The dental anomaly: how and why dental caries and periodontitis are phenomenologically atypical

Use of humanities content in American medical education has been debated for well over 60 years. While many respected scholars and medical educators have purported the value of humanities content in medical training, its inclusion remains unstandardized, and the undergraduate medical curriculum continues to be focused on scientific and technical content. Cited barriers to the integration of humanities include time and space in an already overburdened curriculum, and a lack of consensus on the exact content, pedagogy and instruction. Edmund Pellegrino, physician and scholar of the latter twentieth century, spent much of his professional life promoting the value and importance of the humanities in medical education, seeking the best way to incorporate and teach this content in clinically relevant ways. His efforts included the founding of multiple enterprises starting in the 1960s and 1970s to promote human values in medical education, including the Society for Health and Human Values and its Institute on Human Values in Medicine. Regardless of his efforts and those of many others into the current century, the medical humanities remains a curricular orphan, unable to find a lasting home in medical education and training.     

The Institute on Human Values in Medicine: Its Role and Influence in the Conception and Evolution of Bioethics

For ten years, 1971–1981, the Institute onHuman Values in Medicine (IHVM) played a keyrole in the development of Bioethics as afield. We have written this history andanalysis to bring to new generations ofBioethicists information about the developmentof their field within both the humanitiesdisciplines and the health professions. Thepioneers in medical humanities and ethics cametogether with medical professionals in thedecade of the 1960s. By the 1980s Bioethics wasa fully recognized discipline. We show the rolethat IHVM programs played in defining thefield, training faculty and helping schools todevelop programs. We review the beginnings ofthe IHVM in the crucible of social andtechnological change that led to theestablishment of the IHVM's parentorganization, the Society for Health and HumanValues. We then turn to the IHVM programsthrough which Faculty members receivedfellowships to explore new crossovers betweenthe humanities and the health professions. Wehave not only described the Fellows Program asit existed in 1973–1980, but have completed asurvey of the fellows a quarter of a centuryafter they held their fellowships. We describeother IHVM programs designed to facilitate theinitiation and development of new humanitiesprograms, to explore conceptual issues betweenmedicine and five humanities fields, to conductissue driven or educational method conferencesand to advance humanities programs intograduate education through the Directors ofMedical Education.     

人文课程建设与医学生人文素质培养

人文课程在医学教育中担负着培养医学生思想品德的重要任务。优秀的医学人才不仅需要较高的专业技术水平,更需要有饱含人文情感的人文素质,否则,就很难适应医学的发展及社会对医学人才的要求。因此,加强人文课程的建设,培养医学生的人文素质,使他们成为高素质的医学人才,是医学教育发展的必然和需要。     

医学人文运动与知识考古--中国人文医学的战略与策略

后现代理论影响和刺激了医学人文学,医学人文学学科意义与价值更加显明,医学需要人文学,人文学需要医学,医务人员迫切需要人文医学教育。经济发展、高新生命科学技术入驻世俗生活、医学模式转变、医疗改革与价值论哲学影响,这五大因素构成中国医学人文运动的背景;中国医学人文运动正在兴起。研究医学人文学的知识背景对制订人文医学战略与策略有重要意义。     

The Medical Humanities and the Perils of Curricular Integration

The advent of integration as a feature of contemporary medical curricula can be seen as an advantage for the medical humanities in that it provides a clear implementation strategy for the inclusion of medical humanities content and/or perspectives, while also making its relevance to medical education more apparent. This paper discusses an example of integration of humanities content into a graduate medical course, raises questions about the desirability of an exclusively integrated approach, and argues for the value of retaining a discrete and coherent disciplinary presence for the medical humanities in medical curricula.     

浅谈医学文化中的人文精神培养

20世纪以来,传统医学教育在指导思想上、教育理论上和实践中人文精神存在不足。这是由于长期以来我国的医学教育过分注重医学生的专业知识教育而忽视人文素质教育,专业知识与人文精神分离的结果。因此,着重从医学文化的角度去思考医学的本质和目的,探讨在医学教育中加强人文精神的培养。     

性别的社会性约束与可持续发展

临床医学生人文教育不能模糊医学人文知识和医学人文精神两个不同的概念,需要科学精神和人文精神的辩证统一。临床医学人文教育理论与实践的分离,临床医学人文教学与临床医学专业教学的分离,临床医学人文教育目标、实现途径和评价体系的不确定性,使临床医学生难敌市场经济功利性的负面导引,医学模式的转换在教育层面受阻。     

论新时期医学院校人文学科建设

加强医学人文学科建设是全面推进素质教育、培养创新精神的重要内容,也是深化医学教育改革步伐的重要举措.医学院校开展医学人文教育教学真正目的是进一步优化高等医学院校人才培养模式,使医学人文学科知识内化为医学生的人文思想和人文精神.     

Striving to do Good Things: Teaching Humanities in Canadian Medical Schools

We provide the results of a systematic key-informant review of medical humanities curricula at fourteen of Canada's seventeen medical schools. This survey was the first of its kind. We found a wide diversity of views among medical educators as to what constitutes the medical humanities, and a lack of consensus on how best to train medical students in the field. In fact, it is not clear that consensus has been attempted - or is even desirable - given that Canadian medical humanities programs are largely shaped by individual educators' interests, experience and passions. This anarchic approach to teaching the medical humanities contrasts sharply with teaching in the clinical sciences where national accreditation processes attempt to ensure that doctors graduating from different schools have roughly the same knowledge (or at least have passed the same exams). We argue that medical humanities are marginalized in Canadian curricula because they are considered to be at odds philosophically with the current dominant culture of evidence-based medicine (EBM). In such a culture where adhering to a consensual standard is a measure of worth, the medical humanities - which defy easy metrical appraisal - are vulnerable. We close with a plea for medical education to become more comfortable in the borderlands between EBM and humanities approaches.     

