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Chen CT, Huang AY, Hou PH, Lin JY, Chen HH, Huang SS, Yang SJH. Exploring the significance of medical humanities in shaping internship performance: insights from curriculum categories. MEDICAL EDUCATION ONLINE 2025; 30:2444282. [PMID: 39862129 PMCID: PMC11770856 DOI: 10.1080/10872981.2024.2444282] [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: 04/25/2024] [Revised: 10/14/2024] [Accepted: 12/15/2024] [Indexed: 01/27/2025]
Abstract
BACKGROUND Medical Humanities (MH) curricula integrate humanities disciplines into medical education to nurture essential qualities in future physicians. However, the impact of MH on clinical competencies during formative training phases remains underexplored. This study aimed to determine the influence of MH curricula on internship performance. METHODS The academic records of 1364 medical students across 8 years of admission cohorts were analyzed. Performance in basic sciences, clinical skills, MH, and internship rotations were investigated, including the subgroup analysis of MH curricula. Ten-fold cross-validation machine learning models (support vector machines, logistic regression, random forest) were performed to predict the internship grades. In addition, multiple variables regression was done to know the independent impact of MH on internship grades. RESULTS MH showed the important roles in predicting internship performance in the machine learning model, with substantially reduced predictive accuracy after excluding MH variables (e.g. Area Under the Curve (AUC) declining from 0.781 to 0.742 in logistic regression). Multiple variables regression revealed that MH, after controlling for the scores of other subjects, has the highest odds ratio (OR: 1.29, p < 0.0001) on internship grades. MH explained 29.49% of the variance in internship grades as the primary variable in stepwise regression. In the subgroup analysis of MH curricula, Medical Sociology and Cultural Studies, as well as Communication Skills and Interpersonal Relationships, stood out with AUC values of 0.710 and 0.705, respectively, under logistic regression. CONCLUSION MH had the strongest predictive association with clinical competence during formative internship training, beyond basic medical sciences. Integrating humanities merits greater prioritization in medical curricula to nurture skilled, compassionate physicians. Further research should investigate the longitudinal impacts of humanities engagement.
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Affiliation(s)
- Chao Ting Chen
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Anna Y.Q. Huang
- Computer Science and Information Engineering, National Central University, Taoyuan, Taiwan
| | - Po-Hsun Hou
- Department of psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan
- Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Ji-Yang Lin
- Computer Science and Information Engineering, National Central University, Taoyuan, Taiwan
| | - His-Han Chen
- Department of Psychiatry, Yang Ji Mental Hospital, Keelung, Taiwan
| | - Shiau-Shian Huang
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
- Nankung psychiatric Hospital, Keelung, Taiwan
| | - Stephen J. H. Yang
- Computer Science and Information Engineering, National Central University, Taoyuan, Taiwan
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Katz RA, Graham SS, Buchman DZ. The need for epistemic humility in AI-assisted pain assessment. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2025; 28:339-349. [PMID: 40087254 PMCID: PMC12103351 DOI: 10.1007/s11019-025-10264-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 02/27/2025] [Indexed: 03/17/2025]
Abstract
It has been difficult historically for physicians, patients, and philosophers alike to quantify pain given that pain is commonly understood as an individual and subjective experience. The process of measuring and diagnosing pain is often a fraught and complicated process. New developments in diagnostic technologies assisted by artificial intelligence promise more accurate and efficient diagnosis for patients, but these tools are known to reproduce and further entrench existing issues within the healthcare system, such as poor patient treatment and the replication of systemic biases. In this paper we present the argument that there are several ethical-epistemic issues with the potential implementation of these technologies in pain management settings. We draw on literature about self-trust and epistemic and testimonial injustice to make these claims. We conclude with a proposal that the adoption of epistemic humility on the part of both AI tool developers and clinicians can contribute to a climate of trust in and beyond the pain management context and lead to a more just approach to the implementation of AI in pain diagnosis and management.
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Affiliation(s)
- Rachel A Katz
- Institute for the History & Philosophy of Science and Technology, University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - S Scott Graham
- Department of Rhetoric and Writing, Center for Health Communication, The University of Texas at Austin, Austin, TX, USA
| | - Daniel Z Buchman
- Centre for Addiction and Mental Health, Toronto, ON, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
- Joint Centre for Bioethics, University of Toronto, Toronto, ON, Canada.
