learners to simultaneously experience a narrative exchange model to improve patient-provider communication, support professional resilience, and deepen relationship-centered care skills.
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Affiliation(s)
- Nicole Defenbaugh
- University of Health Sciences and Pharmacy, 1 Pharmacy Place, St. Louis, Missouri 63110, United States of America
| | | | - Vivian C. Foulke
- Lehigh Valley Hospital, 1200 South Cedar Crest Blvd, Allentown, PA 18103, United States of America
| | - James P. Orlando
- St Luke's University Health Network, 801 Ostrum Street, Bethlehem, PA 18015, United States of America
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Krishna LKR, Pisupati A, Teo KJH, Teo MYK, Quek CWN, Chua KZY, Venktaramana V, Raveendran V, Singh H, Hui SLWC, Ng VWW, Ting OY, Loh EKY, Yeoh TT, Owyong JLJ, Ong EK, Phua GLG, Hill R, Mason S, Ong SYK. Professional identity formation amongst peer-mentors in a research-based mentoring programme. BMC MEDICAL EDUCATION 2023; 23:787. [PMID: 37875886 PMCID: PMC10598986 DOI: 10.1186/s12909-023-04718-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 09/25/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND Mentoring plays a pivotal yet poorly understood role in shaping a physician's professional identity formation (PIF) or how they see, feel and act as professionals. New theories posit that mentoring nurtures PIF by functioning as a community of practice through its structured approach and its support of a socialisation process made possible by its assessment-directed personalized support. To test this theory and reshape the design, employ and support of mentoring programs, we evaluate peer-mentor experiences within the Palliative Medicine Initiative's structured research mentoring program. METHODS Semi-structured interviews with peer mentors under the Palliative Medicine Initiative (PMI) at National Cancer Centre Singapore were conducted and triangulated against mentoring diaries to capture longitudinal data of their PMI experiences. The Systematic Evidence-Based Approach (SEBA) was adopted to enhance the trustworthiness of the data. SEBA employed concurrent content and thematic analysis of the data to ensure a comprehensive review. The Jigsaw Perspective merged complementary themes and categories identified to create themes/categories. The themes/categories were compared with prevailing studies on mentoring in the Funnelling Process to reaffirm their accuracy. RESULTS Twelve peer-mentors participated in the interviews and eight peer-mentors completed the mentoring diaries. The domains identified were community of practice and identity work. CONCLUSIONS The PMI's structured mentoring program functions as a community of practice supporting the socialisation process which shapes the peer-mentor's belief system. Guided by a structured mentoring approach, stage-based assessments, and longitudinal mentoring and peer support, peer-mentors enhance their detection and evaluation of threats to their regnant belief system and adapt their self-concepts of identity and personhood to suit their context. These insights will help structure and support mentoring programs as they nurture PIF beyond Palliative Medicine.
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Affiliation(s)
- Lalit Kumar Radha Krishna
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore.
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore.
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore.
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, 169857, Singapore.
- Health Data Science, Institute of Population Health, University of Liverpool, Brownlow Street, Liverpool, L69 3GF, UK.
- Palliative Care Institute, University of Liverpool, 200 London Road, Liverpool, L3 9TA, UK.
- The Palliative Care Centre for Excellence in Research and Education (PalC), Dover Park Hospice, 10 Jln Tan Tock Seng, Singapore, 308436, Singapore.
- Centre for Biomedical Ethics, National University of Singapore, 10 Medical Dr, Singapore, 117597, Singapore.
| | - Anushka Pisupati
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Kelly Jia Hui Teo
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Mac Yu Kai Teo
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Chrystie Wan Ning Quek
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Keith Zi Yuan Chua
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Vaishnavi Venktaramana
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Vijayprasanth Raveendran
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Harpreet Singh
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Sabine Lauren Wong Chyi Hui
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Victoria Wen Wei Ng
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Ong Yun Ting
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Eleanor Kei Ying Loh
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Ting Ting Yeoh
- Division of Oncology Pharmacy, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Jasmine Lerk Juan Owyong
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Eng Koon Ong
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
- Assisi Hospice, 832 Thomson Rd, Singapore, 574627, Singapore
- Office of Medical Humanities, SingHealth Medicine Academic Clinical Programme, Singapore, Singapore
| | - Gillian Li Gek Phua
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, 169857, Singapore
| | - Ruaraidh Hill
- Health Data Science, Institute of Population Health, University of Liverpool, Brownlow Street, Liverpool, L69 3GF, UK
| | - Stephen Mason
- Palliative Care Institute, University of Liverpool, 200 London Road, Liverpool, L3 9TA, UK
| | - Simon Yew Kuang Ong
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
- Division of Medical Oncology, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
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Dellasega C, George DR, Lokon E. The transformative power of participating in Opening Minds Through Art (OMA), an expressive arts program for medical students. GERONTOLOGY & GERIATRICS EDUCATION 2023:1-13. [PMID: 37722717 DOI: 10.1080/02701960.2023.2255537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
Opening Minds Through Art (OMA) is a standardized expressive arts-based program that improves student attitudes toward persons living with dementia. Understanding how this change occurs is important for both educators and clinicians. In this study, narrative analysis was used to explore the impact of OMA on participating medical students. 111 students at six medical schools accepted an invitation to be part of OMA during the 2018-2020 academic years. After completing the program, participants were asked to write briefly about the impact of their OMA experience on their work as future physicians. These narratives were analyzed to identify themes relevant to the impact of the program. Students described appreciating both pragmatic and novel creative experiences in OMA, which differed from their traditional studies. Themes from the evaluation included: Inter and Intrapersonal Connection and Growth; Mastery of Anticipated Challenges; Acquisition of Knowledge and Skills; and Appreciation of Health Care Team Members. Teaching students to embrace clinical work with challenging and perceived "difficult" patients is often unaddressed in the medical school curriculum. This study suggests that the combination of medical knowledge and artistic expression can be used to benefit both students and persons living with dementia.
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Affiliation(s)
- Cheryl Dellasega
- Department of Humanities, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Daniel R George
- Department of Humanities, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Elizabeth Lokon
- Scripps Gerontology Center, Miami University, Oxford, Ohio, USA
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Moretti C, De Luca E, D’Apice C, Artioli G, Sarli L, Bonacaro A. Gender and sex bias in prevention and clinical treatment of women's chronic pain: hypotheses of a curriculum development. Front Med (Lausanne) 2023; 10:1189126. [PMID: 37559926 PMCID: PMC10407111 DOI: 10.3389/fmed.2023.1189126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 07/12/2023] [Indexed: 08/11/2023] Open
Abstract
This discursive paper focuses on undergraduate medical education's role in tackling gender bias in clinical practice, specifically preventing and managing from a non-biomedical perspective chronic pain in women. A preliminary web search of medical schools' curricula was performed to identify programs content related to gender bias in pain management. The web search included 10 universities' websites selected from the top 10 rankings QS Universities Rankings 2022 for medical schools. Additionally, a questionnaire was sent to all deans of the selected academic institutions to explore the curriculum content further. The web search, and the lack of response from the deans, highlighted that relevant curriculum components on gender bias and chronic pain needed to be implemented. Therefore, this paper introduces an innovative curriculum development approach designed by the multi-professional research team to be implemented in medical school programs. This novel educational strategy could also cross-contaminate other healthcare practitioners' university programs and, thus, stimulate an interprofessional debate into fostering inclusiveness and equal opportunities in health.
