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Bekele A, Regnier D, Paul T, Waka TY, Bradley EH. Advancing Global Health Equity: The Role of the Liberal Arts in Health Professional Education. THE JOURNAL OF MEDICAL HUMANITIES 2024; 45:185-192. [PMID: 38102336 PMCID: PMC11068827 DOI: 10.1007/s10912-023-09827-9] [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: 10/29/2023] [Indexed: 12/17/2023]
Abstract
Much innovation has taken place in the development of medical schools and licensure exam processes across the African continent. Still, little attention has been paid to education that enables the multidisciplinary, critical thinking needed to understand and help shape the larger social systems in which health care is delivered. Although more than half of medical schools in Canada, the United Kingdom, and the United States offer at least one medical humanities course, this is less common in Africa. We report on the "liberal arts approach" to medical curricula undertaken by the University of Global Health Equity beginning in 2019. The first six-month semester of the curriculum, called Foundations in Social Medicine, includes courses in critical thinking and communication, African history and global political economy, medical anthropology and social medicine, psychology and health, gender and social justice, information technology and health, and community-based training. Additionally, an inquiry-based pedagogy with relatively small classes is featured within an overall institutional culture that emphasizes health equity. We identify key competencies for physicians interested in pursuing global health equity and how such competencies relate to liberal arts integration into the African medical school curriculum and pedagogical approach. We conclude with a call for a research agenda that can better evaluate the impact of such innovations on physicians' education and subsequent practices.
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Affiliation(s)
- Abebe Bekele
- University of Global Health Equity, Kigali, Rwanda
| | | | - Tomlin Paul
- University of Global Health Equity, Kigali, Rwanda
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Mema B, Helmers A, Proulx C, Min KSK, Navne LE. Through the looking glass: qualitative study of critical care clinicians engaging in humanities. Intensive Care Med 2024; 50:427-436. [PMID: 38451286 DOI: 10.1007/s00134-024-07331-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/20/2024] [Indexed: 03/08/2024]
Abstract
PURPOSE Critical care medicine is facing an epidemic of burnout and consequent attrition. Interventions are needed to re-establish the medical field as a place of professional growth, resilience, and personal well-being. Humanities facilitate creation, reflection, and meaning-making, holding the promise of personal and community transformation. This study aimed to explore how clinicians engage with a humanities program, and what role and impact do the humanities play in their individual and collective journey. METHODS This is a qualitative study employing a phenomenological approach. Participants were faculty and trainees who participated in the program. Data consisted of (a) 60-h observations of humanities evenings, (b) more than 200 humanities artifacts brought by participants, and (c) 15 in-depth participant interviews. Data were analyzed inductively and reflectively by a team of researchers. RESULTS Participants were motivated to engage with the humanities curriculum because of past experiences with art, identifying a desire to re-explore their creativity to make meaning from their clinical experiences and a wish to socialize with and understand their colleagues through a different lens. The evenings facilitated self-expression, and inspired and empowered participants to create art pieces and re-engage with art in their daily lives. More importantly, they found a community where they could be vulnerable and supported, where shared experiences were discussed, emotions were validated, and relationships were deepened between colleagues. CONCLUSIONS Humanities may impact resilience and personal and community well-being by facilitating reflection and meaning-making of challenging clinical work and building bonds between colleagues.
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Affiliation(s)
- Briseida Mema
- Department of Critical Care Medicine, Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Canada.
| | - Andrew Helmers
- Department of Critical Care Medicine, Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Catherine Proulx
- Department of Critical Care Medicine, Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
- University of Toronto, Toronto, Canada
| | - Kyung-Seo Kay Min
- Rare Book School (RBS), University of Virginia, Charlottesville, USA
| | - Laura E Navne
- The Danish Center for Social Science Research, VIVE, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Carr SE, Harris A, Scott K, Ani-Amponsah M, Hooker C, Phillips B, Noya F, Mavaddat N, Vuillermin DM, Reid S, Brett-MacLean P. InspirE5: a participatory, internationally informed framework for health humanities curricula in health professions education. BMC MEDICAL EDUCATION 2022; 22:490. [PMID: 35739520 PMCID: PMC9225807 DOI: 10.1186/s12909-022-03551-z] [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: 01/27/2022] [Accepted: 06/08/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Reporting on the effect of health humanities teaching in health professions education courses to facilitate sharing and mutual exchange internationally, and the generation of a more interconnected body of evidence surrounding health humanities curricula is needed. This study asked, what could an internationally informed curriculum and evaluation framework for the implementation of health humanities for health professions education look like? METHODS The participatory action research approach applied was based on three iterative phases 1. Perspective sharing and collaboration building. 2. Evidence gathering 3. Development of an internationally relevant curriculum and evaluation framework for health humanities. Over 2 years, a series of online meetings, virtual workshops and follow up communications resulted in the production of the curriculum framework. RESULTS Following the perspective sharing and evidence gathering, the InspirE5 model of curriculum design and evaluation framework for health humanities in health professions education was developed. Five principal foci shaped the design of the framework. ENVIRONMENT Learning and political environment surrounding the program. Expectations: Graduate capabilities that are clearly articulated for all, integrated into core curricula and relevant to graduate destinations and associated professional standards. EXPERIENCE Learning and teaching experience that supports learners' achievement of the stated graduate capabilities. EVIDENCE Assessment of learning (formative and/or summative) with feedback for learners around the development of capabilities. Enhancement: Program evaluation of the students and teachers learning experiences and achievement. In all, 11 Graduate Capabilities for Health Humanities were suggested along with a summary of common core content and guiding principles for assessment of health humanities learning. DISCUSSION Concern about objectifying, reductive biomedical approaches to health professions education has led to a growing expansion of health humanities teaching and learning around the world. The InspirE5 curriculum and evaluation framework provides a foundation for a standardised approach to describe or compare health humanities education in different contexts and across a range of health professions courses and may be adapted around the world to progress health humanities education.
