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Volpe RL, Hausman BL, Dalke KB. A New Construct in Undergraduate Medical Education Health Humanities Outcomes: Humanistic Practice. THE JOURNAL OF MEDICAL HUMANITIES 2024; 45:325-332. [PMID: 38753114 DOI: 10.1007/s10912-024-09847-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] [Accepted: 03/19/2024] [Indexed: 05/24/2024]
Abstract
Proposed educational outcomes for the health humanities in medical education range from empathy to visual thinking skills to social accountability. This lack of widely agreed-upon high-level curricular goals limits humanities educators' ability to design purposeful curricula toward clear, common ends and threatens justifications for scarce curricular time. We propose a novel approach to the hoped-for outcomes of health humanities training in medical schools, which has the potential to encompass traditional health humanities knowledge, skills, and behaviors while also being concrete and measurable: humanistic practice. Humanistic practice, adapted from the concept of ethical sensitivity, is an intentional process of applying humanities knowledge and skills to a clinical scenario by 1) noticing that the scenario requires humanities knowledge or skills, 2) informing one's clinical and interpersonal strategy and behavior with humanities knowledge or skills, 3) reflecting on the effectiveness of the strategy and behavior, and 4) reorienting to develop new approaches for future practice. The construct of humanistic practice may help address some of the foundational problems in health humanities outcomes research since it transcends the traditional diverse content domains in the health humanities, can link patient and provider experiences, and may bridge the divide among the additive, curative, and intrinsic epistemic positions of humanities to medical education.
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Affiliation(s)
- Rebecca L Volpe
- Penn State College of Medicine, 500 University Drive, H134, Hershey, PA, 17011, USA.
| | - Bernice L Hausman
- Penn State College of Medicine, 500 University Drive, H134, Hershey, PA, 17011, USA
| | - Katharine B Dalke
- Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Building 421, Philadelphia, PA, 19104, USA
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Orchard AR, Sitoh J, Wyatt A, Moore M. Music in medical education: A critical interpretive synthesis. MEDICAL EDUCATION 2024; 58:507-522. [PMID: 38149320 DOI: 10.1111/medu.15255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 09/15/2023] [Accepted: 10/02/2023] [Indexed: 12/28/2023]
Abstract
INTRODUCTION While many have championed the value of music in medical education, research specific to how and why music has been offered in medical education is sparse and there have been few attempts to synthesise the literature. METHODS A Critical Interpretive Synthesis (CIS) of 56 texts including published articles, correspondence, abstracts and one thesis published between 1977 and 2022 was undertaken to explore the evidence basis for offering music in medical education. RESULTS A total of 52 music-focused programmes/activities were described, encompassing both curricular and extra-curricular, receptive and participatory music activities and a wide range of musical genres. Inductive analysis of data extracted from texts revealed a variety of rationales for the use of music in medical education, which could be grouped within seven interrelated themes: well-being; supportive learning environment; affective engagement; teaching and learning; developing skills for clinical practice; humanism in medicine; and creative expression (identity). DISCUSSION The results of this synthesis demonstrate that there remains a gap between what is claimed about the affordances of music and what has been explicitly addressed in medical education research. Despite a paucity of research in this area, the available data support that the affordances of music are 'multiple' and may not be well represented by linear models. Evidence that engagement with music is beneficial for medical students is strongest in relation to the affordances of music for well-being, facilitating a supportive learning environment, affective engagement, memorisation and creative expression (identity). That engagement with music might enhance humanism, including developing skills for clinical practice, requires further investigation. Accounting for student agency and the 'multiple' affordances of music will ensure that future teaching and research are best positioned to benefit medical students' well-being and personal and professional development.
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Affiliation(s)
- Alice Rae Orchard
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Janell Sitoh
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Amy Wyatt
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Maxine Moore
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
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Ong EK, Tan UTE, Chiam M, Sim WS. The employment of art therapy to develop empathy and foster wellbeing for junior doctors in a palliative medicine rotation - a qualitative exploratory study on acceptability. BMC Palliat Care 2024; 23:84. [PMID: 38556855 PMCID: PMC10983679 DOI: 10.1186/s12904-024-01414-6] [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: 12/22/2022] [Accepted: 03/17/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND The interdisciplinary realm of medical humanities explores narratives and experiences that can enhance medical education for physicians through perspective-taking and reflective practice. However, there is a gap in comprehension regarding its appropriateness at the postgraduate level, especially when utilising art therapists as faculty. This study aims to assess the acceptability of an innovative art therapy-focused educational initiative among junior doctors during a palliative care rotation, with the goal of cultivating empathy and promoting well-being. METHODS A qualitative research project was conducted at the Division of Supportive and Palliative Care (DSPC) in the National Cancer Centre Singapore (NCCS). The study involved the recruitment of junior doctors who had successfully completed a three-month palliative care rotation program, spanning from January 2020 to April 2021. In a single small-group session lasting 1.5 h, with 3 to 4 participants each time, the individuals participated in activities such as collage making, group reflection, and sharing of artistic creations. These sessions were facilitated by an accredited art therapist and a clinical psychologist, focusing on themes related to empathy and wellbeing. To assess the acceptability of the program, two individual interviews were conducted three months apart with each participant. An independent research assistant utilised a semi-structured question guide that considered affective attitude, burden, perceived effectiveness, coherence, and self-efficacy. Thematic analysis of the transcribed data was then employed to scrutinise the participants' experiences. RESULTS A total of 20 individual interviews were completed with 11 participants. The three themes identified were lack of pre-existing knowledge of the humanities, promotors, and barriers to program acceptability. CONCLUSIONS The participants have mixed perceptions of the program's acceptability. While all completed the program in its entirety, the acceptability of the program is impeded by wider systemic factors such as service and manpower needs. It is vital to address these structural limitations as failing to do so risks skewing current ambivalence towards outright rejection of future endeavours to integrate humanities programs into medical education.
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Affiliation(s)
- Eng-Koon Ong
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Blvd, Singapore, 168583, Singapore.
- Assisi Hospice, 832 Thomson Rd, Singapore, 574627, Singapore.
- Duke-NUS Graduate Medical School, 8 College Rd, Singapore, 169857, Singapore.
- Office of Medical Humanities, SingHealth Medicine Academic Clinical Programme, 31 Third Hospital Ave, Singapore, 168753, Singapore.
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Blvd, Singapore, 168583, Singapore.
| | - U-Tong Emily Tan
- Division of Psycho-oncology, National Cancer Centre Singapore, 30 Hospital Blvd, Singapore, 168583, Singapore
| | - Min Chiam
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Blvd, Singapore, 168583, Singapore
| | - Wen Shan Sim
- Duke-NUS Graduate Medical School, 8 College Rd, Singapore, 169857, Singapore
- KK Women's and Children's Hospital, Singapore, 100 Bukit Timah Road, Singapore, 229899, Singapore
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Wangding S, Lingard L, Haidet P, Vipler B, Sukhera J, Moniz T. Disorienting or Transforming? Using the Arts and Humanities to Foster Social Advocacy. PERSPECTIVES ON MEDICAL EDUCATION 2024; 13:192-200. [PMID: 38496362 PMCID: PMC10941688 DOI: 10.5334/pme.1213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 02/19/2024] [Indexed: 03/19/2024]
Abstract
Introduction The arts and humanities (AH) have transformative potential in medical education. Research suggests that AH-based pedagogies may facilitate both personal and professional transformation in medical learners, which may then further enhance the teaching and learning of social advocacy skills. However, the potential for such curricula to advance social advocacy training remains under-explored. Therefore, we sought to identify how AH may facilitate transformative learning of social advocacy in medical education. Methods Building upon previous research, we conducted a critical narrative review seeking examples from the literature on how AH may promote transformative learning of social advocacy in North American medical education. Through a search of seven databases and MedEdPORTAL, we identified 11 articles and conducted both descriptive and interpretative analyses of their relation to key tenets of transformative learning, including: disorientation/dissonance, critical reflection, and discourse/dialogue. Results We found that AH are used in varied ways to foster transformative learning in social advocacy. However, most approaches emphasize their use to elicit disorientation and dissonance; there is less evidence in the literature regarding how they may be of potential utility when applied to disorienting dilemma, critical reflection, and discourse/dialogue. Discussion The tremendous potential of AH to foster transformative learning in social advocacy is constrained due to minimal attention to critical reflection and dialogue. Future research must consider how novel approaches that draw from AH may be used for more robust engagement with transformative learning tenets in medical education.
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Affiliation(s)
- Snow Wangding
- Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Lorelei Lingard
- Department of Medicine, Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Paul Haidet
- Woodward Center for Excellence in Health Sciences Education, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Benjamin Vipler
- Division of Hospital Medicine, University of Colorado Hospital, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Javeed Sukhera
- Departments of Psychiatry, Hartford Hospital and the Institute of Living, Hartford, Connecticut, USA
| | - Tracy Moniz
- Department of Communication Studies, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
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MacGregor W, Horn M, Raphael D. Beyond Empathy to System Change: Four Poems on Health by Bertolt Brecht. THE JOURNAL OF MEDICAL HUMANITIES 2024; 45:53-77. [PMID: 37341851 DOI: 10.1007/s10912-023-09801-5] [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: 03/30/2023] [Indexed: 06/22/2023]
Abstract
Bertolt Brecht's poem "A Worker's Speech to a Doctor" is frequently cited as a means to raise awareness among health workers of the health effects of living and working conditions. Less cited is his Call to Arms trilogy of poems, which calls for class-based action to transform the capitalist economic system that sickens and kills so many. In this article, we show how "A Worker's Speech to a Doctor," with its plea for empathy for the ill, contrasts with the more activist and often militant tone of the Call to Arms trilogy: "Call to a Sick Communist," "The Sick Communist's Answer to the Comrades," and "Call to the Doctors and Nurses." We also show that, while "A Worker's Speech to a Doctor" has been applied in the training of health workers, its accusatorial tone towards health workers' complicity in the system the poem is critiquing risks alienating such workers. In contrast, the Call to Arms trilogy seeks common ground, inviting these same workers into the broader political and social fight against injustice. While we contend that the description of the sick worker as a "Communist" risks estranging these health workers, our analysis of the Call to Arms poems nevertheless indicates that their use can contribute to moving health workers' educational discourse beyond a laudable but fleeting elicitation of empathy for the ill towards a structural critique and deeper systemic understanding in order to prompt action by health workers to reform or even replace the capitalist economic system that sickens and kills so many.