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Affiliation(s)
- Chiara Moretti
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Enrico De Luca
- Faculty of Health and Life Sciences Exeter University, Exeter, United Kingdom
| | - Clelia D’Apice
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Giovanna Artioli
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Leopoldo Sarli
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Antonio Bonacaro
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Department of Nursing, University of Suffolk, Ipswich, United Kingdom
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Zhang T, Zhang L, Wen X, Li H. Level of humanistic care ability and its influencing factors among nursing aides in long-term care facilities. Geriatr Nurs 2023; 52:56-62. [PMID: 37245389 DOI: 10.1016/j.gerinurse.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/12/2023] [Accepted: 05/12/2023] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To determine the level and influencing factors of the humanistic care ability (HCA) in nursing aides, thus providing a baseline for its improvement. METHODS This study investigated 302 nursing aides in six long-term care facilities (LTCFs) in Suzhou between December 2021 and June 2022 by convenience sampling. A descriptive questionnaire and the Caring Ability Inventory were applied in this study. RESULTS The HCA was at a low level, and its influencing factors were education level, marital status, personality, reason for employment, and the degree of perceived care from colleagues (p<0.05). CONCLUSIONS Nursing aides' HCA needs to be strengthened urgently. Nursing aides with poor education, widowed, single, and an introversion type of personality should receive more attention. Additionally, creating a warm atmosphere among colleagues and cultivating the nursing aides' motivation for eldercare will help improve their HCA.
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Affiliation(s)
- Taomei Zhang
- School of Nursing, Medical College of Soochow University, Suzhou, China.
| | - Luxin Zhang
- School of Nursing, Medical College of Soochow University, Suzhou, China.
| | - Xi Wen
- School of Nursing, Medical College of Soochow University, Suzhou, China.
| | - Huiling Li
- School of Nursing, Medical College of Soochow University, Suzhou, China; Department of Nursing, The First Affiliated Hospital of Soochow University, Suzhou, China.
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Ataya J, Jamous I, Dashash M. Measurement of Humanity Among Health Professionals: Development and Validation of the Medical Humanity Scale Using the Delphi Method. JMIR Form Res 2023; 7:e44241. [PMID: 37129940 DOI: 10.2196/44241] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 03/08/2023] [Accepted: 04/06/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND Despite the importance of humanism in providing health care, there is a lack of valid and reliable tool for assessing humanity among health professionals. OBJECTIVE The aim of this study was to design a new humanism scale and to assess the validity of this scale in measuring humanism among Syrian health professional students. METHODS The Medical Humanity Scale (MHS) was designed. It consists of 27 items categorized into 7 human values including patient-oriented care, respect, empathy, ethics, altruism, and compassion. The scale was tested for internal consistency and reliability using Cronbach α and test-retest methods. The construct validity of the scale was also tested to assess the ability of the scale in differentiating between groups of health professional students with different levels of medical humanity. A 7-point Likert scale was adopted. The study included 300 participants including 97 medical, 78 dental, 82 pharmacy, and 43 preparatory-year students from Syrian universities. The Delphi method was used and factors analysis was performed. Bartlett test of sphericity and the Kaiser-Meyer-Olkin measure of sample adequacy were used. The number of components was extracted using principal component analysis. RESULTS The mean score of the MHS was 158.7 (SD 11.4). The MHS mean score of female participants was significantly higher than the mean score of male participants (159.59, SD 10.21 vs 155.48, SD 14.35; P=.008). The MHS mean score was significantly lower in dental students (154.12, SD 1.45; P=.005) than the mean scores of medical students (159.77, SD 1.02), pharmacy students (161.40, SD 1.05), and preparatory-year students (159.05, SD 1.94). However, no significant relationship was found between humanism and academic year (P=.32), university type (P=.34), marital status (P=.64), or financial situation (P=.16). The Kaiser-Meyer-Olkin test (0.730) and Bartlett test of sphericity (1201.611, df=351; P=.01) were performed. Factor analysis indicated that the proportion of variables between the first and second factors was greater than 10%, confirming that the scale was a single group. The Cronbach α for the overall scale was 0.735, indicating that the scale had acceptable reliability and validity. CONCLUSIONS The results of this study suggest that the MHS is a reliable and valid tool for measuring humanity among health professional students and the development of patient-centered care.
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Affiliation(s)
- Jawdat Ataya
- Medical Education Programme, Syrian Virtual University, Damascus, Syrian Arab Republic
- Faculty of Dental Medicine, Damascus University, Damascus, Syrian Arab Republic
| | - Issam Jamous
- Medical Education Programme, Syrian Virtual University, Damascus, Syrian Arab Republic
- Faculty of Dental Medicine, Damascus University, Damascus, Syrian Arab Republic
| | - Mayssoon Dashash
- Medical Education Programme, Syrian Virtual University, Damascus, Syrian Arab Republic
- Faculty of Dental Medicine, Damascus University, Damascus, Syrian Arab Republic
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Kruse JA, Wald HS. Legacy of the Role of Medicine and Nursing in the Holocaust: An Educational Intervention to Support Nursing Student Professional Identity Formation and Ethical Conduct. Nurs Educ Perspect 2023; 44:169-171. [PMID: 35584013 DOI: 10.1097/01.nep.0000000000000996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
ABSTRACT Reflecting on history of medicine and nursing in the Holocaust scaffolds professional identity formation. Students grapple with 1) nurses' active participation in identifying/killing patients with mental and physical disabilities, camouflaged as "euthanasia" or "mercy killing" of German citizens and others, preceding mass murder of Jews and others at death camps; 2) involvement in unethical, cruel experiments; 3) resistance narratives; and 4) relevance for contemporary nursing. Impact of a seminar/colloquium on historical knowledge and personal/professional relevance included reported increased historical awareness/knowledge and themes of nurse as patient advocate/judicious obedience, importance of ethics/values adherence, and value of art/reflective writing for processing experience.
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Affiliation(s)
- Julie A Kruse
- About the Authors Julie A. Kruse, PhD, RN, is an associate professor, School of Nursing, Oakland University, Rochester, Michigan. Hedy S. Wald, PhD, is clinical professor of family medicine, Department of Family Medicine, Warren Alpert Medical School of Brown University; faculty, Harvard Medical School Pediatric Leadership Program; and Commissioner, Lancet Commission on Medicine and the Holocaust. For more information, contact Dr. Kruse at
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Riesen MS, Kiessling C, Tauschel D, Wald HS. "Where my responsibility lies": Reflecting on medicine during the Holocaust to support personal and professional identity formation in health professions education. GMS JOURNAL FOR MEDICAL EDUCATION 2023; 40:Doc24. [PMID: 37361249 PMCID: PMC10285371 DOI: 10.3205/zma001606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 11/27/2022] [Accepted: 01/30/2023] [Indexed: 06/28/2023]
Abstract
Objectives Physicians and the medical/scientific establishment during Nazism and the Holocaust committed egregious ethical violations including complicity with genocide. Critical reflection on this history serves as a powerful platform for scaffolding morally resilient professional identity formation (PIF) with striking relevance for contemporary health professions education and practice. Study aim was to explore the impact of an Auschwitz Memorial study trip within the context of a medicine during Nazism and the Holocaust curriculum on students' personal and PIF. Methods The authors analyzed 44 medical and psychology students' reflective writings from a 2019 Auschwitz Memorial study trip using immersion-crystallization qualitative thematic analysis. Results Six distinct themes and 22 subthemes were identified and mapped to a reflective learning process model: 1. "What am I bringing?" 2. "What am I experiencing through the curriculum?" 3. "What am I initially becoming aware of as a first response?" 4./5. "How and what am I processing?" 6. "What am I taking with me?" Particularly compelling subthemes of power of the place, emotional experience, reflection on myself as a moral person, and contemporary relevance referred to impactful course elements. Conclusions This curriculum catalyzed a critically reflective learning/meaning-making process supporting personal and PIF including critical consciousness, ethical awareness, and professional values. Formative curriculum elements include narrative, supporting emotional aspects of learning, and guided reflection on moral implications. The authors propose Medicine during Nazism and the Holocaust curriculum as a fundamental health professions education component cultivating attitudes, values, and behaviors for empathic, moral leadership within inevitable healthcare challenges.