- Krembil Research Institute, University Health Network, Toronto, ON, Canada.
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Zeren Q, Zeng Y, Zhang JW, Yang J. Flexner's legacy and the future of medical education: Embracing challenge and opportunity. World J Clin Cases 2024; 12:6650-6654. [PMID: 39600482 PMCID: PMC11514341 DOI: 10.12998/wjcc.v12.i33.6650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 09/16/2024] [Accepted: 09/23/2024] [Indexed: 09/27/2024] Open
Abstract
This editorial comments on the article by Alzerwi. We focus on the development course, present challenges, and future perspectives of medical education. Modern medical education is gradually undergoing significant and profound changes worldwide. The emergence of new ideas, methodologies, and techniques has created opportunities for medical education developments and brought new concerns and challenges, ultimately promoting virtuous progress in medical education reform. The sustainable development of medical education needs joint efforts and support from governments, medical colleges, hospitals, researchers, administrators, and educators.
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Affiliation(s)
- Quzhen Zeren
- Department of Gastroenterology, Changdu People's Hospital of Xizang, Changdu 854000, Tibet Autonomous Region, China
| | - Yan Zeng
- Department of Psychology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Jun-Wen Zhang
- Department of Gastroenterology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Jian Yang
- Department of Gastroenterology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
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Bhagat PR, Kinjal YT, Vijay R. The Empathy Quandary in Postgraduate Medical Training. Int J Appl Basic Med Res 2024; 14:233-238. [PMID: 39749171 PMCID: PMC11691101 DOI: 10.4103/ijabmr.ijabmr_288_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 07/17/2024] [Accepted: 09/02/2024] [Indexed: 01/04/2025] Open
Abstract
Background Empathy stands as a cornerstone of humanistic qualities and is essential in healthcare for understanding and alleviating emotional suffering. Despite its necessity, formal empathy training remains elusive in postgraduate medical education across the globe, contributing to decline of humanistic practice among trainees. This study aims to assess and establish the need for empathy training by evaluating the perspectives of postgraduate trainees and faculty. Materials and Methods The study was conducted in a medical college of western India in 2023. Three online validated questionnaires were used to assess empathy-related perceptions among faculty and postgraduate trainees across various specialties. The questionnaires focused on demographic data, importance of empathy in patient care, empathy training, perceived levels of empathy, reasons for shortfalls in empathetic behavior and recommendations for nurturing empathy. Data were analyzed quantitatively and thematically. Results A total of 150 and 127 responses were gathered and analyzed from faculty and trainees, respectively. Excessive workload, lack of formal training, and technology-dependent fast paced lifestyle were attributed for lack of empathy in clinical care. All the faculty agreed that empathy training is essential and majority (67%) believed that lack of empathetic behavior led to dissatisfaction among patients and caregivers. Conclusion Empathetic communication and behaviors are fundamental competencies for health-care professionals. There is need for a structured training for empathy in postgraduate medical curriculum.
