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Table of Contents
VIEW POINT
Year : 2022  |  Volume : 10  |  Issue : 2  |  Page : 133-135

Incorporation of the Humanities Component in the Medical Curriculum


1 Medical Education Unit Coordinator and Member of the Institute Research Council, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Chengalpet District, Tamil Nadu, India
2 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India

Date of Submission06-Apr-2021
Date of Decision27-May-2021
Date of Acceptance31-May-2021
Date of Web Publication02-Mar-2022

Correspondence Address:
Dr. Saurabh RamBihariLal Shrivastava
MD, FAIMER, PGDHHM, DHRM, FCS, ACME, Professor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) – Deemed to be University, Thiruporur - Guduvancherry Main Road, Ammapettai, Nellikuppam, Chengalpet District - 603108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ajim.ajim_45_21

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  Abstract 


In the current setup, the delivery of medical education primarily targets the scientific and technical domain with minimal consideration about the humanity aspect. The training offered to the medical students as a part of humanity helps them to acquire the skills to make ethical decisions, keeping the interests of the patients, family members, and the community in mind. An extensive search of all materials related to the topic was carried out in the PubMed search engine and the Medical Council of India website. A total of 15 articles were selected based on the suitability with the current review objectives. The introduction of medical humanities in the curriculum can be either done in the form of integration across the different professional years or it can be kept optional for the students. It is quite obvious that mere exposing students to medical humanities will not deliver the desired outcomes unless they are being assessed as well to measure the learning. In conclusion, the training offered to the medical students during their course not only targets clinical judgment but even humane judgment. Humanities is an integral aspect of patient care and it is high time that it is integrated within the curriculum based on the well-formulated educational objectives and a comprehensive assessment framework.

Keywords: Curriculum, humanities, medical education, medical humanity


How to cite this article:
Shrivastava SR, Shrivastava PS. Incorporation of the Humanities Component in the Medical Curriculum. APIK J Int Med 2022;10:133-5

How to cite this URL:
Shrivastava SR, Shrivastava PS. Incorporation of the Humanities Component in the Medical Curriculum. APIK J Int Med [serial online] 2022 [cited 2022 May 26];10:133-5. Available from: https://www.ajim.in/text.asp?2022/10/2/133/338901




  Introduction Top


The training offered to the medical students during their under graduation period is quite vast and it is expected that the learner must master a wide range of competencies to eventually accomplish the learning objectives.[1] There are no doubts that medicine continues to advance with each day, which in turn tends to put immense pressure on the medical students as well as the healthcare professionals about the need to enhance their productivity.[2],[3] However, the question that needs to be explored is whether we can extend humanistic care to people regardless of the multiple pressures that surround us?[1],[2],[3] The present review was carried out to explore the integration of the humanity component with the medical curriculum.


  Methods Top


An extensive search of all materials related to the topic was carried out in the PubMed search engine and the Medical Council of India website. Relevant research articles focusing on humanity in medical education published in the period 2009–2021 were included in the review. A total of 17 studies similar to the current study objectives were identified initially, of which, two were excluded due to the unavailability of the complete version of the articles. Overall, 15 articles were selected based on the suitability with the current review objectives and analyzed. Keywords used in the search include humanities, medical humanity, and medical education in the title alone only. Only the articles published in the English language were included in the study. The collected information is presented under the following subheadings, namely, medical humanity, inclusion of medical humanity in curriculum, medical humanities in India, teaching medical humanities, assessment of medical humanities, lessons from the field, implications for practice, and implications for research.


  Medical Humanity Top


Humanism refers to the deep-seated beliefs which a person (medical professional) has toward others and thus, it motivates them to adopt authentic professional behaviors even under stressful circumstances.[2],[3] In the current setup, the delivery of medical education primarily targets the scientific and technical domains with minimal consideration about the humanity aspect. The training offered to the medical students as a part of humanity helps them to acquire the skills to make ethical decisions, keeping the interests of the patients, family members, and the community in mind.[2],[3],[4] In short, the medical students not only learn the scientific background of the disease but even the personal and human aspects of illness.[3],[4]