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Affiliation(s)
- William MacGregor
- Graduate Program in Health Policy and Equity, York University, Toronto, ON, Canada
| | | | - Dennis Raphael
- School of Health Policy and Management, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada.
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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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Ditwiler RE, Hardwick D, Swisher LL. "Definitely a Dark Time:" professional and ethical issues in post-acute care physical therapy during the COVID-19 pandemic. Physiother Theory Pract 2024:1-18. [PMID: 38420945 DOI: 10.1080/09593985.2024.2321216] [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: 09/23/2023] [Accepted: 01/18/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Disproportionate effects of the SARS-CoV-2 (COVID-19) pandemic on older adults in post-acute care settings created many professional and ethical challenges for patients and healthcare providers. OBJECTIVE The purpose of this study was to examine the professional and ethical issues of physical therapists (PTs) and physical therapist assistants (PTAs) in providing facility-based post-acute care in residential settings (skilled nursing facilities, inpatient rehabilitation facilities, and long-term acute care hospitals) during the COVID-19 pandemic. METHODS A qualitative descriptive research design was used to explore professional and ethical issues during the COVID-19 pandemic. PTs and PTAs described their experiences during semi-structured interviews conducted virtually. Interview data was analyzed with reflexive thematic analysis. RESULTS Thematic analysis produced 4 themes: facility-wide battle against infection and death, doing the best you can to provide care amidst COVID-19 constraints, promoting ethical good and doing the right thing, and a dark intense time. CONCLUSIONS Professional and ethical constraints on providing care faced by PTs and PTAs during the COVID-19 pandemic can inform current and future clinical practice. Although some of the challenges faced by PTs and PTAs were unique to COVID-19, many problems represent preexisting systemic and organizational issues that were exacerbated by the pandemic.
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Affiliation(s)
- Rebecca Edgeworth Ditwiler
- School of Physical Therapy and Rehabilitation Sciences, University of South Florida Morsani College of Medicine, Tampa, FL, USA
| | - Dustin Hardwick
- School of Physical Therapy, University of the Incarnate Word, San Antonio, TX, USA
| | - Laura Lee Swisher
- School of Physical Therapy and Rehabilitation Sciences, University of South Florida Morsani College of Medicine, Tampa, FL, USA
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Baral A, Hanna F, Chimoriya R, Rana K. Cannabis Use and Its Impact on Mental Health in Youth in Australia and the United States: A Scoping Review. EPIDEMIOLOGIA 2024; 5:106-121. [PMID: 38534804 DOI: 10.3390/epidemiologia5010007] [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: 01/31/2024] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/28/2024] Open
Abstract
Cannabis is a widely used substance among the youth population, with an estimated 2.8% currently smoking cannabis. Its popularity is growing due to the perception of its harmless nature and lack of dependence. However, this increase in use has been linked to mental health issues, especially since its partial decriminalisation in some part of the United States and Australia. The objective of this scoping review was to investigate the mental health impact of cannabis use among young people in Australia and the United States. A scoping review was conducted according to the Joanna Briggs Institute (JBI) protocol, and articles were searched from ProQuest Central and EBSCO Host (MEDLINE and CINAHL databases). A total of 24 articles were analysed, including systematic reviews, meta-analyses, and cohort, longitudinal, and cross-sectional studies. The findings indicate that cannabis use is associated with depression, psychosis, suicide, cannabis use disorder, dependence, decline in cognitive function, and the development of externalising behaviour, particularly attention deficit hyperactivity disorder. However, the relationship between cannabis use and anxiety is equivocal. Mental health issues were more prevalent with increased frequency, duration, intensity, and type of use. Female, minority, LGBTQI, African American, Aboriginal, and Torres Strait Islander youth and the age of onset of cannabis use were significant factors for the development of mental health problems. The increasing prevalence of cannabis use among high school and college students suggests the need for intervention by teachers, parents, and community health professionals to make them aware of its potential negative mental health outcomes. Moreover, policy-level interventions by the government are required to discourage young people from using cannabis.
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Affiliation(s)
- Aayush Baral
- Public Health Program, Department of Health and Education, Torrens University Australia, Melbourne, VIC 3000, Australia
- Philanthropy Nepal (Paropakari Nepal) Research Collaboration, Auburn, NSW 2144, Australia
| | - Fahad Hanna
- Public Health Program, Department of Health and Education, Torrens University Australia, Melbourne, VIC 3000, Australia
| | - Ritesh Chimoriya
- Philanthropy Nepal (Paropakari Nepal) Research Collaboration, Auburn, NSW 2144, Australia
- School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia
- Concord Institute of Academic Surgery, Concord Repatriation General Hospital, Concord, NSW 2139, Australia
| | - Kritika Rana
- Philanthropy Nepal (Paropakari Nepal) Research Collaboration, Auburn, NSW 2144, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW 2560, Australia
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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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Rueb M, Rehfuess EA, Siebeck M, Pfadenhauer LM. Cinemeducation: A mixed methods study on learning through reflective thinking, perspective taking and emotional narratives. MEDICAL EDUCATION 2024; 58:63-92. [PMID: 37525520 DOI: 10.1111/medu.15166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 05/29/2023] [Accepted: 06/27/2023] [Indexed: 08/02/2023]
Abstract
INTRODUCTION Cinemeducation describes the use of film in medical education. The M23 Cinema (M23C) comprises a film screening and subsequent discussion with experts, affected persons and the audience. Previous research suggests that participating in cinemeducation may affect emotions and attitudes. This study aimed to establish a conceptual framework and explore when learning takes place, how learning occurs and what participants learn during the M23C. METHODS Informed by focused literature searches, discussions of the authors and the research results, a conceptual framework of the M23C was developed, comprising three dimensions (five distinct phases, learning methodology and potential impact). A mixed method study was undertaken, employing an exploratory sequential design. Initially, the qualitative component was conducted by interviewing everyone involved, comprising focus groups, expert interviews, a group interview and one narrative interview. All qualitative data were analysed using qualitative content analysis. The qualitative findings were used to inform the development of a survey among the participants of M23C evenings. The survey results were analysed descriptively. The findings generated by both data sets were integrated using the "following a thread" protocol and visualised by joint displays. RESULTS In total, 15 participants in M23C courses, six members of the current and two of the former organising committee, two experts, two affected persons and the initiator of the M23C were included in the qualitative component (n = 28). A total of 503 participants responded to the survey. The qualitative data confirmed the relevance of the five phases and participants described reflective thinking, perspective taking and emotional narratives as the three dimensions of how they learned during the M23C. Participants reported a change in attitudes, enriching their knowledge, experiencing empathy and learning about other health professions. DISCUSSION Our findings suggest that the M23C as a cinemeducation course provides a unique learning environment in the training of health professionals.
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Affiliation(s)
- Mike Rueb
- Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
- Institute of Medical Education, LMU University Hospital, LMU Munich, Munich, Germany
| | - Eva A Rehfuess
- Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Matthias Siebeck
- Institute of Medical Education, LMU University Hospital, LMU Munich, Munich, Germany
| | - Lisa M Pfadenhauer
- Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
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Orr A, Hussain F, Tomescu O, DeLisser H, Grundy KM, Niepold S, Rizzo A, Shaw S, Balmer D. Extending Arts-Based Interventions in Graduate Medical Education through the Positive Humanities: the Re-FRAME Workshop. J Gen Intern Med 2023; 38:3252-3256. [PMID: 37407762 PMCID: PMC10651601 DOI: 10.1007/s11606-023-08292-3] [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: 03/04/2023] [Accepted: 06/15/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND Arts-and-humanities-based interventions are commonly implemented in medical education to promote well-being and mitigate the risk of burnout. However, mechanisms for achieving these effects remain uncertain within graduate medical education. The emerging field of the positive humanities offers a lens to examine whether and how arts-based interventions support well-being in internal medicine interns. AIM Through program evaluation of this visual art workshop, we used a positive humanities framework to elucidate potential mechanisms by which arts-based curricula support well-being in internal medicine interns. SETTING We launched the re-FRAME workshop at the Philadelphia Museum of Art in winter 2020. PARTICIPANTS Fifty-six PGY-1 trainees from one internal medicine residency program. PROGRAM DESCRIPTION The 3-h re-FRAME workshop consisted of an introductory session on emotional processing followed by two previously described arts-based interventions. PROGRAM EVALUATION Participants completed an immediate post-workshop survey (91% response rate) assessing attitudes towards the session. Analysis of open-ended survey data demonstrated 4 categories for supporting well-being among participants: becoming emotionally aware/expressive through art, pausing for reflection, practicing nonjudgmental observation, and normalizing experiences through socialization. DISCUSSION Our project substantiated proposed mechanisms from the positive humanities for supporting well-being-including reflectiveness, skill acquisition, socialization, and expressiveness-among medical interns.
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Affiliation(s)
- Andrew Orr
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Farah Hussain
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Oana Tomescu
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Horace DeLisser
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Karen M Grundy
- Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Adam Rizzo
- Philadelphia Museum of Art, Philadelphia, PA, USA
| | - Sarah Shaw
- Philadelphia Museum of Art, Philadelphia, PA, USA
| | - Dorene Balmer
- Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Kelly-Hedrick M, Louis SR, Chisolm MS. Character and virtue development in medical learners: another role for the arts? Int Rev Psychiatry 2023; 35:631-635. [PMID: 38461381 DOI: 10.1080/09540261.2023.2268211] [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: 08/02/2023] [Accepted: 10/04/2023] [Indexed: 03/11/2024]
Abstract
Medical education serves to teach students how to think and act as future physicians. Doing so successfully requires supporting learners' acquisition of clinical skills and knowledge, but also attending to their character education and virtue development. The arts and humanities are widely embraced as a fundamental component of a complete medical education. While not frequently touted as a useful pedagogical tool for teaching character and virtue, we argue the integration of arts-based activities into medical education can promote virtue development. In this article, we use the virtues framework from the Jubilee Centre for Character and Virtues at the University of Birmingham to review existing empirical studies of arts-based programs for each of these virtue domains of intellectual, moral, civic, and performance virtues. Learners may benefit from further exploration-both conceptual and empirical-of how the arts can scaffold character development in medical education.