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Affiliation(s)
- Purvi Raj Bhagat
- Department of Ophthalmology, M and J Western Regional Institute of Ophthalmology, B. J. Medical College and Civil Hospital, Ahmedabad, Gujarat, India
| | - Y. Trivedi Kinjal
- Department of Ophthalmology, M and J Western Regional Institute of Ophthalmology, B. J. Medical College and Civil Hospital, Ahmedabad, Gujarat, India
| | - Rajput Vijay
- Department of Medical Education, Nova Southeastern University, Dr. Kiran C. Patel College of Allopathic Medicine, Florida, United States
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Arawi T, El Bachour J, El Khansa T. The Fourth Industrial Revolution: Its Impact on Artificial Intelligence and Medicine in Developing Countries. Asian Bioeth Rev 2024; 16:513-526. [PMID: 39022373 PMCID: PMC11250712 DOI: 10.1007/s41649-024-00284-7] [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: 08/23/2023] [Revised: 02/07/2024] [Accepted: 02/10/2024] [Indexed: 07/20/2024] Open
Abstract
Artificial intelligence (AI) is the ability of a digital computer or computer-controlled robot to perform tasks commonly associated with intelligent beings. Artificial intelligence can be both a blessing and a curse, and potentially a double-edged sword if not carefully wielded. While it holds massive potential benefits to humans-particularly in healthcare by assisting in treatment of diseases, surgeries, record keeping, and easing the lives of both patients and doctors, its misuse has potential for harm through impact of biases, unemployment, breaches of privacy, and lack of accountability to mention a few. In this article, we discuss the fourth industrial revolution, through a focus on the core of this phenomenon, artificial intelligence. We outline what the fourth industrial revolution is, its basis around AI, and how this infiltrates human lives and society, akin to a transcendence. We focus on the potential dangers of AI and the ethical concerns it brings about particularly in developing countries in general and conflict zones in particular, and we offer potential solutions to such dangers. While we acknowledge the importance and potential of AI, we also call for cautious reservations before plunging straight into the exciting world of the future, one which we long have heard of only in science fiction movies.
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Affiliation(s)
- Thalia Arawi
- Salim El Hoss Bioethics and Professionalism Program (SHBPP), Faculty of Medicine, American University of Beirut & Medical Center, Beirut, Lebanon
| | - Joseph El Bachour
- Salim El Hoss Bioethics and Professionalism Program (SHBPP), Faculty of Medicine, American University of Beirut & Medical Center, Beirut, Lebanon
| | - Tala El Khansa
- Salim El Hoss Bioethics and Professionalism Program (SHBPP), Faculty of Medicine, American University of Beirut & Medical Center, Beirut, Lebanon
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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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Bhagat PR, Trivedi KY, Prajapati KM, Chauhan AS, Shah NP, Shah RT, Kathiara RA, Asari WA, Rajput V. Nurturing Empathy through Arts, Literature, and Role Play for Postgraduate Trainees of Ophthalmology. Int J Appl Basic Med Res 2024; 14:42-47. [PMID: 38504843 PMCID: PMC10947765 DOI: 10.4103/ijabmr.ijabmr_454_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 12/18/2023] [Accepted: 12/22/2023] [Indexed: 03/21/2024] Open
Abstract
Background and Purpose Empathy is essential in patient-centered compassionate health care. Lack of formal training, workload, patient factors, and digitalization have been attributed to its regression. Empathy can be nurtured by educational interventions. A structured empathy education module for postgraduate trainees is not available in India. The aim for this research was to develop, deliver, and evaluate one for ophthalmology postgraduate trainees. Methodology This interventional study was conducted in the tertiary ophthalmology department of Western India during 2022-2023. Four workshops comprising of interactive lectures, literature, creative arts, and role plays were delivered with trained facilitators. Data from surveys for trainee self-assessment, patient perception of trainee empathy, pre-post knowledge test, and trainee and facilitator feedback were collected and analyzed. Results Seventy-nine ophthalmology postgraduate trainees participated in this intervention. Excessive workload and lack of training were shared as the barriers to empathetic care. Trainees showed improved knowledge, skills, and attitude in empathy after the workshops. The facilitators and trainees were satisfied with the learning goals, execution, utility, feasibility, and relevance of the workshops. Ninety-three percent trainees want this module to be a part of postgraduate curriculum. Conclusion This study substantiates the use of structured interactive training for cultivating empathy in postgraduate trainees. Barriers against empathy were identified and can be mitigated by restorative measures. Literature, arts, and role plays are the effective education tools for empathy.
