Instructional issues in the medical humanities

This paper examines instructional issues such as how, when, and where the medical humanities are taught in medical school settings. The author interviewed seven humanities scholars teaching in medical schools using open-ended questions which elicited data illustrating 1) informants' teaching styles; 2) where/how their teaching currently fits in the medical curriculum; 3) their suggestions on ideal curricular integration of the medical humanities; and 4) informants' teaching successes.     

Medical Humanities Teaching in North American Allopathic and Osteopathic Medical Schools

Although the AAMC requires annual reporting of medical humanities teaching, most literature is based on single-school case reports and studies using information reported on schools’ websites. This study sought to discover what medical humanities is offered in North American allopathic and osteopathic undergraduate medical schools. An 18-question, semi-structured survey was distributed to all 146 (as of June 2016) member schools of the American Association of Medical Colleges and the American Association of Colleges of Osteopathic Medicine. The survey sought information on required and elective humanities content, hours of humanities instruction, types of disciplines, participation rates, and humanities administrative structure. The survey was completed by 134 schools (145 AAMC; 31 AACOM). 70.8% of schools offered required and 80.6% offered electives in humanities. Global health and writing were the most common disciplines. Schools required 43.9 mean (MD 45.4; DO 37.1) and 30 (MD 29; DO 37.5) median hours in humanities. In the first two years, most humanities are integrated into other course work; most electives are offered as stand-alone classes. 50.0% of schools report only 0-25% of students participating in humanities electives. Presence of a certificate, concentration or arts journal increased likelihood of humanities content but decreased mean hours. Schools with a medical humanities MA had a higher number of required humanities hours. Medical humanities content in undergraduate curriculum is lower than is indicated in the AAMC annual report. Schools with a formal structure have a greater humanities presence in the curriculum and are taken by more students.     

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.     

Access to psychoanalytic ideas in American undergraduate institutions

To determine the prevalence of teaching about psychoanalytic ideas in the undergraduate curricula of 150 highly ranked colleges and universities, a software-based search was conducted to find references to psychoanalytic content in published course catalogues. Results showed that psychoanalytic ideas were represented somewhere in the curricula of most (though not all) of these schools, and that overall there were many times more courses featuring psychoanalytic ideas outside psychology departments than within them. The data also suggest that there are regional differences in the likelihood an undergraduate will encounter psychoanalytic ideas at these schools. Though psychoanalytic ideas are available in some form in most of these schools' psychology departments, the average number of courses per school is small. At the same time, psychoanalytic ideas have found applications in many areas of the humanities and social sciences. The nature of the presentation of psychoanalytic ideas in these areas, however, may often be unfamiliar to clinically oriented analysts, as seen in examples of the courses that were found. Challenges and opportunities of the current academic climate vis-à-vis organized psychoanalysis are described and various suggestions made regarding how analysts can engage the academic world to its benefit.     

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。     

Medical Ethics,Bioethics and Research Ethics Education Perspectives in South East Europe in Graduate Medical Education

Ethics has an established place within the medical curriculum. However notable differences exist in the programme characteristics of different schools of medicine. This paper addresses the main differences in the curricula of medical schools in South East Europe regarding education in medical ethics and bioethics, with a special emphasis on research ethics, and proposes a model curriculum which incorporates significant topics in all three fields. Teaching curricula of Medical Schools in Bulgaria, Bosnia and Herzegovina, Croatia, Serbia, Macedonia and Montenegro were acquired and a total of 14 were analyzed. Teaching hours for medical ethics and/or bioethics and year of study in which the course is taught were also analyzed. The average number of teaching hours in medical ethics and bioethics is 27.1 h per year. The highest national average number of teaching hours was in Croatia (47.5 h per year), and the lowest was in Serbia (14.8). In the countries of the European Union the mean number of hours given to ethics teaching throughout the complete curriculum was 44. In South East Europe, the maximum number of teaching hours is 60, while the minimum number is 10 teaching hours. Research ethics topics also show a considerable variance within the regional medical schools. Approaches to teaching research ethics vary, even within the same country. The proposed model for education in this area is based on the United Nations Educational, Scientific and Cultural Organization Bioethics Core Curriculum. The model curriculum consists of topics in medical ethics, bioethics and research ethics, as a single course, over 30 teaching hours.     

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.     