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Affiliation(s)
| | - Claudia Kiessling
- Witten/Herdecke University, Faculty of Health, Chair for the Education of Personal and Interpersonal Competences in Health Care, Witten, Germany
| | - Diethard Tauschel
- Witten/Herdecke University, Faculty of Health, Integrated Curriculum for Anthroposophic Medicine (ICURAM) within the Professorship for Education, Training and Continuing Education in Anthroposophic Medicine, Witten, Germany
| | - Hedy S. Wald
- Warren Alpert Medical School of Brown University, Department of Family Medicine, Lancet Commission on Medicine and the Holocaust, Providence/RI, U.S.A
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Incongruous identities: Mental distress and burnout disparities in LGBTQ+ health care professional populations. Heliyon 2023; 9:e14835. [PMID: 37009240 PMCID: PMC10039783 DOI: 10.1016/j.heliyon.2023.e14835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/17/2023] [Accepted: 03/20/2023] [Indexed: 03/28/2023] Open
Abstract
Health care professionals are chronically overworked due to structural workplace demands and institutional challenges [1]. During the COVID-19 pandemic, US biomedical health care professionals experienced additional environmental strain [2]. Health care professionals who occupy socio-politically minoritized identities are more likely to report symptoms of distress and workplace overburden than their counterparts [2]. While minority stress and identity formation theories explain the relationship between socially constructed identity and environmental strain, these theories remain largely unexplored in LGBTQ+ health care professional populations. Furthermore, contemporary investigations into health care professional burnout and mental distress fail to include differential impacts of identity-based stress, particularly within LGBTQ+ groups. This paper proposes a theoretical explanation for differential stress experiences by health care professionals and calls for research to investigate identity congruence as a key aspect of professionalization in medical schools. Health professions researchers need to attend to identity-based stress models to address discriminatory experiences with burnout and mental distress.
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Brown EA, Kinder H, Stang G, Shumpert W. Using adult learning characteristics and the humanities to teach undergraduate healthcare students about social determinants of health. HUMANITIES & SOCIAL SCIENCES COMMUNICATIONS 2023; 10:114. [PMID: 36969313 PMCID: PMC10024284 DOI: 10.1057/s41599-023-01599-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 02/27/2023] [Indexed: 06/18/2023]
Abstract
Authors used an andragogy framework to help undergraduate allied health students better understand social determinants of health (SDOH) using a photo essay assignment. The study examined students' perceptions of SDOH in various communities, description of health outcomes associated with their chosen SDOH, and lessons learned and suggestions to improve the assignment for future cohorts. Data were extracted from photo essays from 2019-2021 and entered in Microsoft Excel and Word for data analysis after course completion. Conventional qualitative content analysis was used to analyze student evaluation data from open-ended questions. Data were extracted from 53 student essays from 2019 to 2021. Most photo essays described communities in South Carolina (n = 42, 79.2%), urban areas (n = 37, 69.8%), or intermediary SDOH (75.5%). Several themes emerged concerning lessons learned (awareness and empathy are key to addressing SDOH), health equity (collaboration is necessary to provide resources, especially for underserved populations), and constructive feedback for the instructor (more time to discuss SDOH and assignment with peers and instructor). Faculty must work with students to think about more upstream factors like policy and cultural and societal values. Collecting evaluation data, specifically lessons learned and constructive feedback for faculty, can help faculty continuously improve course topics and assignments. Following a transparency framework can support student success and help faculty become effective leaders in the classroom while teaching subjects like SDOH and social justice.
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Affiliation(s)
- Elizabeth A. Brown
- Old Dominion University, Norfolk, VA USA
- Medical University of South Carolina (MUSC), Charleston, SC USA
| | - Hannah Kinder
- Medical University of South Carolina (MUSC), Charleston, SC USA
| | - Garrett Stang
- Medical University of South Carolina (MUSC), Charleston, SC USA
| | - Wendy Shumpert
- Medical University of South Carolina (MUSC), Charleston, SC USA
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Noorily AR, Willieme A, Belsky M, Grogan K. The art of seeing: The impact of a visual arts course on medical student wellbeing. MEDICAL TEACHER 2023:1-6. [PMID: 36862139 DOI: 10.1080/0142159x.2023.2184675] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
PURPOSE Medical student burnout is becoming increasingly common. The Art of Seeing is a visual arts elective at one US medical school. The purpose of this study was to determine the effect of this course on attributes that are foundational to wellbeing: mindfulness, self-awareness, and stress. METHODS A total of 40 students participated in this study from 2019 through 2021. Fifteen students participated in the pre-pandemic, in-person course, and 25 students participated in the post-pandemic, virtual course. Pre and post-tests included open-ended responses to works of art, which were coded for themes, and standardized scales: mindful attention awareness scale (MAAS), situational self-awareness scale (SSAS), and perceived stress questionnaire (PSQ). RESULTS The students had statistically significant improvements on the MAAS (p < .01), the SSAS (p < .01), and the PSQ (p = 0.046). Improvements in the MAAS and the SSAS did not depend on class format. Students also demonstrated increased focus on the present moment, emotional awareness, and creative expression in the post test free responses. CONCLUSIONS This course significantly improved mindfulness, self-awareness, and stress levels in medical students, and can be used to help enhance wellbeing and mitigate burnout in this population, both in-person and virtually.
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Affiliation(s)
- Ariella R Noorily
- Department of Radiology, NYU Grossman School of Medicine, New York, NY, USA
| | | | | | - Katie Grogan
- Center to Advance Palliative Care, Icahn School of Medicine, Mount Sinai Health System, New York, NY, USA
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Rajagopalan A, Chew QH, Sim K. Medical Humanities in Undergraduate Psychiatry Teaching: Learner Assessment and Mediators of Better Learning Outcomes. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2023; 10:23821205231214393. [PMID: 38025022 PMCID: PMC10644729 DOI: 10.1177/23821205231214393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVES Previous studies have found that the inclusion of medical humanities in medical education was associated with improvements in learner reflectivity and empathy. There is less data, however, on the impact of medical humanities on perceived patient care and mediators of learner outcomes. Our study aimed to determine the impact of medical humanities on perceived learner well-being and patient care, and the mediators of these outcomes in medical undergraduates undergoing psychiatric training. METHODS This cross-sectional study was conducted from August 2021 to December 2022 within undergraduate medical students undergoing psychiatry rotations and who attended sessions entitled "Humanities in Psychiatry." Both quantitative and qualitative data were obtained through anonymized online feedback forms. Path analysis was performed to examine the relationship between learners' perception of the medical humanities writing activity and its potential to improve their well-being, patient care, as well as mediators of these outcomes. RESULTS Overall, 97 medical undergraduates (response rate 67.4%) participated in the study and more than four-fifths reported improvements in listening, reflection, empathy, personal well-being, and perceived patient care. Males showed more interest in additional medical humanities sessions (mean rank 57.9 vs 42.5, P = .005) and greater improvements in personal well-being (mean rank 55.1 vs 44.5, P = .044). Path analysis showed that reflective capacity of learners mediated the relationship between reflective writing and perceived improvements in learner well-being (β = 0.596, 95% CI = 0.409-0.737) and patient care (β = 0.557, 95% CI = 0.379-0.702). CONCLUSIONS Our study found that the majority of learners responded positively to the medical humanities sessions, which suggests that its use could be beneficial in fostering empathy, reflection, learner well-being, and improved patient care. Using the PRISM model, we present practical implications for educators to consider when using medical humanities in relation to psychiatry training.