Affirming the Existential within Medicine: Medical Humanities, Governance, and Imaginative Understanding

This paper first distinguishes governance (collective, autonomous self-regulatory processes) from government (externally-imposed mandatory regulation); it proposes that the second of these is essentially incompatible with a conception of the medical humanities that involves imagination and vision on the part of medical practitioners. It next develops that conception of the medical humanities, as having three distinguishable aspects (all of them distinct from the separate phenomena popularly known as "arts-in-health"): first, an intellectual enquiry into the nature of clinical medicine; second, an important dimension of medical education; third, a resource for moral and aesthetic influences upon clinical practice, supporting "humane health care" as the moral inspirations behind organised medicine. Medical humanities sustains these three aspects through paying proper attention to the existential and subjective aspects of medicine. By encouraging authentic imagination among health care practitioners, medical humanities aligns well with both humane health care and governance in the sense of self-regulation. However, it can neither be achieved mechanistically nor well-measured through proxies such as patient satisfaction. Above all, it should not be allowed to supply, through inappropriate qualitative "targets," new forms of management tyranny.     

医学教育人文精神缺失的弊端及对策

人文精神本是医学学科的根本要旨之一,然而,目前医学教育中普遍存在着人文精神缺失的状况.从医学教育的宗旨、医学模式的转变、医学生的综合素质、医患关系方面剖析了人文精神缺失的弊端并提出了相应对策.     

综合性大学开设长学制高等医学教育的初步研究

我国现有的医学教育学制偏短,不利于培养高质量医学人才。综合性大学有着许多办学优势,有利于开设长学制医学教育,因此,要发挥综合性大学的优势,实行多通道办学模式,学分制和弹性学制,强化公共基础教育和人文素质教育,改善办学条件,提高管理水平,努力培养能参与国际竞争的高层次医学人才。     

医学生医学人文素质现状的调查与分析

医学人文素质同医学科学素质一样,是医学生必备的基本素质.为了解当前在校医学生的医学人文素质现状,我们以复旦大学上海医学院部分在校医学生为调查对象,通过问卷调查的方式,从医学生对国内外医疗相关问题和事件的关注,对医学人文课程和提高医学人文素养的认识,以及医学人文素质对医学重要性的认识等方面,对医学生医学人文素质相关情况进行调查,了解当前在校医学生医学人文现状,为有的放矢的培养医学生的人文素养提供客观依据.     

扬弃与超越——医学人文教育的重新审视与思考

目前,医学人文教育依然存在诸多问题。通过对医学人文教育现状的审视,追根溯源,重新认识人文教育的内涵,并就认识取向、课程体系、教学模式、评价方法、专业教育与人文教育的关系等方面的障碍或弊端提出扬弃与改革措施。     

军医大学人文教育需求的实证研究

军医大学人文教育需求的实证研究,以第三军医大学2005级7个不同专业的学生为主要对象进行医学人文教育需求问卷调查,初步探讨军医大学学生对开设医学人文课程的心理需求和知识需求。调研中还发现,学生对医学人文科学抱有浓厚兴趣,认为具备良好的医学人文素质是未来医生的核心竞争力。     

The Medical Humanities Today: Humane Health Care or Tool of Governance?

The medical humanities have been presented as a panacea for medical reductionism; a means for 'humanizing' medicine. However, there is a lack of consensus about the appropriate contributing disciplines and how curricula should be taught and assessed. This special issue critically examines the role of the medical humanities in medical education and their potential to serve, inadvertently or otherwise, as a tool of governance. The contributors, who include medical educators and medical practitioners, employ a range of perspectives for analysing the pertinent issues.     

从中外医学教育标准的差异看医学生的人文素质培养

通过中外医学教育标准在知识目标、技能目标、职业价值观上的若干差异的比较,探讨人文素质,包括医生职业价值观念、医学人文知识、“批判性思维”能力和交流技巧、沟通能力的培养等在国际医学教育标准的重要地位,并对改进我国医学教育的人文内涵提出建议。     

现代医学教育中应注重自然科学与人文学的统一

现代高等医学教育中缺乏人文精神的养成,对人文学与自然科学之间的关系缺乏正确理解。自然科学在崇尚客观与理性的同时可能忽视物质世界以外的精神世界,而单纯的人文学也可能走向狭隘和极端化,自然科学与人文学应在互制互利下统一。医学生教育阶段加强人文精神的培养十分有利于帮助他们在未来工作中明确科学研究的正确价值取向,正确处理好人与科技的关系。     

What is the Role of the Arts in Medical Education and Patient Care? A Survey-based Qualitative Study

To inform medical education reform efforts, we systematically collected information on the level of arts and humanities engagement in our medical school community. Attitudes regarding incorporating arts and humanities-based teaching methods into medical education and patient care were also assessed. An IRB-approved survey was electronically distributed to all faculty, residents, fellows, and students at our medical school. Questions focused on personal practice of the arts and/or humanities, as well as perceptions of, and experience with formally incorporating these into medical teaching. Of 13,512 community members surveyed, 2,775 responded (21% overall response rate). A majority of respondents agreed or strongly agreed that medical education and patient care could be "enhanced" by the integration of the arts (67% and 74% respectively). There was enthusiastic support for the creation of a formal program in the arts at our medical school (72 %). Integration of the arts into medical education may have a role in improving the quality of medical training and would likely be well received by teachers and learners.