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Affiliation(s)
- Purvi R. Bhagat
- Department of Ophthalmology, M and J Western Regional Institute of Ophthalmology, B.J. Medical College and Civil Hospital, Ahmedabad, Gujarat, India
| | - Kinjal Y. Trivedi
- Department of Ophthalmology, M and J Western Regional Institute of Ophthalmology, B.J. Medical College and Civil Hospital, Ahmedabad, Gujarat, India
| | - Kamini M. Prajapati
- Department of Ophthalmology, M and J Western Regional Institute of Ophthalmology, B.J. Medical College and Civil Hospital, Ahmedabad, Gujarat, India
| | - Abhishek S. Chauhan
- Department of Ophthalmology, M and J Western Regional Institute of Ophthalmology, B.J. Medical College and Civil Hospital, Ahmedabad, Gujarat, India
| | - Neeharika Pinakin Shah
- Department of Ophthalmology, M and J Western Regional Institute of Ophthalmology, B.J. Medical College and Civil Hospital, Ahmedabad, Gujarat, India
| | - Rupal T. Shah
- Department of Ophthalmology, M and J Western Regional Institute of Ophthalmology, B.J. Medical College and Civil Hospital, Ahmedabad, Gujarat, India
| | - Ravija A. Kathiara
- Department of Ophthalmology, M and J Western Regional Institute of Ophthalmology, B.J. Medical College and Civil Hospital, Ahmedabad, Gujarat, India
| | - Wilhemina A. Asari
- Department of Ophthalmology, M and J Western Regional Institute of Ophthalmology, B.J. Medical College and Civil Hospital, Ahmedabad, Gujarat, India
| | - Vijay Rajput
- Department of Medical Education, Nova Southeastern University, Dr. Kiran C. Patel College of Allopathic Medicine, Florida, United States
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Abstract
PURPOSE OF REVIEW The role and importance of integrating humanities into medical education has been recognized for a long time. However, to what extent humanities are included in the medical curricula and how and when they are taught during the medical training in medical schools across the world is unclear. The review was undertaken to study the current status and role of humanities in medical education. RECENT FINDINGS Humanities content in the medical curriculum and the teaching of humanities continue to remain unstandardized. What constitutes medical humanities is unclear as there are several understandings of medical humanities. The benefits and value - both short term and long term - of including humanities in training of doctors and other health professionals remain unresolved and continue to be debated. Although some surveys have shown that exposure to the humanities was significantly correlated with positive personal qualities, including empathy, tolerance for ambiguity, wisdom, emotional appraisal, self-efficacy, and spatial skills, and inversely correlated with some components of burnout, robust evidence from well conducted studies to support the benefits of integrating humanities into medical training is very limited. An overreaching conceptual or theoretical framework for the health humanities in health professionals' education continue to be elusive. SUMMARY The status, stature, profile, and role of humanities in medical education remain varied across medical schools and universities. There is a need for standardized curricula, uniform criteria and guidelines for teaching medical humanities, training modules / materials, methods of assessment and better integration of humanities in medical education.
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Affiliation(s)
- Mohan Isaac
- Clinical Professor of Psychiatry Division of Psychiatry, Faculty of Health and Medical Sciences, The University of Western Australia & Consultant Psychiatrist, Fremantle Hospital Level 7, T Block, Fremantle Hospital, Fremantle, Western Australia 6160, Australia
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Riasat R. Humanities and GP training: the perception of GP trainers towards using medical humanities to teach GP trainees primary care. EDUCATION FOR PRIMARY CARE 2023; 34:26-30. [PMID: 36473174 DOI: 10.1080/14739879.2022.2141665] [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: 12/12/2022]
Abstract
PURPOSE The benefits of medical humanities in medical education have been extensively cited. The aim of this research was to explore the perspectives of UK GP trainers towards using medical humanities to teach GP trainees in primary care. METHOD Phenomenological, qualitative research designed was used. Semi-structured interviews were conducted with eight GP trainers from across the UK, between April and May 2020. Poems were used as discussion prompts for those participants who lacked experience using medical humanities to teach GP trainees. RESULTS Emerging themes were that all participating GP trainers recognised the benefit of medical humanities to GP training, yet only 50% of them were actually using medical humanities in their teaching. An overburdened GP curriculum, a lack of funding and a lack of clinically relevant art and literature resources were identified as barriers for the inclusion of medical humanities into GP training. Furthermore, GP trainers identified the need for peer networks and medical humanities conferences to encourage the use of medical humanities in GP training. CONCLUSION This study provides the perspective of UK GP trainers towards using medical humanities in teaching GP trainees in primary care. GP trainers identified sustainable funding to develop a resource bank of art and literature, peer network events and medical humanities conferences as key interventions to facilitate medical humanities teaching in GP training. Recommendations for future research include robust studies focusing on the effectiveness of various techniques used to integrate medical humanities into GP training, such as poetry.