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Affiliation(s)
| | - Qian Hui Chew
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Kang Sim
- West Region, Institute of Mental Health, Singapore, Singapore
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Makowska M, Szczepek AJ, Nowosad I, Weissbrot-Koziarska A, Dec-Pietrowska J. Perception of Medical Humanities among Polish Medical Students: Qualitative Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:270. [PMID: 36612590 PMCID: PMC9819447 DOI: 10.3390/ijerph20010270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/19/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
Medical humanities (MH) courses are a critical element of the medical curriculum influencing the establishment of a physician in the medical profession. However, the opinion about MH among medical students remains unknown. Interviews from seven focus groups were analysed. The students attended one of three Polish medical schools in Gdansk, Krakow, and Warsaw and were recruited to the discussion focused on the impact of drug manufacturers' presence at medical universities on socialization in the medical profession. Thematic analysis was conducted using the theoretical framework of social constructivism. The students' opinions about the MH classes arose during the analysis. In six groups, students thought that MH courses would be helpful in their future medical practice. However, in four groups, different opinion was expressed that MH courses were unnecessary or even "a waste of time". Factors discouraging students from the MH classes included poorly taught courses (monotonous, uninteresting, unrelated to medical practice, taught by unsuitable lecturers). Secondly, students thought that the time investment in the MH was too extensive. Furthermore, curriculum problems were identified, reflecting the incompatibility between the content of MH courses and teaching semesters. Lastly, some students stated that participation in MH courses should be elective and based on individual interests. Addressing problems recognized in this work could improve the training of future Polish physicians.
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Affiliation(s)
- Marta Makowska
- Department of Economic Psychology, Kozminski University, Jagiellońska 57, 03-301 Warszawa, Poland
| | - Agnieszka J. Szczepek
- Faculty of Medicine and Health Sciences, University of Zielona Góra, 65-046 Zielona Góra, Poland
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Inetta Nowosad
- Faculty of Social Sciences, University of Zielona Góra, 65-046 Zielona Góra, Poland
| | | | - Joanna Dec-Pietrowska
- Faculty of Medicine and Health Sciences, University of Zielona Góra, 65-046 Zielona Góra, Poland
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Arnold-Forster A, Brown M, Moulds A. Health, policy and emotion. MEDICAL HUMANITIES 2022; 48:389-393. [PMID: 36418191 DOI: 10.1136/medhum-2022-012541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/23/2022] [Indexed: 06/16/2023]
Affiliation(s)
- Agnes Arnold-Forster
- Centre for History in Public Health, London School of Hygiene and Tropical Medicine, London, UK
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Assing Hvidt E, Ulsø A, Thorngreen CV, Søndergaard J, Andersen CM. Weak inclusion of the medical humanities in medical education: a qualitative study among Danish medical students. BMC MEDICAL EDUCATION 2022; 22:660. [PMID: 36064397 PMCID: PMC9442995 DOI: 10.1186/s12909-022-03723-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The modern medical education is predominantly grounded in the biomedical sciences. In recent years, medical humanities have been included into the medical curricula in many countries around the world one of the objectives being to promote patient-centred, empathic care by future physicians. Studies have been made of the impact of inclusion of medical humanities components within the medical curriculum. Although some results suggest increased empathy, others remain inconclusive. To gain insight into the depth, context, and impact of inclusion of the medical humanities for future physicians, this study aimed to explore Danish medical students' understanding of and reflections on how the medical humanities relate to the medical education, including the clinic. METHODS We conducted a qualitative research study, involving semi-structured interviews with twenty-three Danish medical students across years of curriculum and medical schools. Interviews were recorded, transcribed verbatim and analyzed using Braun and Clarke's thematic analysis. RESULTS The findings demonstrate the subordinate role of the medical humanities in the medical educational system. Students prioritize biomedical knowledge building in the preclinical curriculum, partly as a reaction to an unbalanced institutional inclusion of the medical humanities. Observing how structural empathy incentives are lacking in the clinical curriculum, the values inherent in the medical humanities are undermined. CONCLUSION Danish medical students become part of an educational environment with lacking institutional conditions and structures to promote the strong inclusion of the medical humanities. A focus is therefore needed on the values, norms and structures of the medical educational systems that undermine a strong inclusion of the medical humanities into medical education.
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Affiliation(s)
- Elisabeth Assing Hvidt
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9 A, 5000, Odense, Denmark.
| | - Anne Ulsø
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9 A, 5000, Odense, Denmark
| | | | - Jens Søndergaard
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9 A, 5000, Odense, Denmark
| | - Christina Maar Andersen
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
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Thacker N, Wallis J, Winning J. 'Capable of being in uncertainties': applied medical humanities in undergraduate medical education. MEDICAL HUMANITIES 2022; 48:325-334. [PMID: 34580192 DOI: 10.1136/medhum-2020-012127] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/21/2021] [Indexed: 06/13/2023]
Abstract
Numerous medical schools have been updating and modernising their undergraduate curricula in response to the changing health needs of today's society and the updated General Medical Council competencies required for qualification. The humanities are sometimes seen as a way of addressing both of these requirements. Medical humanities advocates would argue that the humanities have a vital role to play in undergraduate medical education, allowing students to develop the critical tools required by the 21st-century clinician to deliver the best person-centred care. While we endorse this view, we contend that such training must be taught authentically to have maximal impact. This article arises from a collaboration between Imperial College London and Birkbeck, University of London, which aimed to embed the humanities into Imperial's undergraduate medical curriculum. Here, we use a teaching session on graphic medicine and narrative as a case study to illustrate how the humanities can be a powerful tool for students to explore professional clinical complexity and uncertainty when taught in a transdisciplinary way. In this session, uncertainty operated on several different levels: the introduction of unfamiliar concepts, materials, and methods to students, transdisciplinary approaches to teaching, and the complexities of real-life clinical practice. Further, we argue that to manage uncertainty, medical students must cross from a scientific training based on positivist understandings of evidence and knowledge, to one which foregrounds multiplicity, nuance, interpretive critical thinking, and which understands knowledge as contingent and contextually produced. In facilitating such learning, it is crucial that the teaching team includes experts from both medical and humanities fields to scaffold student learning in an intellectually dynamic way, drawing on their disciplinary knowledge and wide range of personal professional experiences.