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Affiliation(s)
| | - Sarah R Louis
- Department of Arts and Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Margaret S Chisolm
- Department of Psychiatry and Behavioral Sciences, and of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Aggarwal M, Hutchison B, Kokorelias KM, Mehta K, Greenberg L, Moran K, Barber D, Samson K. Impact of remuneration, extrinsic and intrinsic incentives on interprofessional primary care teams: protocol for a rapid scoping review. BMJ Open 2023; 13:e072076. [PMID: 37336539 DOI: 10.1136/bmjopen-2023-072076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2023] Open
Abstract
INTRODUCTION Interprofessional teams and funding and payment provider arrangements are key attributes of high-performing primary care. Several Canadian jurisdictions have introduced team-based models with different payment models. Despite these investments, the evidence of impact is mixed. This has raised questions about whether team-based primary care models are being implemented to facilitate team collaboration and effectiveness. Thus, we present a protocol for a rapid scoping review to systematically map, synthesise and summarise the existing literature on the impact of provider remuneration mechanisms and extrinsic and intrinsic incentives in team-based primary care. This review will answer three research questions: (1) What is the impact of provider remuneration models on team, patient, provider and system outcomes in primary care?; (2) What extrinsic and intrinsic incentives have been used in interprofessional primary care teams?; and (3) What is the impact of extrinsic and intrinsic team-based incentives on team, patient, provider and system outcomes? METHODS AND ANALYSIS We will conduct a rapid scoping review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews guidelines. We will search electronic databases (Medline, Embase, CINAHL, PsycINFO, EconLit) and grey literature sources (Google Scholar, Google). This review will consider all empirical studies and full-text English-language articles published between 2000 and 2022. Reviewers will independently perform the literature search, data extraction and synthesis of included studies. The Mixed Methods Appraisal Tool will be used to appraise the quality of evidence. The literature will be synthesised, summarised and mapped to themes that answer the research question of this review. ETHICS AND DISSEMINATION Ethics approval is not required. Findings from this study will be written for publication in an open-access peer-review journal and presented at national and international conferences. Knowledge users are part of the research team and will assist with disseminating findings to the public, clinicians, funders and professional associations.
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Affiliation(s)
- Monica Aggarwal
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Brian Hutchison
- Department of Family Medicine, Health Research Methods, Evidence, and Impact, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Kristina Marie Kokorelias
- Department of Geriatric Medicine, Sinai Health and University Health Network, Toronto, Ontario, Canada
- Rehabiliation Sciences Institute and Department of Occupational Therapy and Occupational Sciences, University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada
| | - Kavita Mehta
- Association of Family Health Teams of Ontario, Toronto, Ontario, Canada
| | | | - Kimberly Moran
- Ontario College of Family Physicians, Toronto, Ontario, Canada
| | - David Barber
- Department of Family Medicine, Queen's University, Kingston, Ontario, Canada
| | - Kevin Samson
- East Wellington Family Health Team, Erin/Rockwood, Ontario, Canada
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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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Nguyen A, Duong D, O’Sullivan P. Overlapping worlds of art and plastic surgery: developing a concept model and its implications in surgical education. GLOBAL SURGICAL EDUCATION : JOURNAL OF THE ASSOCIATION FOR SURGICAL EDUCATION 2022; 2:9. [PMID: 38013859 PMCID: PMC9734446 DOI: 10.1007/s44186-022-00089-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 11/23/2022] [Accepted: 11/27/2022] [Indexed: 12/14/2022]
Abstract
Purpose Editorials speculate on the relationship between art and plastic surgery, and studies of limited art education in surgical training show intriguing benefits. Identifying the shared concepts and skills in art and plastic surgery could advance incorporating artistic skills and concepts into plastic surgery training and curriculum. Methods Using a grounded theory approach, we interviewed plastic surgeons and formally trained or self-identified artists and then analyzed the transcripts. During the process, we used a constant comparison approach while coding along with data collection. The team developed the codebook from initial transcripts; 2 members coded each transcript. We reconciled codes and summarized codes into themes based on discussion among the team. Results 15 plastic surgeons aged 36-80 years and 16 artists aged 19-62 years were interviewed. We then developed a concept model, "Ways of Making," to illustrate the shared aspects of the artistic and surgical process through their ways of doing, knowing, seeing, and thinking. Both plastic surgeons and artists recognized that strong technical foundational skills are key to developing competency. Both groups spoke about the Elements of Art and Principles of Design, though artists know this formally. Artists and plastic surgeons shared that awareness to one's surroundings or to human features facilitates identifying problems or ideas. They described how technical skills, manual dexterity, and three-dimensional thinking can be taught and nurtured. Both groups also recognized that creativity played a major role in their work. While creativity was seen as innate, participants can learn to be innovative through critical thinking. Conclusion This study provides a model for how plastic surgery and art overlap using data from interviews. Though there are differences between the two fields, the ways of doing, knowing, seeing, and thinking are key components of the artistic and surgical processes. Identifying the shared concepts and skills in art and plastic surgery could help enhance curricula seeking to incorporate artistic skills and concepts into plastic surgery training.
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Affiliation(s)
- Audrey Nguyen
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of California San Francisco (UCSF), 505 Parnassus Ave, Suite M-593, San Francisco, CA 94143 USA
| | - Dawn Duong
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of California San Francisco (UCSF), 505 Parnassus Ave, Suite M-593, San Francisco, CA 94143 USA
| | - Patricia O’Sullivan
- School of Medicine, Departments of Medicine and Surgery, University of California San Francisco, San Francisco, USA
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Yan L, Hu H, Zheng Y, Zhou Y, Li L. The development path of the medical profession in China's engineering universities from the perspective of the 'four new' disciplines. Ann Med 2022; 54:3030-3038. [PMID: 36308419 PMCID: PMC9629106 DOI: 10.1080/07853890.2022.2139409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
In recent years, China has actively promoted the construction of first-class universities and disciplines of the world ('Double First-Class'), and built a new model of university development to solve Chinese problems and support high-quality economic and social development. In the context of China's efforts to promote the construction of new engineering, new medicine, new agriculture, and new liberal arts (referred to as the 'four new' disciplines), these disciplines are developing rapidly. As a specialty dealing with major life issues, medical education has become increasingly prominent. To enhance the comprehensive strength of universities, corresponding to the 'four new' disciplines strategy, engineering universities are building and developing medical specialties one after another. At present, the greatest problem in the medical specialty of engineering universities is the tendency to blindly follow trends and integrate new concepts with traditional methods. However, to date, the integration of medical and nonmedical specialties has been superficial and thus has not been successful. To address this problem, this paper, guided by the policies aimed at developing the 'four new' disciplines, analyses the current situation of traditional medicine education and professional development in engineering universities and proposes measures to enhance the competitiveness of new medicine in engineering universities, thereby promoting the development of universities.KEY MESSAGESThe implementation of the 'four new' disciplines is a strategic choice for higher education.Engineering technology is an efficient path and hands-on approach to solving medical problems.Interdisciplinary and comprehensive educational approaches play an important role in the development of medical science.
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Affiliation(s)
- Li Yan
- Institute of Medical Research, Northwestern Polytechnical University, Xi'an, China
| | - Huijing Hu
- Institute of Medical Research, Northwestern Polytechnical University, Xi'an, China
| | - Yu Zheng
- Department of Ultrasonography, Xían Central Hospital, Xi'an, China
| | - Yin Zhou
- Institute of Medical Research, Northwestern Polytechnical University, Xi'an, China
| | - Le Li
- Institute of Medical Research, Northwestern Polytechnical University, Xi'an, China
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Kagan HJ, Kelly-Hedrick M, Benskin E, Wolffe S, Suchanek M, Chisolm MS. Understanding the role of the art museum in teaching clinical-level medical students. MEDICAL EDUCATION ONLINE 2022; 27:2010513. [PMID: 34866552 PMCID: PMC8648011 DOI: 10.1080/10872981.2021.2010513] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/26/2021] [Accepted: 11/22/2021] [Indexed: 05/19/2023]
Abstract
INTRODUCTION The role of the visual arts in medical education has been understudied, especially with regard to program evaluation and learner assessment of complex competencies such as professional identity, team building, and tolerance for ambiguity. We designed a study to explore how an integrative art museum-based program might benefit 3rd and 4th year medical students. METHODS We piloted 6 sessions with 18 participants. Evaluation methods included post-session surveys and semi-structured focus groups, which we qualitatively analyzed using an open-coding method. RESULTS Seven themes emerged from the analysis related to the overarching realms of 'form' and 'function.' 'Form' themes included structural elements of the sessions that enabled engagement: (1) group format, (2) methods (e.g., discussion prompts, activities), (3) setting (e.g., physical space of the museum, temporal space), and (4) objects (e.g., paintings, sculptures). 'Function' themes included the personal and professional value and meaning derived from the sessions: (1) appreciation of others, (2) critical skills, and (3) personal inquiry. DISCUSSION Our results expand what is known about the role of the visual arts in medical education by suggesting that the visual arts may facilitate clinically relevant learning across a range of competencies via specific formal aspects (group format, method, setting, objects) of art museum-based pedagogical methods.
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Affiliation(s)
- Heather J. Kagan
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Elizabeth Benskin
- Department of Teaching and Learning, Baltimore Museum of Art, Baltimore, MD, USA
| | | | - Melissa Suchanek
- Department of Hematology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Margaret S. Chisolm
- Department of Psychiatry and Behavioral Sciences, and Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- CONTACT Margaret S. Chisolm Johns Hopkins University School of Medicine, 5300 Alpha Commons Drive, 446B, Baltimore, MD21224, USA
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Abstract
Medical humanities initiatives have been integrated in our Pediatric Critical Care program to help clinicians make meaning of key experiences in their professional and personal journeys. In particular, narrative medicine and clinicians' writings illuminate and commemorate these journeys and increase our understanding of our profession in its full complexity. In this piece, we provide an example of a medical humanities curriculum and a selection of pieces written by several participants in it. These pieces form a collective narrative, portraying aspects of our individual and collective biography.
