Developing and Evaluating Medical Humanities Problem-Based Learning Classes Facilitated by the Teaching Assistants Majored in the Liberal Arts: A Longitudinal Crossover Study

Exploration and practice of humanistic education for medical students based on volunteerism

Humanistic education aims to promote educated people's practical and conscious activities to enhance their humanity, cultivate ideal personalities, and realize personal and social values, to develop a humanistic spirit. The advancement of higher education in China has led to the proposal to strengthen scientific and humanistic education integration. Medicine is between science and humanities, shouldering the important task of training senior medical personnel, the quality of medical students will affect the quality of future medical and health work; thus, medical students must explore and practice humanistic education. Promoting and practicing volunteerism is a specific act of constructing spiritual civilization in the whole society, and it is also considered beneficial for improving citizens' sense of responsibility and dedication. Medical students' practice of volunteerism and help in society is a precise manifestation of humanistic care. This review summarizes medical students' exploration and practice of humanistic education in volunteering.

Scenario- and discussion-based approach for teaching preclinical medical students the socio-philosophical aspects of psychiatry

BACKGROUND

This study used a scenario- and discussion-based approach to teach preclinical medical students the socio-philosophical aspects of psychiatry and qualitatively evaluated the learning outcomes in a medical humanities course in Taiwan.

METHODS

The seminar session focused on three hypothetical psychiatry cases. Students discussed the cases in groups and were guided by facilitators from multiple disciplines and professions. At the end of the semester, students submitted a narrative report comprising their reflections on the cases and discussions. The authors utilized content analysis to categorize students' narratives into three facets, namely, the philosophical, social and individual.

RESULTS

In total 163 preclinical medical students participated in the class; 150 of them mentioned the scenario-based lesson in their reports; 33.3% of these reports discussed the case at the philosophical dimension (n = 50), 45.3% at the social dimension (n = 68), and 26.6% at the individual dimension (n = 40). Four major themes emerged: (1) a psychiatric diagnosis has far-reaching consequences for an individual's life, (2) the social structure affects how patients experience psychiatric disorders, (3) students related personal experience or those of friends and family to understand psychiatric disorders, and (4) medical humanities are of particular importance in psychiatric education.

CONCLUSIONS

This study demonstrated that the scenario-based discussions led by a multidisciplinary team of facilitators can benefit medical students with limited clinical experience to contemplate the socio-philosophical aspects of psychiatry. The authors suggest that this pedagogical model during preclinical education should be encouraged.

A Visiting Professorship in Undergraduate Medical Education at the University of Alberta: Reflections on possibilities for medical humanities in China, and elsewhere

This article was migrated. The article was marked as recommended. Enhancing humanities in medical education is a pressing concern in China. Similar to other countries, medical education in China evolved over the past century to emphasize bioscience and technology in treating illness and disease. Increasing recognition of the limitations of biomedical technology led to emergence of the medical humanities in the West in the latter half of the 20 th century, an interdisciplinary area that has continued to expand and grow. In China and elsewhere, activity in this area developed somewhat later. Ongoing patient-doctor disputes and decline in public trust in the medical profession in China has led many to advocate for enhanced emphasis on humanism and medical humanities. In 2017, the Chinese government introduced new healthcare reforms which included an education and training plan that promotes medical humanities teaching. Global developments have led to a wide variety of models and approaches that may be considered in cultivating medical humanities and humanism in China. With the support of China Medical University in Shenyang, Liaoning Province, PRC, Professor Wei visited the Faculty of Medicine & Dentistry at the University of Alberta through the 2019/20 academic year. This article provides an overview of a wide array of medical humanities teaching and learning opportunities associated with the undergraduate medical education program at the University of Alberta. Professor Wei reflects on possibilities for medical humanities in medical education in China given all she learned and experienced as a visiting professor at the University of Alberta, which may be of interest to others who are also developing new approaches to introducing medical humanities as part of their health professions education program. Additional reflections regarding possibilities for global medical humanities are also offered.

Exploring the Socialization Experiences of Medical Students From Social Science and Humanities Backgrounds

PURPOSE

To explore the structural, cultural, and interpersonal issues that may contribute to the inadvertent marginalization of medical students with social science and humanities (SSH) backgrounds.

METHOD

Using the hidden curriculum as an analytic construct, the lead author interviewed 14 medical students with SSH backgrounds at the University of Toronto Faculty of Medicine from February to October 2015. The authors analyzed the interview transcripts for common themes around positive and negative cultural, structural, and interpersonal dimensions of the socialization process.

RESULTS

Participants reported barriers to applying to medical school: needing to complete prerequisite courses and to do well on an exam geared toward those with a strong science background (the Medical College Admission Test) and lacking an application cohort. Some participants felt they were not ideal candidates for medical school. Participants appreciated how their SSH backgrounds and associated skill sets shaped both their perspectives on patient care and their developing professional identities. However, they perceived that others largely deemed their previous training as irrelevant, and they felt marginalized in medical school by peers, instructors, and the curriculum. These experiences led both to self-censorship, which enabled them to seem to conform to normative behaviors, and to the pursuit of reaffirming elective experiences.

CONCLUSIONS

The existing hidden curriculum inadvertently marginalizes SSH medical students; their experiences likely reflect the socialization experiences of other students from underrepresented backgrounds. Curricular and institutional reforms are imperative to shift the hidden curriculum toward one of epistemological inclusion that better supports students from nontraditional backgrounds.