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Affiliation(s)
- Neepa Thacker
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
| | | | - Jo Winning
- English, Theatre and Creative Writing, Birkbeck University of London, London, UK
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Kwok I, Keyssar JR, Spitzer L, Kojimoto G, Hauser J, Ritchie CS, Rabow M. Poetry as a Healing Modality in Medicine: Current State and Common Structures for Implementation and Research. J Pain Symptom Manage 2022; 64:e91-e100. [PMID: 35584740 DOI: 10.1016/j.jpainsymman.2022.04.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 04/01/2022] [Accepted: 04/05/2022] [Indexed: 11/24/2022]
Abstract
In healthcare institutions across the country, the role of poetry continues to emerge within the liminal spaces between the medical humanities and clinical care. While the field of narrative medicine is well-developed generally, formal review of the state of poetry as a healing modality is limited. Poetry in the medical humanities literature has often been described by its indefinability as much as by its impact on healing. The power of poetry in healthcare is thought to be multi-faceted and deserves to be explored further. Poetry can be medicine for both patient and clinician. "Poetic Medicine" is a modality that has been utilized for the healing of grief, loss, wounds of the psyche and spirit, and as a process for expanding resiliency in healthcare-applications that are particularly relevant to the practice of hospice and palliative medicine-for patient and clinician alike. While numerous approaches share common themes, current programs bringing poetry into healthcare have been operating largely in isolation from each other-with a lack of national consensus on definitions or structures of interventions. Such isolation is a major restriction to the study and growth of Poetic Medicine. While it is not known with certitude, the number of Poetic Medicine programs in healthcare in the United States appears to be growing. In this paper, we propose an initial framework to define the role and impact of poetry in healthcare and then describe two different, well-established Poetic Medicine programs in the United States.
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Affiliation(s)
- Ian Kwok
- Division of Geriatrics and Palliative Medicine (I.K.), Weill Cornell Medical College, New York, New York, USA
| | - Judith Redwing Keyssar
- UCSF: University of California San Francisco (J.R.K., L.S.), San Francisco, California, USA; UCSF MERI CENTER : University of California San Francisco (G.K.), San Francisco, California, USA.
| | - Lee Spitzer
- UCSF: University of California San Francisco (J.R.K., L.S.), San Francisco, California, USA
| | - Gayle Kojimoto
- UCSF: University of California San Francisco (J.R.K., L.S.), San Francisco, California, USA; UCSF MERI CENTER : University of California San Francisco (G.K.), San Francisco, California, USA
| | - Joshua Hauser
- Northwestern University Feinberg School of Medicine (J.H.), Chicago, Illinois, USA; and
| | - Christine Seel Ritchie
- MGH Division of Palliative Care and Geriatric Medicine (C.S.R.), Harvard Medical School, Boston, Massachusetts, USA
| | - Michael Rabow
- UCSF: University of California San Francisco (J.R.K., L.S.), San Francisco, California, USA; UCSF MERI CENTER : University of California San Francisco (G.K.), San Francisco, California, USA
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Dammann O, Mežinska S, Gefenas E. Health Humanities in Medicina: The Auxiliary Stance. Medicina (B Aires) 2022; 58:medicina58030411. [PMID: 35334587 PMCID: PMC8951118 DOI: 10.3390/medicina58030411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 11/16/2022] Open
Abstract
At the core of medicine is the idea to help fellow human beings by improving or even restoring their health [...]
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Affiliation(s)
- Olaf Dammann
- Deptartment of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA 02111, USA
- Department of Gynecology & Obstetrics, Hannover Medical School, D-30635 Hannover, Germany
- Department of Neuromedicine and Movement Science, Norwegian University of Science & Technology, NO-7491 Trondheim, Norway
- Correspondence: ; Tel.: +1-617-636-3963
| | - Signe Mežinska
- Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia;
| | - Eugenijus Gefenas
- Center for Health Ethics, Law and History, Institute of Health Sciences, Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania;
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Pravder HD, Elkin DJ, Post SG, Chitkara MB. An Innovative Program Using Magic to Provide Early Clinical Experiences for Preclinical Medical Students: Goals, Experiences, and Results of the MagicAid Program. MEDICAL SCIENCE EDUCATOR 2022; 32:111-120. [PMID: 35043080 PMCID: PMC8758224 DOI: 10.1007/s40670-021-01456-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/19/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Effectively training medical students in compassion, communication, and empathy is essential in fostering a holistic approach to patient care. We sought to address this by implementing an early clinical experience service learning program for medical students in the initial years of their medical education. METHODS Medical students at Stony Brook University initiated, designed, and facilitated the volunteer program, which provides students a framework to learn magic therapy and engage with pediatric patients. The program includes an introductory presentation, training course, and organized bedside sessions with patients. To evaluate the program, a sample of participants partook in a focus group, written questionnaire, and/or online survey. RESULTS From 2015 to 2020, 130 students participated in magic therapy rounds, engaging 1391 patients. Nine themes of student benefit emerged from qualitative analysis, including acquisition of familiarity with the hospital and healthcare team, cultivation of communication skills, contribution to improvement of patient affect, development of empathic qualities and techniques, and improvement in psychological health. Students were very satisfied with their experiences and viewed the activity as helpful for patients, parents, staff, and themselves. CONCLUSIONS The program engaged students in compassionate patient care within a holistic approach to patient care early in training. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s40670-021-01456-y.
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Affiliation(s)
- Harrison D. Pravder
- Renaissance School of Medicine, Stony Brook University, 100 Nicolls Road, Stony Brook, NY 11794 USA
- MagicAid, Great Neck, NY 11021 USA
| | - David J. Elkin
- Renaissance School of Medicine, Stony Brook University, 100 Nicolls Road, Stony Brook, NY 11794 USA
- MagicAid, Great Neck, NY 11021 USA
| | - Stephen G. Post
- Center for Medical Humanities, Department of Family, Population and Preventive Medicine, Compassionate Care and Bioethics, Stony Brook University, HSC, Level 3, Suite 080, Stony Brook, NY 11794 USA
| | - Maribeth B. Chitkara
- Department of Pediatrics, Stony Brook Children’s, 101 Nicolls Road, Stony Brook, NY 11794 USA
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Neto IG. Palliative care and its own identity, through an autoethnography: do you recognize these patterns? Palliat Care Soc Pract 2022; 16:26323524221122346. [PMID: 36118620 PMCID: PMC9478704 DOI: 10.1177/26323524221122346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 07/28/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction: After more than 25 years working in palliative care (PC) observing thousands
of patients and family behaviors, I use my long experience and notes as a
source of data for a qualitative research study. The aim is to identify
frequent families’ behavior patterns in PC and better describe the culture
in PC. Methods: This article is part of a larger project, using autoethnography as
methodology, with the aim of helping doctors and interested health
professionals better understand the culture and reality of PC. The focus is
not the author but patients and families’ patterns of
social behavior – the social context – within the
end-of-life period and how to deal with these professionally.
Confidentiality and privacy of patients’ data were guaranteed. Results: The vast number of treated cases, the regular observation and recording, and
the continuous reflection and analysis over many years have led to these
results. Due to editorial restrictions, in this article I only describe four
of at least eight typical scenarios I have identified. Each is given a short
title and I explore some of their inside-issues, integrating previous
knowledge, research, and explanations, with practical suggestions on how to
deal with them. Significance: As far as we know, these scenarios/patterns have never been described in this
way. This work expands knowledge, innovates, and contributes to better
describing PC culture. The final goal is to create a set of scripts that can
be used to help clinicians quickly identify the clinical situation and how
to deal with it in clinical practice. Reflecting on how patients and
families frequently behave in PC can be very useful and then teach other
professionals to better deal with these challenges.
