Innovation Through Tradition: Rediscovering the “Humanist” in the Medical Humanities

Throughout its fifty-year history, the role of the medical humanist and even the name “medical humanities” has remained raw, dynamic and contested. What do we mean when we call ourselves “humanists” and our practice “medical humanities?” To address these questions, we turn to the concept of origin narratives. After explaining the value of these stories, we focus on one particularly rich origin narrative of the medical humanities by telling the story of how a group of educators, ethicists, and scholars struggling to define their relatively new field rediscovered the studia humanitatis, a Renaissance curriculum for learning and teaching. Our origin narrative is composed of two intertwined stories—the history of the studia humanitatis itself and the story of the scholars who rediscovered it. We argue that as an origin narrative the studia humanitatis grounds the medical humanities as both an engaged moral practice and pedagogical project. In the latter part of the paper, we use this origin narrative to show how medical humanists working in translational science can use their understanding of their historical roots to do meaningful work in the world.     

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。     

结核病直接督导短程化疗策略的伦理学视角

从伦理学角度探讨了结核病直接监督下短程化疗(DOTS)策略以及DOTS策略实施过程中若干问题.DOTS策略被认为是当今结核病诊治和管理的最有效方法,体现了医学伦理学的公益论;尊重病人的选择及隐私是有效控制结核的重要内容,标准化疗方案和个体化疗方案应视病情而定;医务人员应有良好的综合素质.     

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。     

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.     

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.     

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.     

Reading Cultural Studies of Medicine

This article introduces cultural studies of medicine to medical humanities readers. Rather than offer extended definitions of cultural studies of medicine or provide a detailed history of the domain, I have organized this introduction around a close reading and review of three recently published texts in the field. These three texts, dealing respectively with “cyborg” technology, AIDS, and the medical “management” of sexual identity problems, represent excellent examples of the opportunities and possibilities of applying cultural studies approaches to medical topics. After working through these texts (and the semiotic “theories” which animate them), I devote my conclusion to a broader consideration of the role of cultural studies of medicine for both medical practice and medical humanities scholarship.     

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.     

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.     

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。     

Development of a Medical Humanities and Ethics Certificate Program in Texas

Education in the medical humanities and ethics is an integral part of the formation of future physicians. This article reports on an innovative approach to incorporating the medical humanities and ethics into the four-year curriculum in a Certificate Program spanning all four years of the medical school experience. The faculty of the McGovern Center for Humanities and Ethics at the University of Texas Medical School at Houston conceived and implemented this program to teach medical students a range of scholarly topics in the medical humanities and to engage the full human experience into the process of becoming a physician. This study follows six years of experience, and we report student experiences and learning in their own words.     

Mindfulness,Mysticism, and Narrative Medicine

Mindfulness based interventions (MBIs) are rapidly emerging in health care settings for their role in reducing stress and improving physical and mental health. In such settings, the religious roots and affiliations of MBIs are downplayed, and the possibilities for developing spiritual, even mystical, states of consciousness are minimized. This article helps rebalance this trend by using the tools of medical humanities and narrative medicine to explore MBI as a bridge between medical and spiritual approaches to health related suffering. My narrative medicine method draws insights from the arts and humanities that are rarely used in standard clinical research but are increasingly common among medical humanities and narrative medicine scholars. The specific path I take will be to work through historical, linguistic, and philosophic dimensions of mindfulness and mysticism as relevant to illness, suffering, death, and dying. I close with two case examples in which mindfulness is used as an intentionally spiritual practice for health concerns.     

See me,hear me: Using film in health-care classes

This essay argues that film deserves a place within the medical humanities curriculum and demonstrates effective strategies for employing it within medical ethics and humanities classrooms. Part One of the article emphasizes how and why medical ethics teachers can utilize documentary and fictional films, such as “Thomas Szasz and the Myth of Mental Illness,” “The Deadly Deception,”Whose Life Is It Anyway? and “Voices From the Front” in their courses. Such films encourage students to move beyond abstract debates and confront the human pain inherent in all ethical dilemmas. Part Two focuses on documentary and fiction film in the medical humanities classroom. In this section, the author details how to incorporates films, such asThe Doctor, The Waterdance andHospital, into the humanities classroom, juxtaposing them with various literary works, such asOther Women's Children, Borrowed Time, andCeremony. Part Three of the essay presents a detailed discussion ofThe Elephant Man andFrankenstein, illustrating how visual and literary texts compliment each other within the humanities classroom. Overall, the author demonstrates how films function as engaging and complex visual texts providing unique insights in the particularities of American health care and, as such, can become valuable components within medical ethics and humanities classrooms.     

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。     

“精选、精讲、精练”教学法在临床教学中的应用

临床医学是集多学科知识为一体的专业学科,具有基础知识与临床实践紧密结合的显著特性。为适应新世纪医学教育的系统性转型,配合器官系统为中心课程模式的有效运行,我院采用“精选、精讲、精练”的教学方法,通过系统性整合各专业学科课程,加强学科间的知识联系,实现基础向临床的转化、从而开辟专业课程综合化发展的道路,给学生提供最优化的教学内容,在掌握专业技术的同时,拓宽临床思维,履践医学人文精神,为培养医学生未来临床岗位胜任能力奠定坚实基础。     

微创体系中人文思想的探索

医学人文学是发展现代医学的一项重要内容.从微创医学体系中的人文思想、探索微创人文思想的意义、实现微创医学过程中的微创人文思想三个方面对建立在现代医学模式基础上的微创医学体系发展中的有关人文思想进行了系统的探索,以揭示微创医学体系中人文思想的意义和价值,同时强调其在医疗实践中的实际应用.     

Moral growth in medical students

Although students bring to medical school a fairly well established value system, the potential for moral growth through the medical school environment and experience is substantial. The educational environment poses a succession of developmental and adaptive tasks to be accomplished. Several of these tasks are discussed here, tasks that are value-laden and involve, directly or indirectly, the interplay of ethical theory and practice. During the past quarter century, the two influences that have had the greatest impact on the moral growth and moral reasoning capacity of medical students have been the incorporation into the medical school curriculum of courses in medical humanities and the admission to medical school of an increasing number of female students. The female students have brought to medical school a level or dimension of moral reasoning (morality as care or responsibility for others) to augment the male students' focus on rights and justice considerations.     

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。     

Bearing Response-Ability: Theater, Ethics and Medical Education

This paper addresses a growing concern within the medical humanities community regarding the perceived need for a more empathically-focused medical curricula, and advocates for the use of creative pedagogical forms as a means to attend to issues of suffering and relationality. Drawing from the ethical philosophy of Emmanuel Levinas, I critique the notion of empathy on the basis that it erases difference and disregards otherness. Rather, I propose that the concept of empathy may be usefully replaced with that of ethical responsibility, which suggests a shared sense of humanity outside the boundaries of presumed knowledge of the other. To illustrate this argument, I theorize the importance of theater within medical education. Theater, I argue, may engender ethical responsibility in the Levinasian sense, and thus may allow learners to differently engage with the experience of the suffering other. As such, I examine Margaret Edson's widely used play Wit as a platform for such an ethical encounter to occur. Thus, rather than working to understand the value of theater in medical education in terms of knowledge and skill acquisition, I theorize that its primacy within medical curricula arises from its ethical/relational potential, or potential to engender new forms of inter-human relationality.