  Inclusion of Medical Humanity in Curriculum Top


Obviously, the development of such values essentially will depend on the extent of integration of humanities into medical education, so that attributes such as professionalism, being self-aware, improved communication skills, and reflective practice can be inculcated among medical students.[5],[6],[7] The inclusion of the medical humanities component not only ensures the delivery of comprehensive and compassionate care as patients are regarded as a whole person but also minimizes the possibility of stress and encourages resilience among the health care personnel.[6],[7],[8] Further, exposure to the medical humanities plays an important role in the development of critical thinking skills, which is quite essential for the learning progression of medical students.[1],[3],[9]

Acknowledging the importance of medical humanity in clinical practice in terms of the development of compassion and empathy, a significant number of medical schools in the developed nations have already integrated humanities in the curriculum.[4],[5],[6],[7] However, we are yet to see such kind of developments in developing nations. This could be because in the world of outcome-based education, the inclusion of any component in the curriculum should significantly contribute toward the development of measurable competencies.[1],[7],[8],[9],[10] Although medical humanities have been linked with multiple benefits both for patients as well as healthcare professionals, nevertheless, it is still a new component, and it will take some time for its worldwide acceptance.[3],[4],[6]


  Medical Humanities in India Top


On a positive note, the regulatory body in India has advocated for the formal introduction of the humanities component in the curriculum as a part of teaching-learning activities offered for the students enrolled from the 2019 academic year onward.[11] The rationale behind this development has been the need that the students should have an understanding about the sociocultural and the economic background of the patients so that personalized care can be offered to them. It has been envisaged to give exposure to humanities under the attitude, ethics, and communication (AETCOM) module, without defining an additional timeframe that might result in the lengthening of the overall course duration.[11]


  Teaching Medical Humanities Top


The introduction of the medical humanities in the curriculum can be either done in the form of integration across the different professional years or it can be kept optional for the students.[4],[12] We must understand that the medical curriculum is already overburdened and thus, the humanities component can be introduced either as a part of ethical dilemmas or exposure to standardized patients or palliative care or using exposing students to different clinical scenarios, wherein they have to communicate with their patients.[12],[13],[14] In addition, students can also be encouraged to write narratives and reflect on the ethical dilemmas encountered wither during their clinical postings or the case vignettes or videos.[4],[5],[6],[7],[15] The idea is that students should be exposed to a wide range of learning experiences spread throughout the training period.[1],[9],[10],[11]


  Assessment of Medical Humanities Top


As the saying goes, assessment drives learning, it is quite obvious that mere exposing students to medical humanities will not deliver the desired outcomes, unless they are being assessed as well to measure the learning.[5],[8],[13] It is quite an effective option to employ qualitative methods for the assessment of the medical humanities and follow the same with the delivery of constructive feedback. Further, most of the workplace-based assessment tools with a global rating scale or rubrics of milestones can be also used to assess the learning.[1],[2],[3] Reflective writing also goes a long way to assess the medical humanities component.[2],[16] However, the overall success of the introduction or assessment of the humanities component in medical education will depend on the capacity building of the faculty members and the extent of support offered by them.[8],[13],[16]


  Lessons from the Field Top


At Shri Sathya Sai Medical College and Research Institute, a constituent unit of the Sri Balaji Vidyapeeth, Deemed-to-be University, Puducherry, specific steps have been taken for the seamless integration of the humanity component in the medical curriculum. The AETCOM module released by the regulatory body has been used as the guiding document and with reference to that teaching-learning and assessment has been planned across all the professional years of the training period. The undergraduate medical students have been exposed to the ethical dilemmas and specifically encouraged to identify the humanity component in the given case scenarios and subsequently they were asked to come out with a possible explanation of how best the situation can be dealt by them. In the overall process, the faculty members have guided them and finally, the students have been asked to reflect on the entire experience in their logbooks. Furthermore, some topics have been assigned as a part of self-directed learning to make the learning process continuous and self-paced.


  Implications for Practice Top


To be frank, we have been teaching humanity-related issues to the students as a part of the hidden curriculum till now, but the issue was that it lacked structure. However, to enable the systematic introduction of the humanity component in the medical curriculum, we must realize that a conscious attempt has to be made. The first and foremost thing has to be the sensitization of the faculty members about the need that they should orient the students about the humanity-related issues in the field of medicine and in what all ways it can influence the clinical practice. The AETCOM module can be used as the guiding document in the training sessions organized by the Medical Education Unit and the teachers can also be sensitized about the different teaching-learning methods that can be employed and the approaches to assess the learned aspects.