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Using a Limerick Writing Contest to Address Residency and Career Stress and Foster Connection Among Pediatric Residents Approaching Graduation. Acad Pediatr 2022; 22:1081-1084. [PMID: 34995823 DOI: 10.1016/j.acap.2021.12.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 12/22/2021] [Accepted: 12/28/2021] [Indexed: 11/22/2022]
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Kelly-Hedrick M, Chugh N, Williams R, Smyth Zahra F, Stephens M, Chisolm MS. The Online "Personal Responses Tour": Adapting an Art Museum-Based Activity for a Virtual Setting. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2022; 46:510-514. [PMID: 34296418 PMCID: PMC8298041 DOI: 10.1007/s40596-021-01505-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/23/2021] [Indexed: 05/19/2023]
Affiliation(s)
| | | | - Ray Williams
- The University of Texas at Austin, Austin, TX, USA
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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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22
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Hoang BL, Monrouxe LV, Chen KS, Chang SC, Chiavaroli N, Mauludina YS, Huang CD. Medical Humanities Education and Its Influence on Students' Outcomes in Taiwan: A Systematic Review. Front Med (Lausanne) 2022; 9:857488. [PMID: 35652071 PMCID: PMC9150274 DOI: 10.3389/fmed.2022.857488] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 04/20/2022] [Indexed: 11/13/2022] Open
Abstract
Background Medical education has emphasized the importance of integrating medical humanities training into the curriculum to benefit medical and nursing students' future practice, featuring in the list of national funding priorities for healthcare education research in Taiwan for many years. However, the extent to which this drive has resulted in medical humanities training, what rationales underpin its inclusion, and its efficacy is largely unknown. This study aims to address these issues across medical humanities programs within the Taiwanese context. Methods We conducted a systematic review. Inclusion criteria included studies in English or Mandarin reporting outcomes of medical humanities courses in healthcare education settings in Taiwan between 2000 and 2019. We searched across five electronic databases (PubMed, Embase, ERIC, PsycInfo, Web of Science), following PRISMA guidelines. The Best Evidence Medical Education (BEME) Global Scale and Kirkpatrick Levels are used for identifying the strength of evidence. Results 17 articles were extracted from the 134 identified. Intrinsic and instrumental rationales for the inclusion of medical humanities education were common, compared with epistemological-based and critical-based approaches. Several positive impacts were identified in relation to participation including modification of attitudes, knowledge, and skills. However, the highest level (i.e., unequivocal) of evidence characterized by effects on students' behaviors or ongoing interaction with colleagues and patients is lacking. Conclusion Findings suggest that although medical humanities education is widely implemented in Taiwan, no clear consensus has been reached regarding the rationale for inclusion or how it is localized from Western to Asian contexts. Future research still needs to explore the long-term impact of medical humanities education for medical and nursing students and its impact on patient care. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO, identifier: CRD42019123967.
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Affiliation(s)
- Bao Lan Hoang
- Chang Gung Medical Education Research Centre (CG-MERC), Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Lynn Valerie Monrouxe
- Faculty of Medicine and Health, Susan Wakil Health Building, The University of Sydney, Sydney, NSW, Australia
| | - Kuo-Su Chen
- Chang Gung Medical Education Research Centre (CG-MERC), Chang Gung Memorial Hospital, Linkou, Taiwan.,Department of Nephrology, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Shu-Ching Chang
- Department of Medical Humanities and Social Sciences, Chang Gung University College of Medicine, Taoyuan, Taiwan.,Department of Pathology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | | | - Yosika Septi Mauludina
- Chang Gung Medical Education Research Centre (CG-MERC), Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chien-Da Huang
- Chang Gung Medical Education Research Centre (CG-MERC), Chang Gung Memorial Hospital, Linkou, Taiwan.,Department of Medical Education and Thoracic Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan
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Balhara KS, Irvin N, Zink KL, Mohan S, Olson AS, Tackett S, Regan L. "A sorely neglected field": A multisite study of self-reported humanities exposure among emergency medicine residents. AEM EDUCATION AND TRAINING 2022; 6:e10772. [PMID: 35784381 PMCID: PMC9242415 DOI: 10.1002/aet2.10772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The Association of American Medical Colleges has identified the humanities as fundamental to medical education across all specialties. Evidence from undergraduate medical education (UME) demonstrates the humanities' positive impacts on outcomes that could be relevant to patient care and trainee well-being in emergency medicine (EM) residency training. However, less is known about the humanities' role in graduate medical education (GME). OBJECTIVES The objectives were to describe EM residents' self-reported exposure to the humanities and its relationship with their empathy, tolerance of ambiguity, and patient-centeredness, and to assess their attitudes toward the humanities in GME. METHODS This cross-sectional survey-based study was conducted at six U.S. EM residency programs in 2018-2019. Quantitative analyses included linear regressions testing for trends between humanities exposures and outcomes, adjusted for sex, year in training, and clustering within programs; adjunct analysis of free-text responses was performed using an exploratory constructivist approach to identify themes about views on the humanities' role in medicine. RESULTS Response rate was 54.8% (153/279). A total of 65% of respondents were male and 28.1% of respondents had a preceding humanities degree. Preceding humanities degree and current self-reported humanities exposure were positively associated with performance on empathy subscales (p = 0.02). Seventy-five percent (n = 114) of respondents agreed humanities are important in GME; free-text responses revealed perceived positive impacts of humanities on generating well-rounded clinicians and enhancing patient care. CONCLUSIONS Engagement with the humanities may be associated with empathy among EM residents. Although the magnitude of associations was smaller than that seen in UME, this study demonstrates resident interest in humanities and suggests that extracurricular engagement with the humanities may be insufficient to prolong positive impacts seen in UME. Further research is needed to explore how to sustain these benefits through integration or addition of the humanities in existing GME curricula.
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Affiliation(s)
- Kamna S. Balhara
- Department of Emergency MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Nathan Irvin
- Department of Emergency MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Korie L. Zink
- Department of Emergency MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Sanjay Mohan
- Division of Medical Toxicology, Ronald O. Perelman Department of Emergency MedicineNYU Grossman School of MedicineNew YorkNew YorkUSA
| | - Adriana S. Olson
- Section of Emergency Medicine, Department of MedicineUniversity of ChicagoChicagoIllinoisUSA
| | - Sean Tackett
- Division of General Internal MedicineJohns Hopkins Bayview Medical CenterBaltimoreMarylandUSA
- Biostatistics Epidemiology and Data Management CoreJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | | | - Linda Regan
- Department of Emergency MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
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Balhara KS, Ehmann MR, Irvin N. Antiracism in Health Professions Education Through the Lens of the Health Humanities. Anesthesiol Clin 2022; 40:287-299. [PMID: 35659401 DOI: 10.1016/j.anclin.2021.12.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Racism represents a public health crisis, adversely impacting patient outcomes and health care workplace inclusivity. Dismantling racism requires transforming both racist systems and individual and collective consciousness. Focusing on antiracism in health professions education through the transdisciplinary lens of the health humanities can spur self-reflection, critical thinking, and collaboration among health professions educators and trainees to create more equitable structures of care. This article describes how the health humanities provide a powerful framework for antiracist health professions education. The authors conclude with a snapshot of an existing humanities-based antiracist curriculum, with suggestions to facilitate implementation in other settings.
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Affiliation(s)
- Kamna S Balhara
- Emergency Medicine Residency Program, Johns Hopkins University School of Medicine, Johns Hopkins Department of Emergency Medicine, 1830 E Monument Street, Suite 6-100, Baltimore, MD 21287, USA.
| | - Michael R Ehmann
- Emergency Medicine Residency Program, Johns Hopkins University School of Medicine, Johns Hopkins Department of Emergency Medicine, 1830 E Monument Street, Suite 6-100, Baltimore, MD 21287, USA. https://twitter.com/MichaelEhmannMD
| | - Nathan Irvin
- Johns Hopkins University School of Medicine, Johns Hopkins Department of Emergency Medicine, 1830 E Monument Street, Suite 6-100, Baltimore, MD 21287, USA. https://twitter.com/swervinnirvin
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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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Carr SE, Noya F, Phillips B, Harris A, Scott K, Hooker C, Mavaddat N, Ani-Amponsah M, Vuillermin DM, Reid S, Brett-MacLean P. Health Humanities curriculum and evaluation in health professions education: a scoping review. BMC MEDICAL EDUCATION 2021; 21:568. [PMID: 34753482 PMCID: PMC8579562 DOI: 10.1186/s12909-021-03002-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 10/27/2021] [Indexed: 05/21/2023]
Abstract
BACKGROUND The articulation of learning goals, processes and outcomes related to health humanities teaching currently lacks comparability of curricula and outcomes, and requires synthesis to provide a basis for developing a curriculum and evaluation framework for health humanities teaching and learning. This scoping review sought to answer how and why the health humanities are used in health professions education. It also sought to explore how health humanities curricula are evaluated and whether the programme evaluation aligns with the desired learning outcomes. METHODS A focused scoping review of qualitative and mixed-methods studies that included the influence of integrated health humanities curricula in pre-registration health professions education with programme evaluate of outcomes was completed. Studies of students not enrolled in a pre-registration course, with only ad-hoc health humanities learning experiences that were not assessed or evaluated were excluded. Four databases were searched (CINAHL), (ERIC), PubMed, and Medline. RESULTS The search over a 5 year period, identified 8621 publications. Title and abstract screening, followed by full-text screening, resulted in 24 articles selected for inclusion. Learning outcomes, learning activities and evaluation data were extracted from each included publication. DISCUSSION Reported health humanities curricula focused on developing students' capacity for perspective, reflexivity, self- reflection and person-centred approaches to communication. However, the learning outcomes were not consistently described, identifying a limited capacity to compare health humanities curricula across programmes. A set of clearly stated generic capabilities or outcomes from learning in health humanities would be a helpful next step for benchmarking, clarification and comparison of evaluation strategy.
