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      Beyond “Dr. Feel-Good” : A Role for the Humanities in Medical Education

      Academic Medicine
      Ovid Technologies (Wolters Kluwer Health)

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          Abstract

          Although educators embrace the values that are nominally included in the idea of "the art and science of medicine," the arts and humanities have remained at the edges of medical education. One reason for this exile is the overwhelming emphasis in the curriculum on biomedical science over the social sciences and humanities. Other causes are self-inflicted-a frequent lack of theoretical rigor in the design of educational offerings and, more important, no clear answer to the question of how the humanities can make better physicians. A common justification for including the arts and humanities in medical education-that spending time with literature, music, and the visual arts contributes to student and faculty reflection and well-being-is compelling; however, it risks further marginalizing the field as a soft, feel-good supplement to training.In this Invited Commentary, the author proposes several unique ways in which the arts and humanities contribute to the development of physicians who practice with excellence, compassion, and justice.These ways include disrupting taken-for-granted beliefs and assumptions; introducing a pause in perceiving, thinking, and acting; encouraging engagement with complexity and ambiguity; seeing past the surface to historical and societal influences and causes; and encouraging an awareness of the multiple, unique voices and perspectives of patients. Ultimately, the humanities prompt awareness of the space in which physicians care for human beings in their moments of greatest need and bear witness to fundamental changes in their patients and in themselves.

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          Most cited references9

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          A conceptual framework for the use of illness narratives in medical education.

          The use of narratives, including physicians' and patients' stories, literature, and film, is increasingly popular in medical education. There is, however, a need for an overarching conceptual framework to guide these efforts, which are often dismissed as "soft" and placed at the margins of medical school curricula. The purpose of this article is to describe the conceptual basis for an approach to patient-centered medical education and narrative medicine initiated at the University of Michigan Medical School in the fall of 2003. This approach, the Family Centered Experience, involves home visits and conversations between beginning medical students and patient volunteers and their families and is aimed at fostering humanism in medicine. The program incorporates developmental and learning theory, longitudinal interactions with individuals with chronic illness, reflective learning, and small-group discussions to explore the experience of illness and its care. The author describes a grounding of this approach in theories of empathy and moral development and clarifies the educational value that narratives bring to medical education. Specific pedagogical considerations, including use of activities to create "cognitive disequilibrium" and the concept of transformative learning, are also discussed and may be applied to narrative medicine, professionalism, multicultural education, medical ethics, and other subject areas in medical education that address individuals and their health care needs in society.
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            Beyond curriculum reform

            F Hafferty (1998)
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              "Making strange": a role for the humanities in medical education.

              Stories, film, drama, and art have been used in medical education to enhance empathy, perspective-taking, and openness to "otherness," and to stimulate reflection on self, others, and the world. Yet another, equally important function of the humanities and arts in the education of physicians is that of "making strange"-that is, portraying daily events, habits, practices, and people through literature and the arts in a way that disturbs and disrupts one's assumptions, perspectives, and ways of acting so that one sees the self, others, and the world anew. Tracing the development of this concept from Viktor Shklovsky's "enstrangement" (ostranenie) through Bertolt Brecht's "alienation effect," this essay describes the use of this technique to disrupt the "automaticity of thinking" in order to discover new ways of perceiving and being in the world.Enstrangement may be used in medical education in order to stimulate critical reflection and dialogue on assumptions, biases, and taken-for-granted societal conditions that may hinder the realization of a truly humanistic clinical practice. In addition to its ability to enhance one's critical understanding of medicine, the technique of "making strange" does something else: By disrupting fixed beliefs, this approach may allow a reexamination of patient-physician relationships in terms of human interactions and provide health care professionals an opportunity-an "open space"-to bear witness and engage with other individuals during challenging times.
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                Author and article information

                Journal
                Academic Medicine
                Academic Medicine
                Ovid Technologies (Wolters Kluwer Health)
                1040-2446
                2017
                December 2017
                : 92
                : 12
                : 1659-1660
                Article
                10.1097/ACM.0000000000001957
                28991843
                85096ace-f089-467d-a86f-58b241a453a9
                © 2017
                History

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