循证医学发展中的辩证思维观

介绍循证医学的起源、概念、研究方法及其对现代临床医学的指导意义.对如何从辩证法的角度看待循证医学的发展与传统的经验医学、医学基本训练、创造性思维和人文素质的提高之间的关系进行了阐述.     

将医学人文课程的教学目标落到实处

教学目标是教学的统帅和灵魂,具有导向、评价、调节、激励等多方面的功能。医学人文素质教育之所以处地乏力状态,很大程度上是没有将医学人文课程的教学目标落到实处。为改变医学人文课程教学乏力的状态,提高教学效果,有必要加强教学目标、教学内容、教学策略、教学资源、教学评价几方面的工作,将医学人文课程的教学目标落到实处。     

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。     

The educational philosophies behind the medical humanities programs in the United States: An empirical assessment of three different approaches to humanistic medical education

This study investigates the three major educational philosophies behind the medical humanities programs in the United States. It summarizes the characteristics of the Cultural Transmission Approach, the Affective Developmental Approach, and the Cognitive Developmental Approach. A questionnaire was sent to 415 teachers of medical humanities asking for their perceptions of the amount of time and effort devoted by their programs to these three philosophical approaches. The 234 responses constituted a 54.6% return. The approximately 80:20 gender ratio of males to females and other demographic data on age and educational background were consistent with other studies of the field of medical humanities. Reflections on the results in Table II indicate that some changes need to take place in the teaching of the medical humanities if the perceived ideal is to be achieved. In order for the current teachers of the medical humanities to think that the appropriate philosophies behind the teaching of the medical humanities are being implemented as they should be, much less time and effort need to be devoted to the Cultural Transmission Approach. With no other published reports on the educational philosophies behind the medical humanities programs, this study created a new knowledge base about this relatively young and rapidly emerging field.     

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。     

Who we are: The political origins of the medical humanities

The medical humanities were organized, beginning in the late 1960s, by a small group of people who shared a critique of medical education and a commitment to vigorous action to change it. They proposed to create several demonstration programs in humanities education at American schools. Although the group began with a religious orientation, it soon acquired a broader, more secular mission. As a result of shrewd political organizing, the group attracted members from within medicine, and was awarded a grant to promote the medical humanities. This paper describes these events and sets them in the context of the social and medical history of the 1960s and early 1970s.     

Toward an Aesthetic Medicine: Developing a Core Medical Humanities Undergraduate Curriculum

The medical humanities are often implemented in the undergraduate medicine curriculum through injection of discrete option courses as compensation for an overdose of science. The medical humanities may be reformulated as process and perspective, rather than content, where the curriculum is viewed as an aesthetic text and learning as aesthetic and ethical identity formation. This article suggests that a "humanities" perspective may be inherent to the life sciences required for study of medicine. The medical humanities emerge as a revelation of value inherent to an aesthetic medicine taught and learned imaginatively.     

Perceptions of Ethical Climate and Research Pressures in Different Faculties of a University: Cross-Sectional Study at the University of Split,Croatia

We determined the prevailing ethical climate at three different schools of a single university, in order to explore possible differences in the ethical climate related to different research fields: the School of Electrical Engineering, Mechanical Engineering, and Naval Architecture; the School of Humanities and Social Sciences; and the School of Medicine. We used the Ethical Climate Questionnaire to survey the staff (teachers and administration) at the three schools, and used the research integrity and organizational climate (RIOC) survey for early-stage researchers at the three schools. The dominant ethical climate type perceived collectively at the three university schools (response rate 49%, n = 294) was Laws and professional codes, which is associated with the cosmopolitan level of analysis and the ethical construct of principle. Individually, the same climate predominated at the schools for engineering and humanities, but the School of Medicine had the Self-interest ethical climate, which is associated with the individual level of analysis and the egoism ethical construct. In the RIOC survey (response rate 85%; n = 70), early-stage researchers from the three university schools did not differ in their perceptions of the organizational research integrity climate, or in their perceived individual, group or organizational pressures. Our study is the first, to the best of our knowledge, to show differences in perceived ethical climate at a medical school compared to other schools at a university. Further studies are needed to explore the reasons for these differences and how they translate to organizational outcomes, such as job satisfaction, commitment to the institution and dysfunctional behaviour, including research misconduct.

     

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.     

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.