Once the teachers are empowered, the students also need to be sensitized about the significance of each of these issues. Simultaneously, we have to allocate specific time within the curriculum as per the norms prescribed by the regulatory body to cover medical humanity-related topics. However, we must be very cautious that we do not prolong the duration of the curriculum. There is always an option to initiate an elective module on Medical Humanity, wherein the interested students can be explained about the existing issues in depth. It is an encouraging practice to obtain the views of the Curriculum Committee and the Medical Education Unit to enable better implementation of teaching-learning and assessment of medical humanity.


  Implications for Research Top


As the formal introduction of medical humanity is a novel approach in different parts of the world, it is a direct indication that there is ample scope available to perform research activities. The research can actually start with identifying the unmet needs of the students, so that specific types of case scenarios or content can be covered during the allocated sessions. We can even conduct qualitative or mixed-methods type of research activities to understand the perception of students about humanities in medicine. In addition, we can conduct research to identify the views of students like how training on humanity component has helped them in their clinical practice or say interaction with patients and their relatives. Further, specific research can be carried out to evaluate the overall components of teaching-learning and assessment, so that based on the responses obtained, the nature of the delivery of the humanity component can be modified.


  Conclusion Top


The training offered to the medical students during their course not only targets clinical judgment but even humane judgment. Humanities is an integral aspect of patient care and it is high time that it is integrated within the curriculum based on the well-formulated educational objectives and a comprehensive assessment framework.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Ousager J, Johannessen H. Humanities in undergraduate medical education: A literature review. Acad Med 2010;85:988-98.  Back to cited text no. 1
    
2.
Johna S, Rahman S. Humanity before science: Narrative medicine, clinical practice, and medical education. Perm J 2011;15:92-4.  Back to cited text no. 2
    
3.
Walsh K. The humanities in medical education: Lessons from the past. Br J Gen Pract 2015;65:141.  Back to cited text no. 3
    
4.
Halperin EC. Preserving the humanities in medical education. Med Teach 2010;32:76-9.  Back to cited text no. 4
    
5.
Ghias K, Khan KS, Ali R, Azfar S, Ahmed R. Impact of humanities and social sciences curriculum in an undergraduate medical education programme. J Pak Med Assoc 2020;70:1516-22.  Back to cited text no. 5
    
6.
Liao L. Opening our eyes to a critical approach to medicine: The humanities in medical education. Med Teach 2017;39:220-1.  Back to cited text no. 6
    
7.
Sklar DP. Health humanities and medical education: Joined by a common purpose. Acad Med 2017;92:1647-9.  Back to cited text no. 7
    
8.
Wald HS, McFarland J, Markovina I. Medical humanities in medical education and practice. Med Teach 2019;41:492-6.  Back to cited text no. 8
    
9.
Belling C. Commentary: Sharper instruments: On defending the humanities in undergraduate medical education. Acad Med 2010;85:938-40.  Back to cited text no. 9
    
10.
Kumagai AK. Beyond “Dr. Feel-Good”: A role for the humanities in medical education. Acad Med 2017;92:1659-60.  Back to cited text no. 10
    
11.
Medical Council of India. Early Clinical Exposure for Undergraduate Medical Education Program 2019. New Delhi: MCI Press; 2019. p. 38-9.  Back to cited text no. 11
    
12.
Pfeiffer S, Chen Y, Tsai D. Progress integrating medical humanities into medical education: A global overview. Curr Opin Psychiatry 2016;29:298-301.  Back to cited text no. 12
    
13.
Boudreau JD, Fuks A. The humanities in medical education: Ways of knowing, doing and being. J Med Humanit 2015;36:321-36.  Back to cited text no. 13
    
14.
Parent K, Jones K, Phillips L, Stojan JN, House JB. Teaching patient-and family-centered care: Integrating shared humanity into medical education curricula. AMA J Ethics 2016;18:24-32.  Back to cited text no. 14
    
15.
Doukas DJ, McCullough LB, Wear S; Project to Rebalance and Integrate Medical Education (PRIME) Investigators. Perspective: Medical education in medical ethics and humanities as the foundation for developing medical professionalism. Acad Med 2012;87:334-41.  Back to cited text no. 15
    
16.
Wershof Schwartz A, Abramson JS, Wojnowich I, Accordino R, Ronan EJ, Rifkin MR. Evaluating the impact of the humanities in medical education. Mt Sinai J Med 2009;76:372-80.  Back to cited text no. 16
    




 

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Inclusion of Med...
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