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Affiliation(s)
- Isabel Galriça Neto
- Palliative Care Unit, Hospital da Luz-Lisboa, Lisbon University Medical School, Catolica University Medical School, Av.Lusíada 100, Lisboa 1500-650, Portugal
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Shapiro J, McMullin J, Miotto G, Nguyen T, Hurria A, Nguyen MA. Medical Students' Creation of Original Poetry, Comics, and Masks to Explore Professional Identity Formation. THE JOURNAL OF MEDICAL HUMANITIES 2021; 42:603-625. [PMID: 34779996 PMCID: PMC8664798 DOI: 10.1007/s10912-021-09713-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/30/2021] [Indexed: 05/09/2023]
Abstract
INTRODUCTION This study examines differences in students' perceived value of three artmaking modalities (poetry, comics, masks) and whether the resulting creative projects offer similar or different insights into medical students' professional identity formation. METHODS Mixed-methods design using a student survey, student narrative comments and qualitative analysis of students' original work. RESULTS Poetry and comics stimulated insight, but masks were more enjoyable and stress-reducing. All three art modalities expressed tension between personal and professional identities. DISCUSSION Regardless of type of artmaking, students express concern about encroachments of training on personal identity but hoped that personal and professional selves could be integrated.
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Affiliation(s)
- Johanna Shapiro
- Department of Family Medicine, School of Medicine, UC Irvine Medical Center, University of California Irvine, rte 81, bldg. 200, rm 835, 101 City Dr. South, Orange, CA, 92868, USA.
| | - Juliet McMullin
- Department of Anthropology, University of California Riverside, Riverside, CA, USA
| | | | - Tan Nguyen
- Department of Family Medicine, School of Medicine, UC Irvine Medical Center, University of California Irvine, rte 81, bldg. 200, rm 835, 101 City Dr. South, Orange, CA, 92868, USA
| | - Anju Hurria
- Department of Psychiatry and Human Behavior, School of Medicine, University of California Irvine, Orange, CA, 92868, USA
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Srolovitz M, Borgwardt J, Burkart M, Clements-Cortes A, Czamanski-Cohen J, Ortiz Guzman M, Hicks MG, Kaimal G, Lederman L, Potash JS, Yazdian Rubin S, Stafford D, Wibben A, Wood M, Youngwerth J, Jones CA, Kwok IB. Top Ten Tips Palliative Care Clinicians Should Know About Music Therapy and Art Therapy. J Palliat Med 2021; 25:135-144. [PMID: 34665661 DOI: 10.1089/jpm.2021.0481] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Palliative care is provided by an interdisciplinary team, including physicians, advanced practice providers, nurses, social workers, chaplains, and other disciplines based on need. Music therapists and art therapists are becoming increasingly available to palliative care teams and are advancing the diverse and unique clinical services available to effectively meet the holistic needs of patients with serious illnesses and their families. This article provides a concrete exploration of clinical music therapy and art therapy within palliative care and hospice paradigms, with discussion of therapists' training and expertise, therapeutic approaches within the setting of interprofessional team-based care, and discussion of evidence-based symptom management and outcomes supporting the inclusion of music and art therapies within medical education and clinical employment.
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Affiliation(s)
- Melissa Srolovitz
- Penn Medicine Hospice, Penn Medicine at Home, University of Pennsylvania Health System, Bala Cynwyd, Pennsylvania, USA
| | - Jennifer Borgwardt
- Penn Medicine Hospice, Penn Medicine at Home, University of Pennsylvania Health System, Bala Cynwyd, Pennsylvania, USA
| | - Moreen Burkart
- VNA Hospice of the Treasure Coast, Vero Beach, Florida, USA
| | | | - Johanna Czamanski-Cohen
- The School of Creative Arts Therapies, Faculty of Welfare and Health Sciences, University of Haifa, Haifa, Israel.,Emili Sagol Creative Arts Therapies Research Center, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | | | - Molly G Hicks
- Penn Medicine Hospice, Penn Medicine at Home, University of Pennsylvania Health System, Bala Cynwyd, Pennsylvania, USA
| | - Girija Kaimal
- Department of Creative Arts Therapies, Drexel University, Philadelphia, Pennsylvania, USA
| | | | - Jordan S Potash
- Art Therapy Program, The George Washington University, Alexandria, Virginia, USA
| | | | - Daniel Stafford
- Lucille Packard Children's Hospital, Stanford University, Palo Alto, California, USA
| | - Angela Wibben
- Palliative Care Consult Service, University of Colorado Hospital, Aurora, Colorado, USA
| | | | - Jean Youngwerth
- Department of Medicine, UCHealth University of Colorado Hospital Palliative Care Service, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Christopher A Jones
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Ian B Kwok
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College, New York, New York, USA
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Pastrana T, Wüller J, Weyers S, Bruera E. Insights from a community-based palliative care course: a qualitative study. BMC Palliat Care 2021; 20:106. [PMID: 34256751 PMCID: PMC8278762 DOI: 10.1186/s12904-021-00769-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 05/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The vast majority of medical students have no exposure to clinical palliative care encounters, especially in the community. Medical schools should respond to current challenges and needs of health systems by guaranteeing students adequate training that addresses palliative care needs of populations in different settings. The main purpose of this qualitative study was to capture the experiences of a select group of medical students' following a community-based PC course. METHODS We carried out a qualitative study using two focus groups to capture the experience of medical students in a course that combined classroom teaching with community-based learning for undergraduate medical students in Germany. Discussions were transcribed and analyzed thematically. RESULTS Fifteen female students in their 2nd to 5th year participated in the focus groups, which provided didactic teaching and experiential learning. Four areas were particularly relevant: (1) authenticity, (2) demystification of the concepts of palliative care through personal contact with patients, (3) translation of theoretical knowledge into practice, and (4) observation of a role model interacting with seriously ill patients and engaging in difficult conversations. CONCLUSION Students whose encounters with patients and their families went beyond a review of their medical records had a better grasp of the holistic nature of PC than those who did not. Bringing students directly from the hospital to patients in their homes reinforced the benefits of an integrated healthcare system.
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Affiliation(s)
- Tania Pastrana
- Department of Palliative Medicine, Medical Faculty, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany.
| | - Johannes Wüller
- Home Care Städteregion Aachen Non-profit Limited Liability Company, Aachen, Germany
| | - Simone Weyers
- Institute of Medical Sociology, Centre for Health and Society (CHS), Düsseldorf University Hospital, Düsseldorf, Germany
| | - Eduardo Bruera
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Fagiolo S. Telling lives in medicine: the impact of biography collections in medical education. J Med Libr Assoc 2021; 109:510-513. [PMID: 34629984 PMCID: PMC8485942 DOI: 10.5195/jmla.2021.1312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
This article briefly discusses the value and impact of biography collections in medical education by illustrating the case of the Campus Bio-Medico University of Rome (UCBM) Library. The UCBM Library collects, curates, and provides access to a special biography collection with the purpose of documenting the history of men and women who contributed in the field of medicine and related sciences. This article highlights the importance of academic medical libraries collecting biographical works in order to transmit knowledge and values in medical school curriculum.