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Affiliation(s)
- Rahhiel Riasat
- Warwick Medical School, The University of Warwick, Coventry, UK
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10
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Lunen JC. Reflection, Sense of Belonging, and Empathy in Medical Education-Introducing a "Novel" Model of Empathetic Development by Literature. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2023; 10:23821205231207702. [PMID: 37860600 PMCID: PMC10583515 DOI: 10.1177/23821205231207702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 09/27/2023] [Indexed: 10/21/2023]
Abstract
Empathy, self-reflection, and inclusion of the medical humanities in medical education are increasingly gaining attention. This seems prudent, as studies indicate that high physician empathy is associated with better patient outcomes and could protect against physician burnout. In addition, utilizing self-reflection has been reported to surge diagnostic accuracy and increase the ability of clinical health care providers. Therefore, in medical education, there is a need to address these, however intricate, most important skills. Not oblivious to this, for decades many medical schools have reaped experience from the humanities, sprouting the field of the medical humanities. However, significant barriers encountered when teaching the medical humanities to medical students are of concern. Consequently, a theory-based, inclusive, representative, and intuitive approach to the teachings is coveted. The aim of this article is to describe and present such an approach. To this end, I introduce a novel Model of Empathetic Development by Literature, schematizing the path from reading a text to displaying an act of empathy. Ever mindful of the relevance and feasibility to medical students, this article reflects on thoughts and evidence behind the hypothesis; that sense of belonging, self-reflection, and empathy could be gained by reading and discussing literary fiction. Referring to both original research articles, books of popular science, and philosophical considerations, a clear line of reasoning for the inclusion of literary fiction in medical education is made. Thereafter, it is outlined, how-in a medical humanities course at Copenhagen University-specific literary excerpts are utilized to bring forth reflection on different aspects, circumstances, and conditions of being a physician, thereby kindling the medical students' sense of belonging to their profession. As such, this perspective piece demonstrates a concrete approach to how a literary educative technique could manifest.
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Affiliation(s)
- Jonas Christian Lunen
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Occupational Health and Social Medicine, Holbæk Hospital, Holbæk, Denmark
- Copenhagen Academy for Medical Education and Simulation, Copenhagen, Denmark
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Assing Hvidt E, Ulsø A, Thorngreen CV, Søndergaard J, Andersen CM. Weak inclusion of the medical humanities in medical education: a qualitative study among Danish medical students. BMC MEDICAL EDUCATION 2022; 22:660. [PMID: 36064397 PMCID: PMC9442995 DOI: 10.1186/s12909-022-03723-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The modern medical education is predominantly grounded in the biomedical sciences. In recent years, medical humanities have been included into the medical curricula in many countries around the world one of the objectives being to promote patient-centred, empathic care by future physicians. Studies have been made of the impact of inclusion of medical humanities components within the medical curriculum. Although some results suggest increased empathy, others remain inconclusive. To gain insight into the depth, context, and impact of inclusion of the medical humanities for future physicians, this study aimed to explore Danish medical students' understanding of and reflections on how the medical humanities relate to the medical education, including the clinic. METHODS We conducted a qualitative research study, involving semi-structured interviews with twenty-three Danish medical students across years of curriculum and medical schools. Interviews were recorded, transcribed verbatim and analyzed using Braun and Clarke's thematic analysis. RESULTS The findings demonstrate the subordinate role of the medical humanities in the medical educational system. Students prioritize biomedical knowledge building in the preclinical curriculum, partly as a reaction to an unbalanced institutional inclusion of the medical humanities. Observing how structural empathy incentives are lacking in the clinical curriculum, the values inherent in the medical humanities are undermined. CONCLUSION Danish medical students become part of an educational environment with lacking institutional conditions and structures to promote the strong inclusion of the medical humanities. A focus is therefore needed on the values, norms and structures of the medical educational systems that undermine a strong inclusion of the medical humanities into medical education.