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Affiliation(s)
- Sandra E Carr
- Health Professions Education, University of Western Australia, Perth, Australia.
| | - Farah Noya
- Health Professions Education, University of Western Australia, Perth, Australia
| | - Brid Phillips
- 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
| | - 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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Stouffer K, Kagan HJ, Kelly-Hedrick M, See J, Benskin E, Wolffe S, Yenawine P, Chisolm MS. The Role of Online Arts and Humanities in Medical Student Education: Mixed Methods Study of Feasibility and Perceived Impact of a 1-Week Online Course. JMIR MEDICAL EDUCATION 2021; 7:e27923. [PMID: 34550086 PMCID: PMC8495565 DOI: 10.2196/27923] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 04/05/2021] [Accepted: 08/01/2021] [Indexed: 05/19/2023]
Abstract
BACKGROUND The arts and humanities have been integrated into medical student education worldwide. Integrated arts and humanities courses have been found to serve four primary functions: mastering skills, perspective taking, personal insight, and social advocacy. To what extent and how arts and humanities programs achieve these educational outcomes remain unclear. OBJECTIVE In this study, we aimed to explore how the arts and humanities may lead to perceived benefits in clinical skills development, professional identity formation, and self-care, and to evaluate the feasibility of delivering an arts and humanities-based course online. METHODS We developed and delivered a 1-week online arts and humanities course to second- through fourth-year medical students. A total of 18 students enrolled in the course across its 2 offerings in Spring 2020. The course was primarily visual arts based but also included activities based in other arts and humanities, such as literature, reflective writing, dance, film, music, philosophy, and religion. Using a mixed methods approach, daily polls assessed student engagement in and perceptions of the various activities, and a postcourse survey assessed student perceptions of the course as a whole. RESULTS At least 93% of poll respondents (14/15 to 17/18) across the 2 cohorts rated each type of activity as good or excellent. Qualitative analysis of student responses to the postcourse survey revealed themes concerning both the form (overall course design and online format) and the function of the course (skills development, appreciation of new perspectives, and personal inquiry). CONCLUSIONS Results suggested that the arts and humanities may support the development of clinically relevant skills and attitudes. A more unique finding was that integrative arts and humanities courses delivered online-including those that are primarily visual arts based-engage students and may yield personal and professional benefits.
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Affiliation(s)
- Kaitlin Stouffer
- Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Heather J Kagan
- Department of Internal Medicine, Johns Hopkins Hospital, Baltimore, MD, United States
| | | | - Julia See
- University of Miami School of Medicine, Miami, FL, United States
| | | | - Suzy Wolffe
- The Baltimore Museum of Art, Baltimore, MD, United States
| | | | - Margaret S Chisolm
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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Hall K, De Gagne JC. Arts and Humanities to Teach Civility in Health Professions. Creat Nurs 2021; 26:241-245. [PMID: 33273128 DOI: 10.1891/crnr-d-18-00053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Incivility is defined as rude or disruptive behavior which may result in psychological or physiological distress for the people involved. These behaviors, which appear to be more pervasive than ever in today's society, both in academia and in the health-care system, negatively affect professionals' well-being and the workplace environment. Nurses have an obligation to practice with compassion and respect, and to develop creative solutions for addressing incivility. Education about incivility should begin in prelicensure programs for all health professions, so that students understand the behavior expected of them as professionals. When health-care professionals embody the ideals of respect and civility, they set an example for others to follow. The arts and humanities can be used as a pedagogical tool to provide innovative learning opportunities to teach these values through the affective domain of learning. This article discusses one of the creative avenues for facilitating such opportunity, the use of the arts and humanities to teach civility in health professions education.
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Moniz T, Golafshani M, Gaspar CM, Adams NE, Haidet P, Sukhera J, Volpe RL, de Boer C, Lingard L. The prism model: advancing a theory of practice for arts and humanities in medical education. PERSPECTIVES ON MEDICAL EDUCATION 2021; 10:207-214. [PMID: 33914287 PMCID: PMC8368821 DOI: 10.1007/s40037-021-00661-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/15/2021] [Accepted: 03/24/2021] [Indexed: 05/19/2023]
Abstract
INTRODUCTION The arts and humanities have transformative potential for medical education. Realizing this potential requires an understanding of what arts and humanities teaching is and what it aims to do. A 2016 review of exclusively quantitative studies mapped three discursive positions (art as intrinsic to, additive to or curative for medicine) and three epistemic functions (art for mastering skills, perspective taking, and personal growth and activism). A more inclusive sample might offer new insights into the position and function of arts and humanities teaching in medical education. METHODS Informed by this 2016 framework, we conducted discursive and conceptual analyses of 769 citations from a database created in a recent scoping review. We also analyzed the 15 stakeholder interviews from this review for recurring themes. These three analyses were iteratively compared and combined to produce a model representing the complex relationship among discursive functions and learning domains. RESULTS The literature largely positioned arts and humanities as additive to medicine and focused on the functions of mastering skills and perspective taking. Stakeholders emphasized the intrinsic value of arts and humanities and advocated their utility for social critique and change. We offer a refined theory of practice-the Prism Model of four functions (mastering skills, perspective taking, personal insight and social advocacy)-to support more strategic use of arts and humanities in medical education across all learning domains. DISCUSSION The Prism Model encourages greater pedagogical flexibility and critical reflection in arts and humanities teaching, offering a foundation for achieving its transformative potential.
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Affiliation(s)
- Tracy Moniz
- Department of Communication Studies, Mount Saint Vincent University, Halifax, Nova Scotia, Canada.
| | | | - Carolyn M Gaspar
- Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Paul Haidet
- Woodward Center for Excellence in Health Sciences Education, Penn State College of Medicine, Hershey, PA, USA
| | - Javeed Sukhera
- Departments of Psychiatry/Paediatrics and Centre for Education Research & Innovation, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Rebecca L Volpe
- Department of Humanities, Penn State College of Medicine and Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Claire de Boer
- Doctors Kienle Center for Humanistic Medicine, Center Stage Arts in Health, Penn State College of Medicine and Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Lorelei Lingard
- Department of Medicine, Centre for Education Research & Innovation, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
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Moniz T, Golafshani M, Gaspar CM, Adams NE, Haidet P, Sukhera J, Volpe RL, de Boer C, Lingard L. How Are the Arts and Humanities Used in Medical Education? Results of a Scoping Review. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:1213-1222. [PMID: 33830951 DOI: 10.1097/acm.0000000000004118] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
PURPOSE Although focused reviews have characterized subsets of the literature on the arts and humanities in medical education, a large-scale overview of the field is needed to inform efforts to strengthen these approaches in medicine. METHOD The authors conducted a scoping review in 2019 to identify how the arts and humanities are used to educate physicians and interprofessional learners across the medical education continuum in Canada and the United States. A search strategy involving 7 databases identified 21,985 citations. Five reviewers independently screened the titles and abstracts. Full-text screening followed (n = 4,649). Of these, 769 records met the inclusion criteria. The authors performed descriptive and statistical analyses and conducted semistructured interviews with 15 stakeholders. RESULTS The literature is dominated by conceptual works (n = 294) that critically engaged with arts and humanities approaches or generally called for their use in medical education, followed by program descriptions (n = 255). The literary arts (n = 197) were most common. Less than a third of records explicitly engaged theory as a strong component (n = 230). Of descriptive and empirical records (n = 424), more than half concerned undergraduate medical education (n = 245). There were gaps in the literature on interprofessional education, program evaluation, and learner assessment. Programming was most often taught by medical faculty who published their initiatives (n = 236). Absent were voices of contributing artists, docents, and other arts and humanities practitioners from outside medicine. Stakeholders confirmed that these findings resonated with their experiences. CONCLUSIONS This literature is characterized by brief, episodic installments, privileging a biomedical orientation and largely lacking a theoretical frame to weave the installments into a larger story that accumulates over time and across subfields. These findings should inform efforts to promote, integrate, and study uses of the arts and humanities in medical education.
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Affiliation(s)
- Tracy Moniz
- T. Moniz is associate professor, Department of Communication Studies, Mount Saint Vincent University, Halifax, Nova Scotia, Canada; ORCID: https://orcid.org/0000-0002-5078-4611
| | - Maryam Golafshani
- M. Golafshani is a second-year medical student, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Carolyn M Gaspar
- C.M. Gaspar is a PhD candidate, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada; ORCID: https://orcid.org/0000-0003-0412-5495
| | - Nancy E Adams
- N.E. Adams is associate librarian and assistant dean of foundational sciences, Penn State College of Medicine, Hershey, Pennsylvania; ORCID: https://orcid.org/0000-0003-0534-6716
| | - Paul Haidet
- P. Haidet is director of medical education research, Woodward Center for Excellence in Health Sciences Education, Penn State College of Medicine, Hershey, Pennsylvania
| | - Javeed Sukhera
- J. Sukhera is associate professor, Departments of Psychiatry and Paediatrics, and scientist, Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; ORCID: https://orcid.org/0000-0001-8146-4947
| | - Rebecca L Volpe
- R.L. Volpe is associate professor and vice chair for education, Department of Humanities, Penn State College of Medicine, and director, Clinical Ethics Consultation Service, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania; ORCID: https://orcid.org/0000-0003-3406-9498
| | - Claire de Boer
- C. de Boer is director, The Doctors Kienle Center for Humanistic Medicine, and founding director, Center Stage Arts in Health, Penn State College of Medicine and Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania. She is president, National Organization for Arts in Health, San Diego, California
| | - Lorelei Lingard
- L. Lingard is professor, Department of Medicine, and scientist, Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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Maggio LA, Larsen K, Thomas A, Costello JA, Artino AR. Scoping reviews in medical education: A scoping review. MEDICAL EDUCATION 2021; 55:689-700. [PMID: 33300124 PMCID: PMC8247025 DOI: 10.1111/medu.14431] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 11/19/2020] [Accepted: 12/04/2020] [Indexed: 05/12/2023]
Abstract
OBJECTIVES Over the last two decades, the number of scoping reviews in core medical education journals has increased by 4200%. Despite this growth, research on scoping reviews provides limited information about their nature, including how they are conducted or why medical educators undertake this knowledge synthesis type. This gap makes it difficult to know where the field stands and may hamper attempts to improve the conduct, reporting and utility of scoping reviews. Thus, this review characterises the nature of medical education scoping reviews to identify areas for improvement and highlight future research opportunities. METHOD The authors searched PubMed for scoping reviews published between 1/1999 and 4/2020 in 14 medical education journals. The authors extracted and summarised key bibliometric data, the rationales given for conducting a scoping review, the research questions and key reporting elements as described in the PRISMA-ScR. Rationales and research questions were mapped to Arksey and O'Malley's reasons for conducting a scoping review. RESULTS One hundred and one scoping reviews were included. On average, 10.1 scoping reviews (SD = 13.1, median = 4) were published annually with the most reviews published in 2019 (n = 42). Authors described multiple reasons for undertaking scoping reviews; the most prevalent being to summarise and disseminate research findings (n = 77). In 11 reviews, the rationales for the scoping review and the research questions aligned. No review addressed all elements of the PRISMA-ScR, with few authors publishing a protocol (n = 2) or including stakeholders (n = 20). Authors identified shortcomings of scoping reviews, including lack of critical appraisal. CONCLUSIONS Scoping reviews are increasingly conducted in medical education and published by most core journals. Scoping reviews aim to map the depth and breadth of emerging topics; as such, they have the potential to play a critical role in the practice, policy and research of medical education. However, these results suggest improvements are needed for this role to be fully realised.