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Affiliation(s)
- Sofia Fagiolo
- , Cataloging Librarian, Library, Campus Bio-Medico University of Rome, Italy
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Training Healthcare Professionals on How to Promote Physical Activity in the UK: A Scoping Review of Current Trends and Future Opportunities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136701. [PMID: 34206335 PMCID: PMC8297298 DOI: 10.3390/ijerph18136701] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 06/17/2021] [Accepted: 06/18/2021] [Indexed: 11/19/2022]
Abstract
What physical activity (PA) training do current and future healthcare professionals (HCPs) receive in the UK? How is PA training delivered to them? The present scoping review looks at existing evidence to respond these questions. Seven databases were searched: Medline, SportDISCUS, PsycINFO, EMBASE, CINAHL, Cochrane Review Database, and Web of Science. Grey literature sources and key stakeholders were consulted. Studies were screened for inclusion, data were extracted and charted, and findings were synthesised according to the two research questions. Of the 3535 identified studies, 25 were included. The results show that no standardised approach was used to deliver PA promotion in HCPs training. PA training content was chiefly underpinned by an epidemiological approach. Online delivery of content predominated in continuing professional development training, whereas in undergraduate healthcare curriculum, delivery strategies varied. Overall, the process of embedding PA in HCPs’ curriculum and culture is ongoing. In addition to highlighting what is present within healthcare education, this study identifies further opportunities. Potential avenues include extending PA promotion into other workforces, including social workers.
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Acceptability and effectiveness of a poetic narrative video facilitated large classroom teaching in psychiatry. Med J Armed Forces India 2021; 77:S157-S160. [PMID: 33612947 DOI: 10.1016/j.mjafi.2021.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 01/02/2021] [Indexed: 11/23/2022] Open
Abstract
Background Lecture based large classroom teaching is limited in scope of learning by being primarily. Teacher focussed, directive and monotonous with students often being passive participants. In psychiatry, problem is further compounded because of stigma around the subject and lack of summative assessment. Narratives and poems have been used in education to facilitate teaching. Methods 50 randomly selected medical undergraduate students were subjected to short poetic narrative video facilitated large classroom interactive lecture, while 50 other students were imparted traditional classroom lecture. Acceptability and effectiveness of this teaching learning modality was done with a questionnaire and multiple-choice questions on the given topic post the lecture. Result Around 90 percent of the student found the modified classroom teaching to be acceptable. It was equally effective as traditional classroom teaching. Student and faculty reflected on the whole experience as innovative, immersive and appealing to empathy. Conclusion Poetic narrative facilitated classroom teaching is an acceptable and equally effective modality of large classroom teaching.
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Stodola TJ, Bruna SP. Medical Anthropology Courses and Concepts Tested on the MCAT: A Content Analysis of 40 U.S. Course Syllabi. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2021; 8:23821205211010812. [PMID: 33997288 PMCID: PMC8107945 DOI: 10.1177/23821205211010812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 03/15/2021] [Indexed: 06/12/2023]
Abstract
The Association of American Medical Colleges recommends students seeking to enter medical school complete courses in the social sciences. Despite calls to teach social science-including anthropology-in pre-medical curriculum, little is known about what is taught in undergraduate medical anthropology courses and if concepts taught in those courses addresses topics tested in the MCAT exam. Given the growing number of anthropology students in baccalaureate allied health fields, there is a growing need to examine if anthropological coursework addresses relevant MCAT topics. Using a mixed methods content analysis, this study examined syllabi from forty U.S.-based medical anthropology courses to assess if MCAT concepts are taught in Medical Anthropology courses. Survey data was examined using descriptive statistics; syllabi were analyzed with NVivo using a binary coding scheme and modified grounded theory. Overall, only 8.69% of 155 possible concepts and terms from the Psychological, Social, and Biological Foundations of Behavior section of the MCAT were present in the syllabi. We close with considerations for future course design of medical anthropology courses.
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Affiliation(s)
| | - Sean P Bruna
- Sean P Bruna, Department of Anthropology,
Western Washington University, 516 High Street, Bellingham, WA 98225, USA.
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Kangasjarvi E, Ng SL, Friesen F, Simpson JS. Patients as teachers and arts-based reflection in surgical clerkship: A preliminary exploration. MEDICAL TEACHER 2020; 42:1362-1368. [PMID: 32847442 DOI: 10.1080/0142159x.2020.1807482] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Involving patients in medical education as teachers is not a novel approach, yet it has not been widely adopted by undergraduate surgical curricula in Canada. The Patients as Teachers initiative in surgery (PAT) program, with an arts-based reflection assignment, was developed for surgical clerks with the goals of emphasizing patient-centredness in surgical practice, humanistic aspects of medicine, and to counterbalance the commonplace emphasis on technical competency in surgery. METHODS Qualitative data was collected exploring the question: What was the experience and impact of the PAT program on patient teachers and students? Patient teachers (n = 5) were invited to participate in one-on-one interviews and students (n = 46) were invited to participate in focus groups at the end of the program. RESULTS Findings converged around two main themes: what students/patient teachers valued about the PAT program and what they perceived was learned. While patient teachers felt a sense of emotional healing and appreciated a chance to contribute to medical education, students valued having protected time to learn in depth from the patient teachers. Students also begrudgingly came to appreciate the arts-based reflection assignment. CONCLUSION By bringing patient voice to the forefront and encouraging reflection, the PAT program emphasized to students the compassionate and humanistic side of surgical care. Future studies could examine the mechanisms by which learning occurs and long-term impacts.
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Affiliation(s)
- Emilia Kangasjarvi
- Faculty of Medicine, Centre for Faculty Development, University of Toronto at St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Stella L Ng
- Faculty of Medicine, Centre for Faculty Development, University of Toronto at St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Centre for Ambulatory Care Education, Women's College Hospital, Toronto, Ontario, Canada
- Department of Speech-Language Pathology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Farah Friesen
- Faculty of Medicine, Centre for Faculty Development, University of Toronto at St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Jory S Simpson
- Department of Surgery, Division of General Surgery, Faculty of Medicine, St. Michael's Hospital, Unity Health Toronto, University of Toronto, Toronto, Ontario, Canada
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Costa M, Kangasjarvi E, Charise A. Beyond empathy: a qualitative exploration of arts and humanities in pre-professional (baccalaureate) health education. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2020; 25:1203-1226. [PMID: 32100196 PMCID: PMC7704487 DOI: 10.1007/s10459-020-09964-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 02/17/2020] [Indexed: 06/10/2023]
Abstract
For nearly four decades, researchers have explored the integration of arts and humanities content into health professions education (HPE). However, enduring controversies regarding the purpose, efficacy, and implementation of humanities initiatives suggest that the timing and context of trainees' exposure to such content is a key, but seldom considered, factor. To better understand the affordances of introducing humanities-based health curriculum prior to the HPE admissions gateway, we conducted a qualitative instrumental case study with participants from Canada's first Health Humanities baccalaureate program. Fully anonymized transcripts from semi-structured interviews (n = 11) and focus groups (n = 14) underwent an open-coding procedure for thematic narrative analysis to reveal three major temporal domains of described experience (i.e., prior to, during, and following their participation in a 12-week semester-long "Introduction to Health Humanities" course). Our findings demonstrate that perceptions of arts- and humanities content in health education are generated well in advance of HPE admission. Among other findings, we define a new concept-epistemological multicompetence-to describe participants' emergent capability to toggle between (and advocate for the role of) multiple disciplines, arts and humanities particularly, in health-related teaching and learning at the pre-professional level. Improved coordination of baccalaureate and HPE curricula may therefore enhance the development of capabilities associated with arts and humanities, including: epistemological multicompetence, aesthetic sensibility, and other sought-after qualities in HPE candidates. In conclusion, attending to the pre-professional admissions gateway presents a new, capabilities-driven approach to enhancing both the implementation and critical understanding of arts and humanities' purpose, role, and effects across the "life course" of health professions education.