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Affiliation(s)
- Elisabeth Assing Hvidt
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9 A, 5000, Odense, Denmark.
| | - Anne Ulsø
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9 A, 5000, Odense, Denmark
| | | | - Jens Søndergaard
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9 A, 5000, Odense, Denmark
| | - Christina Maar Andersen
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
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Nagy M, Radakovich N, Nazha A. Why Machine Learning Should Be Taught in Medical Schools. MEDICAL SCIENCE EDUCATOR 2022; 32:529-532. [PMID: 35528308 PMCID: PMC9054965 DOI: 10.1007/s40670-022-01502-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/07/2022] [Indexed: 06/14/2023]
Abstract
The rapid development of machine learning (ML) applications in healthcare promises to transform the landscape of healthcare. In order for ML advancements to be effectively utilized in clinical care, it is necessary for the medical workforce to be prepared to handle these changes. As physicians in training are exposed to a wide breadth of clinical tools during medical school, this offers an ideal opportunity to introduce ML concepts. A foundational understanding of ML will not only be practically useful for clinicians, but will also address ethical concerns for clinical decision making. While select medical schools have made effort to integrate ML didactics and practice into their curriculum, we argue that foundational ML principles should be taught broadly to medical students across the country.
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Affiliation(s)
- Matthew Nagy
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, USA
| | - Nathan Radakovich
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, USA
| | - Aziz Nazha
- Center for Clinical Artificial Intelligence, Cleveland Clinic, Cleveland, USA
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Cribb A, Entwistle V, Mitchell P. Talking it better: conversations and normative complexity in healthcare improvement. MEDICAL HUMANITIES 2022; 48:85-93. [PMID: 34035179 PMCID: PMC8867266 DOI: 10.1136/medhum-2020-012129] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/15/2021] [Indexed: 05/06/2023]
Abstract
In this paper, we consider the role of conversations in contributing to healthcare quality improvement. More specifically, we suggest that conversations can be important in responding to what we call 'normative complexity'. As well as reflecting on the value of conversations, the aim is to introduce the dimension of normative complexity as something that requires theoretical and practical attention alongside the more recognised challenges of complex systems, which we label, for short, as 'explanatory complexity'. In brief, normative complexity relates to the inherent difficulty of deciding what kinds of changes are 'improvements' or, more broadly, what is valuable in healthcare. We suggest that explanatory and normative complexity intersect and that anyone interested in healthcare improvement needs to be sensitive to both. After briefly introducing the idea of normative complexity, we consider some contrasting examples of conversations, reflecting on how they do and might contribute to healthcare quality. We discuss both conversations that are deliberately organised and facilitated ('orchestrated conversations') and more informally occurring and routine conversations. In the first half of the paper, we draw on some examples of orchestrated and routine conversations to open up these issues. In the second half of the paper, we bring some more theoretical lenses to bear on both conversations and normative complexity, summarise what we take to be the value of conversations and draw together some of the implications of our discussion. In summary, we argue that conversations can play a crucial role in negotiating the normative complexity of healthcare quality improvement because of their capacity to hold together a plurality of perspectives, to contribute and respond to emergence and to help underpin institutional conditions for empathy and imagination.