Reclaiming magical incantation in graduate medical education

Critical thinking relies upon conceptualization (what is the possible pathophysiology?), analysis (how do I relate an aberration in physiology to the lived experience of illness?), and synthesizing (how do I best intervene?). These cognitive skills are subsumed in the category of reflective competencies and are necessary for developing a differential diagnosis or a plan of care. A vulnerability of teaching medicine through the filter of heuristics is that it may simply recapitulate the teacher's style of cognitive shortcuts. Poorly calibrated heuristics may culminate in systematic errors of judgment. If the aim is to teach critical reasoning in the arena of clinical education, then a new paradigm is called for. Teaching critical reasoning as it applies to medical decision-making begins with recognizing decision scripts.Key Points• Medical heuristics are high-stakes endeavors.• The process of examining the choice of heuristics employed in any given clinical scenario is a meta-reasoning strategy.• Debiasing reduces cognitive errors due to motivated reasoning.

Curricular evaluation of "SHOKUIKU program" as a postgraduate minor course of food and nutrition education using a text-mining procedure

Background

"SHOKUIKU", food and nutrition education, is a national promotion to enable people to acquire an adequate knowledge of SHOKU (which include food, nutrition, dietary habits, etc.) in Japanese society and to allow people to make appropriate SHOKU choices in Japan. In order to educate SHOKUIKU experts who can promote evidence-based SHOKUIKU with advanced professional knowledge and skills, an original "SHOKUIKU program" was established. To evaluate this program, a short answer questionnaire was given to students. Results were objectively analyzed by text mining procedures.

Methods

Five hundred forty four comment papers submitted by a total of 52 consenting students after each lecture in the 12 omnibus-style lectures were examined as cross-sectional data. A total of 2507 sentences were decomposed into words, and word classes of morpheme in Japanese were properly specified. Subsequently, on the basis of a constructed keyword data base, 123 morphemes with high frequency were investigated with co-occurrence network analysis. Furthermore, multivariate network analyses according to the student's major were performed.

Results

Students majoring in food and nutritional sciences recognized that evidence-based SHOKUIKU is "difficult" but "necessary" to "convey" reliable information at "actual" SHOKUIKU sites. On the other hand, students studying other majors not only got an "interesting" opportunity to "learn" "nutrition" and "eating habits" but also thought about their own SHOKUIKU promotion in relation to their major.

Conclusions

These results suggest that the students of the Food Course assumed that they would practice the evidence-based SHOKUIKU themselves, while the students of other courses learned new knowledge more passively. The results also confirmed that students comprehensively grasped the 12 omnibus-style lectures and understood the significance of evidence-based SHOKUIKU regardless of their major. Our original educational program could be valuable for postgraduate students to promote SHOKUIKU.

Efficient undergraduate learning of liver transplant: building a framework for teaching subspecialties to medical students

BACKGROUND

Liver recipients may develop various diseases after transplant. However, because of inadequate study of liver transplant during undergraduate education, the quality of post-transplant care provided to these patients remains suboptimal. Herein, we introduce an innovative and integrated multimodal pedagogical approach to effectively disseminate key information regarding liver transplant to undergraduate students. The goal is to examine this approach through students' assessment in multiple dimensions.

METHODS

This prospective observational study evaluated student reactions to our pedagogical approach. Fifth-year medical students during the academic year 2015-2016 attended a 2-h session on what nontransplant doctors should know about liver transplants. The pedagogical strategy consisted of an online preclass self-learning exercise, an in-class interactive discussion (facilitated by the class teacher who is a liver transplant specialist to avoid distractions within the short-time frame), and a postclass essay assignment (to integrate and apply concepts). After the class, questionnaires were distributed to individual students to collect data, if returned, concerning the students' learning experience and feedback to improve teaching quality. Descriptive statistics, Mann-Whitney U tests, chi-squared tests, and McNemar's tests were used to analyze quantitative data. Qualitative data were content-coded through a descriptive approach using thematic analysis.

RESULTS

Of the 266 attendees, 263 (98.9%) completed the questionnaires and 182 (69.2%) provided comments. Student feedback indicated they "felt better" and "more satisfied" compared with problem-based learning (PBL) (51.0 and 63.1%, respectively) or large-lecture class (92.0 and 88.6%, respectively) approaches. Regarding confidently managing liver transplant patients in future, 80 (30.4%) and 246 (93.5%) students expressed preclass and postclass confidence, respectively (p < 0.001). The bell curve of the postclass self-assessment score of learning shifted toward right and became steeper compared with that of the preclass score (p < 0.001), suggesting students acquired considerable knowledge. The course was typically perceived to be cost-effective, practical, tension-free, and student-friendly.

CONCLUSION

This pedagogical approach effectively propagated knowledge concerning liver transplant to medical students, who expressed considerable satisfaction with the approach.

Progress integrating medical humanities into medical education: a global overview

PURPOSE OF REVIEW

The article reviews the most recent developments in integrating humanities into medical education. Global implications and future trends are illustrated.

RECENT FINDINGS

The main concern of medical humanities education is teaching professionalism; one important aspect that has emerged is the goal of nurturing emotion through reflexivity. Relating effectively to all stakeholders and being sensitive to inequitable power dynamics are essential for professional social accountability in modern medical contexts. Mediating doctors' understanding of the clinical encounter through creative arts and narrative is part of most recent pedagogic innovations aimed at motivating learners to become empowered, engaged and caring clinicians. Scenario-based and discursive-oriented evaluations of such activities should be aligned with the medical humanities' problem-based learning curriculum. Medical humanities education fosters professional reflexivity that is important for achieving patient-centered care.

SUMMARY

Countering insufficient empathy with reflective professionalism is an urgent challenge in medical education; to answer this need, creative arts and narrative understanding have emerged as crucial tools of medical humanities education. To ensure competent professional identity formation in the era of translational medicine, medical humanities programs have adopted scenario-based assessments through inclusion of different voices and emphasizing personal reflection and social critique.