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Affiliation(s)
- Marcela Costa
- Federal University of Pernambuco, Recife, Brazil
- SCOPE: The Health Humanities Learning Lab, University of Toronto Scarborough, Scarborough, Canada
| | - Emilia Kangasjarvi
- Centre for Faculty Development, Faculty of Medicine, University of Toronto at St. Michael’s Hospital, Toronto, Canada
| | - Andrea Charise
- SCOPE: The Health Humanities Learning Lab, University of Toronto Scarborough, Scarborough, Canada
- Interdisciplinary Centre for Health & Society (ICHS), University of Toronto Scarborough, 1265 Military Trail, c/o Highland Hall Rm. 220, Toronto, ON M1C 1A4 Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada
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Al-Azri NH. Towards Culture-Oriented Medical Philosophy, Education, Research and Practice. Sultan Qaboos Univ Med J 2020; 20:e290-e295. [PMID: 33414932 PMCID: PMC7757935 DOI: 10.18295/squmj.2020.20.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 06/05/2020] [Accepted: 07/01/2020] [Indexed: 11/24/2022] Open
Abstract
Medicine is a sociotechnical system wherein culture manifests itself in all its aspects. Culture, however, is often intangible and is frequently neglected in formal healthcare education, research and practice. This sounding board article attempts to generate interest in making culture a serious component of healthcare systems at different levels, including its founding philosophical underpinnings, educational systems, research activities and clinical practice. It is recommended that a framework of culture-oriented medical philosophy, education, research and practice be implemented. Each component of this framework is briefly discussed in relation to healthcare. Culture should be reflected explicitly in healthcare through research activities, medical humanities, cultural competence, communication and ethics.
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37
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Shalev D, McCann R. Can the Medical Humanities Make Trainees More Compassionate? A Neurobehavioral Perspective. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2020; 44:606-610. [PMID: 31933116 DOI: 10.1007/s40596-020-01180-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 01/08/2020] [Indexed: 06/10/2023]
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Finn GM, Brown MEL, Laughey W. Holding a mirror up to nature: the role of medical humanities in postgraduate primary care training. EDUCATION FOR PRIMARY CARE 2020; 32:73-77. [PMID: 32926808 DOI: 10.1080/14739879.2020.1816860] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The humanities are academic disciplines that study aspects of human society, experience and culture. Typically, the humanities, including philosophy, literature, art, music, history and language have been used to interpret and record our understanding of the world. In recent decades, the humanities have seen somewhat of a renaissance within medicine, particularly within undergraduate medical education. This leading article explores the value of utilising medical humanities, such as art, poetry and theatre, within postgraduate primary care training. Using examples of approaches already interwoven into the fabric of undergraduate medical education, such as simulated patient consultations and anatomical body painting, the tangible benefits of applying humanities disciplines within general practice training are discussed. The humanities have much to offer from the value of utilising an artistic lens to examine the body, the creation of socially cohesive working environments and supporting the development of empathy within trainees. This article recommends the provision of both increased informal and formal engagement with the medical humanities within postgraduate primary care training, providing practical tips for GP educators looking to integrate the humanities within pre-existing tutorials.
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Affiliation(s)
- Gabrielle M Finn
- Health Professions Education Unit, Hull York Medical School, University of York, York, UK.,Division of Medical Education, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Megan E L Brown
- Health Professions Education Unit, Hull York Medical School, University of York, York, UK
| | - William Laughey
- Health Professions Education Unit, Hull York Medical School, University of York, York, UK
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Interactions between Medicine and the Arts. Wien Klin Wochenschr 2020; 132:1-65. [DOI: 10.1007/s00508-020-01706-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Segar N, Sullivan J, Litwin K, Hauser J. Poetry for Veterans: Using Poetry to Help Care for Patients in Palliative Care-A Case Series. J Palliat Med 2020; 24:464-467. [PMID: 32830990 DOI: 10.1089/jpm.2020.0078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Although there is growing evidence that close reading of literature and reflective writing can improve providers' appreciation of the patient experience, foster physician development, and combat burnout, there has been less work on the experience of reading literature with patients, and even less literature about its effect on those facing serious or life-threatening illness. In addition, longer form reading may be unsuitable for some patient populations, given high burden of fatigue and possible contribution of delirium. Time pressure may also preclude discussion by a practitioner working in a busy clinical context. Hypothesis: We feel the condensed medium of poetry presents a natural opportunity to engage patients with the medical humanities, helping them to articulate difficult or joyful experiences, and/or serving as necessary diversion when facing serious illness. Project Description: Poetry for patients-a project developed through collaboration between Northwestern Memorial Hospital, The Jesse Brown VA, and the Poetry Foundation in Chicago, an independent literary organization committed to a vigorous presence for poetry in our culture-has developed three short collections of poems, and an accompanying discussion guides for use specifically with patients and families. Hereunder, we present three case examples of a short (10-30 minutes) reading session with patients demonstrating that it is feasible to incorporate reading poetry with patients facing serious illness. Potential therapeutic value includes helping patients to articulate pain and joy, giving patients a vehicle to recapture their creative voice, and altering the power dynamics inherit to the provider-patient relationship. We have also noted enhanced life review, often on themes otherwise difficult to access. In turn, these readings have deepened our ability to see out patients as creative, intellectual, and larger than their medical illness.
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Affiliation(s)
- Nora Segar
- Yale New Haven Health, New Haven, Connecticut, USA
| | | | | | - Joshua Hauser
- Palliative Care, Northwestern University, Chicago, Illinois, USA
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Forde E, Scallan S, Jackson S, Bowditch W, Wedderburn C. Can the arts enhance postgraduate GP training? EDUCATION FOR PRIMARY CARE 2020; 31:98-103. [PMID: 31964283 DOI: 10.1080/14739879.2020.1713907] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The value of arts-based medical education is becoming increasingly well established in undergraduate curricula. However, little is known about its value, and acceptability, to qualified doctors undertaking postgraduate training. In this work we examined GP trainees' views on whether arts-based education was useful for their professional development and, if so, what they perceived its value to be. All first and second year GP trainees on the Dorset Vocational Training Scheme attended a one day course which showcased how the arts (film, poetry, painting, photography, theatre) could enhance their professional development as doctors. GP trainees rated the day as interesting, enjoyable and thought proving. The majority felt that the arts could contribute to making them more competent and humane doctors. Following this, we ran a mandatory six months arts based course for six GP trainees, and evaluated their feedback through qualitative analysis of a focus group discussion. Overall, GP trainees found the course enjoyable and valuable to their learning. It not only gave them a deeper appreciation of the patient's perspective, but also encouraged them to think about their own health and wellbeing.
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Affiliation(s)
- Emer Forde
- GP Centre, Bournemouth University, Poole, UK
| | - Samantha Scallan
- GP Education Unit, Southampton University Hospital NHS Trust, Southampton, UK
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