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Affiliation(s)
- Alan Cribb
- Centre for Public Policy Research, King's College London, London, UK
| | - Vikki Entwistle
- Health Services Research Unit and School of Divinity, History and Philosophy, University of Aberdeen, Aberdeen, UK
| | - Polly Mitchell
- Centre for Public Policy Research, King's College London, London, UK
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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: 9] [Impact Index Per Article: 2.3] [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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Siri A, Gazzaniga V, Licata M, Ciliberti R. The teaching of the History of Medicine in Italy: a path in progress. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021245. [PMID: 34212937 PMCID: PMC8343748 DOI: 10.23750/abm.v92i3.9388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 10/12/2020] [Indexed: 12/03/2022]
Abstract
Background: The increasing attention to the potential application of technology in medicine represents a dangerous warning in the direction of a reductionist approach. The academic system should therefore be strongly engaged to ensure even in medical practice the greatest enhancement of the human dimension. Targets: How much space is offered to the teaching of History of Medicine (HM) in Italian Universities? This work aims to answer this question through an in-depth analysis of the teaching plans of the Master’s Degree courses in Medicine and Surgery (MD) activated in Italy. Materials and Methods: The survey was carried out through the consultation of information, relating to the year 2019-2020, contained in the UniversItaly portal of the Italian Ministry of Education, University and Research, created to accompany students in their studies, as well as through the information published in the web portals of the various universities. Results and Discussion: In Italy in 43 out of 97 Universities there is the Degree Course in Medicine and Surgery for a total of 66 degree courses; some Universities have activated more degree courses depending on the number of learners or on issues of territorial distribution. The teaching of HM is present in the curricula of 54 MD) (82%) and in these is mandatory. In 93% of the cases, it is included in Integrated Courses (IC) and for only 4 MD) it results as autonomous teaching. For the most part (86%) it is included in the first year’s educational plan. The typology of the different ICs is extremely varied, both in terms of denomination, year, and content, as well as in the overall CFUs assigned (university credits). The current teaching staff is divided as follows: 6 full professors; 12 associate professors; 13 Researchers (RU/RD); 20 contract professors. 19 are the researchers/professors engaged in the scientific field of the HM (MED/02). Conclusion: Those findings indicate that the HM subject in the Italian medical education programs is not yet universally recognized as able to stimulate medical students to a holistic view of the person and illness and therefore not sufficiently valued. (www.actabiomedica.it)
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"Inform the Head, Give Dexterity to the Hand, Familiarise the Heart": Seeing and Using Digitised Eighteenth-Century Specimens in a Modern Medical Curriculum. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1317:163-179. [PMID: 33945137 DOI: 10.1007/978-3-030-61125-5_9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Recent years have seen an explosion of interest in digitising museum collections. Among the objects of interest are anatomical and pathological specimens found in medical museums. As researchers increasingly produce digital replicas of these preparations, ways of integrating these resources into the medical curriculum must be explored. This article takes a medical humanities approach to this topical question, comparing the historic use of anatomical specimens to modern intentions, and exploring the potential for using digital anatomy to help integrate humanities into the curriculum. The use of anatomical specimens by William Hunter (1718-1783), whose collection is now kept at the Hunterian in the University of Glasgow, provides a key historic focus. The teaching intentions for his private courses of anatomy are examined, to investigate how specimens were used in an eighteenth-century "curriculum". The motivations behind digitisation and the use of digital anatomy in modern curriculums are then examined and compared. Many of these motivations are shared with Hunter's: the desire to maintain a unique anatomical resource, the need to provide multisensory engagement in learning, and a desire to attempt to show "natural" anatomy without the interference of human processes. The balance between fostering empathy and maintaining detachment is also key for both. Using digital replicas of historic specimens to teach anatomy also opens up a unique opportunity to educate students in the medical humanities in a fully integrated way. Understanding the full story of the specimens they use, as explored in the first half of the article, allows students to place themselves, their dissection subjects, and healthcare as a whole in a historical context. As well as fostering empathy in the dissection lab, the stories behind the specimens can be used to introduce key humanities topics, including ethics, institutional bias, and social aspects of health and disease. It is essential that this potential is explored now while digital anatomy is still a relatively young field, and therefore collaborations between anatomists and medical humanities practitioners can be built and included from the ground up.
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Da Vinci, 500 años después: del humanismo a la humanización. PERSONA Y BIOÉTICA 2019. [DOI: 10.5294/pebi.2019.23.2.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Leonardo Da Vinci es uno de los prototipos del humanismo. Con ocasión de los quinientos años de su fallecimiento se hace una reflexión sobre lo que el humanismo le puede aportar al proceso de humanización, principalmente en las ciencias de la salud en general y a la educación médica en particular. La historia del pensamiento clasifica los humanismos en renacentista, socialista, existencialista y hermenéutico, antihumanismo y nuevo humanismo. Se señala, por contraste, el transhumanismo. Sobre cada uno de ellos se mencionan sus líneas de pensamiento principales y sus primeros y principales impulsores. Finalmente se explican algunas reacciones de la filosofía contemporánea frente a los humanismos y se concluye que para humanizar con propiedad es necesario tomar como base los elementos básicos aportados por el humanismo clásico y algunos puntos clave de la Bioética.
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