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Affiliation(s)
- Sandra E Carr
- Health Professions Education, University of Western Australia, Perth, Australia.
| | - Anna Harris
- Faculty of Arts and Social Sciences, Maastricht University, Maastricht, Netherlands
| | - Karen Scott
- Medical School, University of Sydney, Sydney, Australia
| | | | - Claire Hooker
- Medical School, University of Sydney, Sydney, Australia
| | - Brid Phillips
- Health Professions Education, University of Western Australia, Perth, Australia
| | - Farah Noya
- Health Professions Education, University of Western Australia, Perth, Australia
- Medical School, University of Pattimura Indonesia, Nusaniwe, Indonesia
| | - Nahal Mavaddat
- Medical School, University of Western Australia, Perth, Australia
| | | | - Steve Reid
- University of Cape Town, Cape Town, South Africa
| | - Pamela Brett-MacLean
- Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
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Pentecost M, Adams V, Baru R, Caduff C, Greene JA, Hansen H, Jones DS, Kitanaka J, Ortega F. Revitalising global social medicine. Lancet 2021; 398:573-574. [PMID: 34058131 DOI: 10.1016/s0140-6736(21)01003-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Michelle Pentecost
- Department of Global Health and Social Medicine, King's College London, London, UK; Department of Anthropology, University of Cape Town, Cape Town, South Africa
| | - Vincanne Adams
- Department of Humanities and Social Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Rama Baru
- Centre of Social Medicine and Community Health, Jawaharlal Nehru University, New Delhi, India
| | - Carlo Caduff
- Department of Global Health and Social Medicine, King's College London, London, UK
| | - Jeremy A Greene
- Center for Medical Humanities and Social Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21210, USA.
| | - Helena Hansen
- Center for Social Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - David S Jones
- Department of Global Health and Social Medicine, Harvard Medical School and Department of the History of Science, Faculty of Arts and Sciences, Harvard University, Cambridge, MA, USA
| | - Junko Kitanaka
- Department of Human Sciences, Faculty of Letters, Keio University, Tokyo, Japan
| | - Francisco Ortega
- Catalan Institution for Research and Advanced Studies, Barcelona, Spain; Medical Anthropology Research Center, Universitat Rovira i Virgili, Tarragona, Spain
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Leone M, Ciccacci F, Orlando S, Petrolati S, Guidotti G, Majid NA, Tolno VT, Sagno J, Thole D, Corsi FM, Bartolo M, Marazzi MC. Pandemics and Burden of Stroke and Epilepsy in Sub-Saharan Africa: Experience from a Longstanding Health Programme. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2766. [PMID: 33803352 PMCID: PMC7967260 DOI: 10.3390/ijerph18052766] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 03/03/2021] [Accepted: 03/05/2021] [Indexed: 12/20/2022]
Abstract
Eighty percent of people with stroke live in low- to middle-income nations, particularly in sub-Saharan Africa (SSA) where stroke has increased by more than 100% in the last decades. More than one-third of all epilepsy-related deaths occur in SSA. HIV infection is a risk factor for neurological disorders, including stroke and epilepsy. The vast majority of the 38 million people living with HIV/AIDS are in SSA, and the burden of neurological disorders in SSA parallels that of HIV/AIDS. Local healthcare systems are weak. Many standalone HIV health centres have become a platform with combined treatment for both HIV and noncommunicable diseases (NCDs), as advised by the United Nations. The COVID-19 pandemic is overwhelming the fragile health systems in SSA, and it is feared it will provoke an upsurge of excess deaths due to the disruption of care for chronic diseases such as HIV, TB, hypertension, diabetes, and cerebrovascular disorders. Disease Relief through Excellent and Advanced Means (DREAM) is a health programme active since 2002 to prevent and treat HIV/AIDS and related disorders in 10 SSA countries. DREAM is scaling up management of NCDs, including neurologic disorders such as stroke and epilepsy. We described challenges and solutions to address disruption and excess deaths from these diseases during the ongoing COVID-19 pandemic.
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Affiliation(s)
- Massimo Leone
- The Foundation of the Carlo Besta IRCCS Neurologic Institute, 20133 Milan, Italy
| | - Fausto Ciccacci
- UniCamillus Saint Camillus International, University of Health Sciences, 00100 Rome, Italy;
| | | | - Sandro Petrolati
- San Camillo Hospital Department of Cardioscience, 00100 Rome, Italy;
| | - Giovanni Guidotti
- Azienda Sanitaria Locale (ASL) Roma 1 Regione Lazio, 00100 Rome, Italy;
| | | | - Victor Tamba Tolno
- Community of S. Egidio DREAM Program, Blantyre 312224, Malawi; (V.T.T.); (J.S.)
| | - JeanBaptiste Sagno
- Community of S. Egidio DREAM Program, Blantyre 312224, Malawi; (V.T.T.); (J.S.)
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