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Affiliation(s)
- Lauren A. Maggio
- Department of MedicineUniformed Services University of the Health SciencesBethesdaMDUSA
| | - Kelsey Larsen
- Department of Politics, Security, and International AffairsUniversity of Central FloridaOrlandoFLUSA
| | - Aliki Thomas
- School of Physical and Occupational TherapyInstitute of Health Sciences EducationFaculty of MedicineMcGill UniversityMontrealQCCanada
| | | | - Anthony R. Artino
- Department of Health, Human Function, and Rehabilitation SciencesThe George Washington University School of Medicine and Health SciencesWashingtonDCUSA
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Kim K. Bedside education in the art of medicine (BEAM): A learner's perspective on arts-based teaching. J Eval Clin Pract 2021; 27:549-553. [PMID: 32588945 DOI: 10.1111/jep.13427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 05/14/2020] [Accepted: 05/17/2020] [Indexed: 11/29/2022]
Abstract
In today's culture of the medical profession, it is fairly unusual for students to actually witness physicians talking with patients about anything outside scientific explanation. That other side of medicine - the one that goes beyond explanation to understanding - goes unexplored, and the patient's personal narrative is consequently less understood. Meanwhile, though reflective writing is the most frequently used didactic method to promote introspection and deeper consolidation of new ideas for medical learners, there is robust evidence that other art forms - such as storytelling, dance, theatre, literature and the visual arts - can also help deepen reflection and understanding of the human aspect of medical practice. The overall goal of the Bedside Education in the Art of Medicine (BEAM) project is to redress these issues through early interventions within the culture of the medical profession. By creating an arts-based humanities curriculum, we hope to broaden medical learners' understanding and shine a light on what it means - for patients and clinicians - to be human, live well, experience loss, encounter disease, and engage in a therapeutic relationship. BEAM is envisioned as a modular, online resource of "third things" that any clinician anywhere will be able to access via a smartphone application to deliver brief, focused, humanistic clinical teaching in either hospital or ambulatory care settings. This commentary foregrounds a learner's perspective to model BEAM's usage in an in-depth manner; it examines the relation of a painting by Edward Hopper to medical education through the lens of a poem by Victoria Chang, in the context of the BEAM web-based app educational resource. By assessing the poignancy of the painting via the poem, I demonstrate the capacity of the arts and humanities in medical education, with a specific focus on the development of interpretative skills and tolerance for ambiguity that all authentic, engaged physicians need.
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Affiliation(s)
- Kain Kim
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland, USA
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Brand G, Sheers C, Wise S, Seubert L, Clifford R, Griffiths P, Etherton-Beer C. A research approach for co-designing education with healthcare consumers. MEDICAL EDUCATION 2021; 55:574-581. [PMID: 33155301 DOI: 10.1111/medu.14411] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 10/07/2020] [Accepted: 10/26/2020] [Indexed: 05/26/2023]
Abstract
CONTEXT Community and consumer involvement in health professions education (HPE) is of growing interest among researchers and educators, particularly in preparing health care graduates to effectively learn from, and collaborate with, people with lived experience of health issues. However, to date there has been limited direction on methodological approaches to engage health care consumers in the research and co-design of HPE. APPROACH In this paper, we describe the background to our work with health care consumers including the five core principles for successful co-design (inclusive; respectful; participative; iterative; outcomes focused) and how they can be applied as a research approach in HPE. We introduce the use of arts and humanities-based teaching methodologies including engagement, meaning-making and translational education strategies to illustrate how this research approach has been applied to reframe mental health education and practice in Australia. Furthermore, we share some reflective insights on the opportunities and challenges inherent in using a co-design research approach in HPE. CONCLUSIONS For the consumer voice to be embedded across HPE, there needs to be a collective commitment to curriculum redesign. This paper advances our understandings of the educational research potential of working with health care consumers to co-design rich and authentic learning experiences in HPE. Co-design research approaches that partner with and legitimise health care consumers as experts by experience may better align education and health professional practice with consumers' actual needs, an important first step in transforming hierarchical health care relationships towards more humanistic models of care.
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Affiliation(s)
- Gabrielle Brand
- School of Nursing and Midwifery, Monash University, Frankston, VIC, Australia
- School of Allied Health, Faculty of Health & Medical Sciences, The University of Western Australia, Crawley, WA, Australia
| | - Carli Sheers
- Facilitated by the Consumer and Community Involvement Program (CCIP), Perth, WA, Australia
| | - Steve Wise
- 27Creative Photography & Design, Medical Illustrations, Royal Perth Bentley Group, Royal Perth Hospital, Perth, WA, Australia
| | - Liza Seubert
- School of Allied Health, Faculty of Health & Medical Sciences, The University of Western Australia, Crawley, WA, Australia
| | - Rhonda Clifford
- School of Allied Health, Faculty of Health & Medical Sciences, The University of Western Australia, Crawley, WA, Australia
| | | | - Christopher Etherton-Beer
- Royal Perth Bentley Group, East Metropolitan Health Service, Medical Division, Medical School, University of Western, Perth, WA, Australia
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Brand G, Osborne A, Wise S, Isaac C, Etherton-Beer C. Using MRI art, poetry, photography and patient narratives to bridge clinical and human experiences of stroke recovery. MEDICAL HUMANITIES 2020; 46:243-249. [PMID: 31171636 DOI: 10.1136/medhum-2018-011623] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/19/2019] [Indexed: 06/09/2023]
Abstract
Integrating co-produced humanities-based pedagogy into patient and workforce education is of growing interest. The aim of our Depth of Field: Exploring Stroke Recovery project grew from a strong commitment to use patients' lived experiences as a voice to educate new stroke patients and the health professional staff who will care for them. The aim of the initial Quality Improvement project at a West Australian Stroke Rehabilitation Unit (SRU) was to co-produce a reflective learning resource with stroke patients and their families to help navigate the stroke recovery journey. A series of artefacts (documentary-style photographs, audio-narrated vignettes, MRI images and poetry) were collected from four stroke patients and their families at differing stages of recovery over 12 months as they recounted the honest and raw reality of what life is really like following a stroke. These artefacts were used in a pilot qualitative project to explore new stroke patients, their families and SRU health professional staff perceptions towards the artefacts in order to inform the final educational resource. These findings enhance our understandings of how we can use art and patient (healthcare consumers) voice to widen the lens of stroke recovery and provides a valuable template to co-produce peer-to-peer and health professions education reflective learning resources to promote more human- centred approaches to care.
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Affiliation(s)
- Gabrielle Brand
- Division of Health Professions Education, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia
- School of Nursing & Midwifery; Monash Centre for Scholarship in Health Education, Monash University, Melbourne, Victoria, Australia
| | - Ashlee Osborne
- Division of Health Professions Education, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Steve Wise
- Medical Illustration Department, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Collette Isaac
- Royal Perth Hospital, Perth, Western Australia, Australia
| | - Christopher Etherton-Beer
- Medical School, Faculty of Health & Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia
- Royal Perth Bentley Group, Royal Perth Hospital, Perth, Western Australia, Australia
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Gonzalo JD, Davis C, Thompson BM, Haidet P. Unpacking Medical Students' Mixed Engagement in Health Systems Science Education. TEACHING AND LEARNING IN MEDICINE 2020; 32:250-258. [PMID: 31875724 DOI: 10.1080/10401334.2019.1704765] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Phenomenon: Medical education is better aligning with the needs of health systems. Health systems science competencies, such as high-value care, population health, and systems thinking, are increasingly being integrated into curricula, but not without challenges. One challenge is mixed receptivity by students, the underlying reasons of which have not been extensively explored. In this qualitative study, we explored the research question: "How do students perceive health systems science curricula across all four years, and how do such perceptions inform the reasons for mixed quality ratings?" Approach: Following large-scale health systems science curricular changes in their medical school, we used students' open-ended comments obtained from course evaluations related to 1st-, 2nd-, and 4th-year courses and performed a qualitative thematic analysis to explore students' perceptions. We identified themes, synthesized findings into a conceptual figure, and agreed upon results and quotations. Findings: Five themes were identified: (1) perceived importance and relevance of health systems science education, (2) tension between traditional and evolving health systems science-related professional identity, (3) dissatisfaction with redundancy of topics, (4) competition with basic and clinical science curricula, and, (5) preference for discrete, usable, testable facts over complexity and uncertainty. The relationship between themes is described along a continuum of competing agendas between students' traditional mindset (which focuses on basic/clinical science) and an emerging medical education approach (which focuses on basic, clinical, and health systems science). Insights: Health systems science education can be viewed by learners as peripheral to their future practice and not aligned with a professional identity that places emphasis on basic and clinical science topics. For some students, this traditional identity limits engagement in health systems science curricula. If health systems science is to achieve its full potential in medical education, further work is required to explore the adoption of new perspectives by students and create activities to accelerate the process.
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Affiliation(s)
- Jed D Gonzalo
- Department of Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Christopher Davis
- Family and Community Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Britta M Thompson
- Department of Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Paul Haidet
- Department of Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA
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Ng SL, Mylopoulos M, Kangasjarvi E, Boyd VA, Teles S, Orsino A, Lingard L, Phelan S. Critically reflective practice and its sources: A qualitative exploration. MEDICAL EDUCATION 2020; 54:312-319. [PMID: 31914210 DOI: 10.1111/medu.14032] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 09/11/2019] [Accepted: 10/31/2019] [Indexed: 05/17/2023]
Abstract
CONTEXT Critical reflection may improve health professionals' performance of the social roles of care (eg collaboration) in indeterminate zones of practice that are ambiguous, unique, unstable or value-conflicted. Research must explore critical reflection in practice and how it is developed. In this study, we explored what critical reflection consisted of in a context known for indeterminacy, and to what sources participants attributed their critically reflective insights and approaches. METHODS The study context was the interface between health care and education for children with chronic conditions or disabilities necessitating health-related recommendations and supports (eg accommodations or equipment) at school. We conducted a secondary analysis of 42 interview transcripts from an institutional ethnographic study involving health professionals, school-based educators and parents of children with chronic conditions or disabilities. We coded all transcripts for instances of critical reflection, moments that seemed to lack but could benefit from critical reflection, and participant-attributed sources of critically reflective insights. RESULTS Critically reflective practice involved getting to know the other, valuing and leveraging different forms and sources of knowledge, identifying and communicating workarounds (ie strategies to circumvent imperfect systems), seeing inequities, and advocating as collaborators, not adversaries. Participants invariably attributed critically reflective insights to personal experiences such as former careers or close personal relationships. CONCLUSIONS This study shows that personal experiences and connections inspire critically reflective views, and that being critically reflective is not a binary trait possessed (or not) by individuals. It is learnable through personally meaningful experiences. Health professions education could aim to preserve philosophical space for personal experience as a source of learning and integrate evidence-informed approaches to foster critically reflective practice.
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Affiliation(s)
- Stella L Ng
- Centre for Faculty Development, St Michael's Hospital, Toronto, Ontario, Canada
- Wilson Centre for Research in Education, University of Toronto, Toronto, Ontario, Canada
| | - Maria Mylopoulos
- Wilson Centre for Research in Education, University of Toronto, Toronto, Ontario, Canada
| | - Emilia Kangasjarvi
- Centre for Faculty Development, St Michael's Hospital, Toronto, Ontario, Canada
| | - Victoria A Boyd
- Wilson Centre for Research in Education, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Sabrina Teles
- The Department of Recreation and Leisure Studies, University of Waterloo, Waterloo, Ontario, Canada
| | - Angela Orsino
- Developmental Paediatrics, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Lorelei Lingard
- Department of Medicine and Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Shanon Phelan
- Faculty of Rehabilitation Medicine, Occupational Therapy, University of Alberta, Edmonton, Alberta, Canada
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Charon R, Ship A, Asch SM. Arts, Humanities, Medicine, and Discovery: a Creative Calling. J Gen Intern Med 2020; 35:407-408. [PMID: 31792859 PMCID: PMC7018877 DOI: 10.1007/s11606-019-05513-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Rita Charon
- Department of Medical Humanities and Ethics, Columbia University Irving Medical Center, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | | | - Steven M Asch
- Stanford Division of Primary Care and Population Health, Palo Alto, CA, USA.
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Baker L, Kangasjarv E, McNeil B, Houston P, Mooney S, Ng S. "Disadvantaged patient populations": A theory-informed education needs assessment in an urban teaching hospital. CANADIAN MEDICAL EDUCATION JOURNAL 2019; 10:e21-e31. [PMID: 31807224 PMCID: PMC6892306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Recent calls in medical education and health care emphasize equitable care for disadvantaged patient populations (DPP), with education highlighted as a key mechanism toward this goal. As a first step in understanding potential education needs we wanted to better understand the DPP concept. METHODS Framed as a critical needs assessment, we used a critical discourse analysis approach to explore the meanings and effects of DPP. We analyzed transcripts from 15 focus groups with trainees, staff and patients. RESULTS We identified three main assumptions about DPP: 1) disadvantaged patients require care above what is normal; 2) the system is to blame for failures in serving disadvantaged patients; and 3) labeling patients is problematic and stigmatizing. Patients appreciated that the DPP concept opened up better access to care, but also felt 'othered' by the concept. As a result, patients felt they were not accessing the same level of care in terms of compassion and respect. CONCLUSION We must define access beyond ability to receive services; access must also engender a sense of common humanity and respect. With this aim, we suggest three, theory-informed educational approaches to help improve care for DPP: 1) sharing authentic and varied stories; 2) fostering dialogue; 3) aligning assessment and educational approaches.
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Affiliation(s)
- Lindsay Baker
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Ontario, Canada
- Centre for Faculty Development, Faculty of Medicine, University of Toronto at St. Michael’s Hospital, Ontario, Canada
- The Wilson Centre, Faculty of Medicine, University of Toronto at Toronto General Hospital, Ontario Canada
- The Li Ka Shing Knowledge Institute, St. Michael's Hospital, Ontario, Canada
| | - Emilia Kangasjarv
- Centre for Faculty Development, Faculty of Medicine, University of Toronto at St. Michael’s Hospital, Ontario, Canada
| | - Beck McNeil
- Toronto Public Service and Leadership Development Programs, People, Equity and Human Rights Division, City of Toronto, Ontario, Canada
| | - Patricia Houston
- Department of Anesthesia, Faculty of Medicine, University of Toronto, Ontario, Canada
- Department of Anaesthesia, St. Michael’s Hospital, Unity Health Toronto, Ontario, Canada
| | - Stephanie Mooney
- Education Portfolio, St. Michael’s Hospital, Unity Health Toronto, Ontario, Canada
| | - Stella Ng
- Centre for Faculty Development, Faculty of Medicine, University of Toronto at St. Michael’s Hospital, Ontario, Canada
- The Wilson Centre, Faculty of Medicine, University of Toronto at Toronto General Hospital, Ontario Canada
- The Li Ka Shing Knowledge Institute, St. Michael's Hospital, Ontario, Canada
- Toronto Public Service and Leadership Development Programs, People, Equity and Human Rights Division, City of Toronto, Ontario, Canada
- Department of Speech-Language Pathology, Faculty of Medicine, University of Toronto, Ontario, Canada
- Centre for Ambulatory Care Education, Women’s College Hospital, Ontario, Canada
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Ng SL, Wright SR, Kuper A. The Divergence and Convergence of Critical Reflection and Critical Reflexivity: Implications for Health Professions Education. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2019; 94:1122-1128. [PMID: 30920447 DOI: 10.1097/acm.0000000000002724] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
As a field, health professions education (HPE) has begun to answer calls to draw on social sciences and humanities (SS&H) knowledge and approaches for curricular content, design, and pedagogy. Two commonly used SS&H concepts in HPE are critical reflection and critical reflexivity. But these are often conflated, misunderstood, and misapplied. Improved clarity of these concepts may positively affect both the education and practice of health professionals. Thus, the authors seek to clarify the origins of each, identify the similarities and differences between them, and delineate the types of teaching and assessment methods that fit with critical reflection and/or critical reflexivity. Common to both concepts is an ultimate goal of social improvement. Key differences include the material emphasis of critical reflection and the discursive emphasis of critical reflexivity. These similarities and differences result in some different and some similar teaching and assessment approaches, which are highlighted through examples. The authors stress that all scientific and social scientific concepts and methods imported into HPE must be subject to continued scrutiny both from within their originating disciplines and in HPE. This continued questioning is core to the ongoing development of the HPE field and also to health professionals' thinking and practice.
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Affiliation(s)
- Stella L Ng
- S.L. Ng is director of research, Centre for Faculty Development, and Arrell Family Chair in Health Professions Teaching, St. Michael's Hospital, scientist, Centre for Ambulatory Care Education and the Wilson Centre, and assistant professor, Department of Speech-Language Pathology, University of Toronto, Toronto, Ontario, Canada. S.R. Wright is scientist, Michael Garron Hospital, Centre for Ambulatory Care Education and the Wilson Centre, and assistant professor, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada. A. Kuper is associate professor of medicine and faculty co-lead in person-centred care, Department of Medicine, scientist and associate director, Wilson Centre for Research in Education, University Health Network, University of Toronto, and staff physician, Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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Volpe RL, Hopkins M, Van Scoy LJ, Wolpaw DR, Thompson BM. Does Pre-clerkship Medical Humanities Curriculum Support Professional Identity Formation? Early Insights from a Qualitative Study. MEDICAL SCIENCE EDUCATOR 2019; 29:515-521. [PMID: 34457509 PMCID: PMC8368951 DOI: 10.1007/s40670-018-00682-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
There is a lack of consensus about the outcomes of medical humanities training. In this qualitative study, the authors analyzed pre-clerkship small group discussions to assess the nature of learning in medical humanities. Twenty-two medical students (12 females and 10 males) in three humanities small groups consented to participate. The authors used inductive thematic analysis to qualitatively analyze the text from 13 weeks of curriculum. Findings indicate that students reflect about negotiating the clinician-patient relationship within the stressful environment characteristic of today's healthcare systems, that they worry about sacrificing their personal values in pursuit of honoring professional expectations, and that they encounter and commonly confront ambiguity. These themes were used to develop a descriptive framework of humanities small groups as a structure and safe space for the early development of professional identity.
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Affiliation(s)
- Rebecca L. Volpe
- Department of Humanities, Penn State College of Medicine, 500 University Drive, H134, Hershey, PA 17011 USA
| | - Margaret Hopkins
- Department of Humanities, Penn State College of Medicine, 500 University Drive, H134, Hershey, PA 17011 USA
| | - Lauren Jodi Van Scoy
- Pulmonary, Allergy and Critical Care Division, Penn State College of Medicine, Hershey, PA USA
| | - Daniel R. Wolpaw
- Department of Humanities and Medicine, Penn State College of Medicine, Hershey, PA USA
| | - Britta M. Thompson
- Department of Medicine and Woodward Center for Excellence in Health Sciences Education, Hershey, PA USA
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Building bridges between medicine and the humanities: The role of scaffolds and articulation in surgical learning. BIOMEDICA 2019; 39:55-64. [PMID: 31021547 DOI: 10.7705/biomedica.v39i1.4012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Indexed: 11/21/2022]
Abstract
Introduction: Learning about medicine from the humanities is a complex process that requires pedagogical strategies to avoid fragmentation and the paradox of transference. Instructional design in surgical education for these purposes is limited.
Objective: To present the results of an educational strategy for the integration of surgery and the medical humanities based on the theoretical perspectives of the cognitive apprenticeship model and to assess its association with the students’ perceptions of learning.
Materials and methods: An instructional design was developed for the teaching of clinical conditions through the medical humanities. Students’ perceptions of teachers’ support and articulation for the integration of both disciplines, as well as students’ self-perceptions of learning, were evaluated using validated questionnaires. Linear regression models were used to test the proposed association.
Results: A total of 216 students was included in the analysis. High scores were obtained for each variable. The increase of one unit of teacher support and articulation for the integration of both disciplines was associated with an increase in student perception of learning (b) of 0.45 (CI 95% 0.30-0.60) and 0.40 (CI 95% 0.25 -0.55) (R2=0.64, p<0.001), respectively.
Conclusions: Educational strategies focused on the techniques of support and articulation with the aim of integrating the medical humanities and surgery, demonstrated positive associations with students’ perceptions of learning. Further studies are needed to evaluate the effects of these interventions on memory and long-term learning.
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Ilcewicz HN, Poirier TI, Pailden J. Use of mixed-methods approach to assess the impact of a pre-professional health humanities honors course on developing interpersonal skills. CURRENTS IN PHARMACY TEACHING & LEARNING 2018; 10:1456-1465. [PMID: 30514535 DOI: 10.1016/j.cptl.2018.08.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 06/15/2018] [Accepted: 08/03/2018] [Indexed: 06/09/2023]
Abstract
INTRODUCTION The purpose of this study was to use a mixed-methods approach to provide evidence for growth in empathy, respect for patient autonomy, ability to relate to others, and self-awareness as a result of participating in a health humanities course. METHODS The mixed-methods approach gathered quantitative data using a quasi-experimental design of a pre/post course survey and qualitative data from reflective writings and student papers. The reflective writings and student papers were evaluated using an adapted rubric to assess the quality of the reflections on measures of empathy, respect for patient autonomy, ability to relate to others, and self-awareness. RESULTS Twenty-five students were enrolled in the course. Matched pair data was available from 22 students (88% response rate) for the quantitative survey data. Qualitative data was available from all 25 participants. The pre- and post-course surveys revealed a statistically significant increase in empathy (p < 0.001) as a result of completing the health humanities course. The final written report contained the highest quality of reflections compared to all other reflective writing assignments. Evidence for understanding empathy was prominent in the final written report. CONCLUSIONS The evaluation of development of interpersonal skills through use of health humanities resources may be reproduced by using a mixed-methods assessment approach. The quantitative and qualitative data presented provide some evidence for enhancing awareness and understanding of empathy, particularly by utilizing health humanities resources in an undergraduate interdisciplinary seminar course.
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Affiliation(s)
- Haley N Ilcewicz
- Southern Illinois University Edwardsville School of Pharmacy, 200 University Park, Edwardsville, IL 62025, United States.
| | - Therese I Poirier
- Southern Illinois University Edwardsville School of Pharmacy, 200 University Park, Edwardsville, IL 62025, United States.
| | - Junvie Pailden
- Department of Mathematics and Statistics, Southern Illinois University Edwardsville, Box 1653, Edwardsville, IL 62026, United States.
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Ledger A, Joynes V. "A huge part of my life": Exploring links between music, medical education, and students' developing identities as doctors. MEDEDPUBLISH 2018; 7:183. [PMID: 38074596 PMCID: PMC10701835 DOI: 10.15694/mep.2018.0000183.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2024] Open
Abstract
This article was migrated. The article was marked as recommended. This paper explores the place of music in the development of future doctors, through the lens of a mixed method, longitudinal evaluation of a two-week music and medicine special studies project for second and third year medical students. Methods of evaluation included a cohort-wide survey (n=147) and individual interviews with students who had undertaken the music and medicine project (n = 4). Analysis of survey responses indicated that music is important to medical students and that many students recognise links between music and medicine. Medical students who undertook the music and medicine project reported benefits for their ongoing development, including changes in the way they understand and use music in their own lives and exposure to career options they had not considered previously. These benefits are discussed in relation to Dennhardt et al.'s (2016) framework of epistemic functions of arts-based teaching in medical education and to wider debates about whether medical humanities teaching should be compulsory or optional. We then propose that there is room for music in medical education within integrated medical humanities teaching, to promote critical thinking and openness to new perspectives. Optional music and medicine study should also be available for medical students who identify as musicians, to support them in the process of developing their identities as doctors.
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Kaptein AA, Hughes BM, Murray M, Smyth JM. Start making sense: Art informing health psychology. Health Psychol Open 2018; 5:2055102918760042. [PMID: 29552350 PMCID: PMC5846955 DOI: 10.1177/2055102918760042] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Growing evidence suggests that the arts may be useful in health care and in the training of health care professionals. Four art genres - novels, films, paintings and music - are examined for their potential contribution to enhancing patient health and/or making better health care providers. Based on a narrative literature review, we examine the effects of passive (e.g. reading, watching, viewing and listening) and active (e.g. writing, producing, painting and performing) exposure to the four art genres, by both patients and health care providers. Overall, an emerging body of empirical evidence indicates positive effects on psychological and physiological outcome measures in patients and some benefits to medical training. Expressive writing/emotional disclosure, psychoneuroimmunology, Theory of Mind and the Common Sense Model of Self-Regulation are considered as possible theoretical frameworks to help incorporate art genres as sources of inspiration for the further development of health psychology research and clinical applications.
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Affiliation(s)
- Ad A Kaptein
- Leiden University Medical Center, The Netherlands
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Sklar DP. Health Humanities and Medical Education: Joined by a Common Purpose. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2017; 92:1647-1649. [PMID: 29210729 DOI: 10.1097/acm.0000000000001972] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Baker CJ, Shaw MH, Mooney CJ, Daiss SDP, Clark SB. The Medical Humanities Effect: a Pilot Study of Pre-Health Professions Students at the University of Rochester. THE JOURNAL OF MEDICAL HUMANITIES 2017; 38:445-457. [PMID: 28589308 DOI: 10.1007/s10912-017-9446-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Qualitative and quantitative research on the impact of medical and health humanities teaching in baccalaureate education is sparse. This paper reviews recent studies of the impact of medical and health humanities coursework in pre-health professions education and describes a pilot study of baccalaureate students who completed semester-long medical humanities courses in the Division of Medical Humanities & Bioethics at the University of Rochester. The study format was an email survey. All participants were current or former baccalaureate students who had taken one or more courses in literature and narrative in medicine, bioethics, history of medicine, and/or visual arts and healthcare during the past four years. The survey gathered numerical data in several areas: demographic information, career plans, self-reported influence of coursework on educational and career plans, and self-reported influence of coursework on intellectual skills and abilities. It also gathered narrative commentary that elaborated on students' responses to the numerically-based questions. Notable findings from preliminary analysis of the data include higher scores of self-reported impact of the coursework on specific habits of mind and on preparedness for intended career rather than on gaining admission to future educational programs. Discussion of the results focuses on several potential future directions this type of study might take, including multi-center, longitudinal, and sequential approaches.
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Affiliation(s)
- Clayton J Baker
- Division of Medical Humanities and Bioethics, University of Rochester School of Medicine and Dentistry (URSMD), 601 Elmwood Avenue, Box 676, Rochester, NY, 14642, USA.
| | - Margie Hodges Shaw
- Division of Medical Humanities and Bioethics, University of Rochester School of Medicine and Dentistry (URSMD), 601 Elmwood Avenue, Box 676, Rochester, NY, 14642, USA
| | - Christopher J Mooney
- Division of Medical Humanities and Bioethics, University of Rochester School of Medicine and Dentistry (URSMD), 601 Elmwood Avenue, Box 676, Rochester, NY, 14642, USA
| | - Susan Dodge-Peters Daiss
- Medical Humanities & Bioethics, URSMD and Memorial Art Gallery of the University of Rochester, Rochester, NY, USA
| | - Stephanie Brown Clark
- Division of Medical Humanities and Bioethics, University of Rochester School of Medicine and Dentistry (URSMD), 601 Elmwood Avenue, Box 676, Rochester, NY, 14642, USA.
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Gaufberg E. Mapping the Landscape, Journeying Together: The Gold Foundation's Model for Research-Based Advocacy in Humanism in Medicine. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2017; 92:1671-1673. [PMID: 29019801 DOI: 10.1097/acm.0000000000001987] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Mapping the Landscape, Journeying Together (MTL) is an initiative of the Arnold P. Gold Foundation Research Institute. The MTL initiative awards teams with a grant to complete a rigorous review of the literature on a topic related to humanism in health care. Teams may then seek a discovery or advocacy grant to fill in gaps in knowledge or to make or advocate for change. In this Commentary, the author reveals the MTL journey through the metaphor of cartography. She describes the initial development of a road map, as well as the MTL community's experience of navigation, discovery, and exploration. MTL participants are not only incrementally adding to a complex body of knowledge but also actively cultivating a robust community of practice.
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Affiliation(s)
- Elizabeth Gaufberg
- E. Gaufberg is associate professor of medicine and psychiatry, Harvard Medical School, Boston, Massachusetts; Jean and Harvey Picker Director, Arnold P. Gold Foundation Research Institute, Cambridge, Massachusetts; and director, Cambridge Health Alliance Center for Professional Development, Cambridge, Massachusetts; ORCID: http://orcid.org/0000-0002-0903-6048
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Abstract
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.
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Kelly M, Dornan T. Mapping the landscape or exploring the terrain? Progressing humanism in medical education. MEDICAL EDUCATION 2016; 50:273-275. [PMID: 26896009 DOI: 10.1111/medu.12967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Martimianakis MA, Hafferty FW. Exploring the interstitial space between the ideal and the practised: humanism and the hidden curriculum of system reform. MEDICAL EDUCATION 2016; 50:278-80. [PMID: 26896011 DOI: 10.1111/medu.12982] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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