Transcript IIC Humanities work in basic medical education

IIC
Humanities work in basic
medical education - What about
in GP training?
Martina Torppa (Finland)
Monica Lindh (Sweden)
Fergus D.O.Kelly (Ireland)
+ Aino-Maija Lahtinen, Elisa Laaksamo and
Jenny Takala
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Workshop structure
• “Medicine and the essence of humanity” – study module
• International experiences
• Educational agenda
• Group work
• Discussion
• Conclusion
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“Medicine and the essence of
humanity” – study module
Martina Torppa
GP, Adm. competency
Chief physician / Clinical lecturer
Health Centre of Helsinki (Malmi)/
University of Helsinki, Faculty of Medicine,
Research & Development Unit for Medical Education
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Medical Humanities – is there a
need for it?
• Medical education is biomedicine dominated?
• biomedicine prepares us well enough for
clinical work?
• The role of art and humanities based knowledge in
medical education? in CPD?
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Martina Torppa
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“Medicine and the essence of
humanity” – study module
• autumn 2004
• voluntary study module, University of Helsinki, Faculty of
Medicine, Department of Public Health, Section of
General Practice
• open for all medical students in the faculty
• 6 seminars, learning journals and reflective essays
• 7 students participated
• data collected for research purposes
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’Principles’
• To explore medicine and medical practice from
multiple perspectives
– historical and social contexts of medicine
– insights into human being
– experiential learning
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The six seminars
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History of medicine
Pastoral theology
Philosophy
Literature
Painting
Drama
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Two learning experiences
Jenny – Drama
Elisa - Literature
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Drama and Medicine – What on
earth do they have in common,
other than the tv-series ER?
Jenny Takala
Bachelor of medicine
Faculty of Medicine, University of Helsinki
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Jenny Takala
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Medical Humanities and
a lesson in Drama
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Four tasks
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Listening
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Literature and medicine – to
read or not to read?
Elisa Laaksamo
2nd year Medical student
Faculty of Medicine, University of Helsinki
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How did we start?
• Our reading histories
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The texts that we remember are probably the ones which
have most affected us.
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A reader can learn much (about the story etc.).
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Reading can be associated with things actual in one’s
own life.
Marja-Liisa Vartio
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Elisa Laaksamo
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Hänen olivat linnut (1967)
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What did we read?
• Kafka – First Sorrow
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Elisa Laaksamo
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What I learned in this course
and how could it help me in my development as a
medical student?
• Art
• Interpretation skills
• Listening, hearing,
dialogue
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Elisa Laaksamo
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International experiences
Sweden
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Humanities in Medical
Education – Swedish
experiences
Presentation at Duodecim/EURACT Conference
5 May 2006, Turku Finland
Dr Monica Lindh
Family Practitioner Hofors Health Centre
& Director of Vocational Training in GP/FM Gästrikland, Sweden
E-mail: [email protected]
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Medical Humanities –
Basic Medical Education
Examples
• “Professional development“
Ongoing theme from term 1
Ethics, consultation, roles, leadership, philosophy
• Reading literature/novels
• Using hero of novel in MEQ-assessment
• Elective courses
“Life, love and death – culture and biology in medical care”
“Text studies and creative writing” (interdisciplinary)
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Medical Humanities –
Internship
Examples
• Sessions with hospital priest - “comfort”, ethics
Fixed small group, for 21 months
• Leadership-training
• Consultation skills – use of actors
• “evening events”
lecture + social activity eg theatre, museum
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Medical Humanities –
Vocational training (1)
Examples
• Leadership-training:
ethics & priorities, law, communication, rhetoric
• Consultation-skills:
video, role-play, actors
• Seminars:
“the personal doctor”
body and soul
literature and medicine
history of medicine
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Medical Humanities –
Vocational training (2)
Examples
• 3-day mountain trip, annual
“lectures”, discussion, reflection, story-telling
• Literature and writing
course by Prof Merete Mazzarella, Finland
• Balint-group
• Reading novels
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Medical Humanities Institution Sweden
Example
• Humanistic Medicine at Centre for Bioethics
At LIME www.lime.ki.se
Interdisciplinary, inter-and cross-professional
Education and research
History of medical ideas, social science,
literature, arts, ethnology,
philosophy, ethics, religion
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HUMANITIES IN MEDICAL EDUCATION IN
SWEDEN - REFERENCES
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Ahlzén R. The doctor and the literary text – potentials and pitfall.Med Health Care Philos. 2002;5:147-55.
AhlzenR, Stolt CM. The Humanistic Medicine Program at the Karolinska Institute, Stockholm, Sweden.
Academic Medicine. Special Theme: Humanities Education. 2003 Oct;78(10):1039-42.
Hellquist G, Rödjer S, von Below B, Sveinsdóttir G, Björkelund C. Tidig yrkeskontakt stärker
studenternas professionella utveckling. TYK - en ny kurs i läkarutbildningen i Göteborg. [Early professional
contact supports professsional development of medical students. EPC - a new course in
medical education in Göteborg].Läkartidningen 2005;102:2646-51.
Håkansson A, Haffling AC, Beckman A, Jakobsson K, Löwenhielm P. Romanfigurer ger liv åt tentans
patientfall.Läkartidningen 2003;43:3425-7
Petersson C. Litteratur och läkekonst. Skönlitteraturen en genväg till den motsägelsefulla människan.
Läkartidningen 2005;102:2414-6.
Stolt CM. Vad är humanistisk medicin? [What is medical humanities?].Ugeskrift for Laeger.
2000;162/51:6995-7.
Tidsskrift for Den norske laegeforening 2000;30:3736-8. [Danish Med Bull. 2000;162/51:6995-7, also
published in J Norwegian Med Association 2000;30:3736-8].
Stolt CM. "Medicinen och det mänskliga. Vårdkonst och vardagsetik. Humanism och humaniora" [Medicine
and the Human. The art of caring and every day ethics, humanism and the arts] Natur och Kultur,
Stockholm 2003.
Stolt CM. Medicin och lyrik. Vetenskapens språk räcker inte. [Medicine and Poetry. Scientific language is
not enough].Läkartidningen 2003;51-52:4308-17.
Stolt CM. Poetry and Medicine.European Journal of Clinical Hypnosis 2005; 6 (3): 38-42
Wachtler C, Lundin S, Troein M. Humanities for medical students? A qualitative study of a medical
MLindh-06
humanities curriculum in a medical school program.BMC Med Educ. 2006 Mar 6;6:16.
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International experiences
Ireland
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“In my Father’s
time”
Humanities and medical education
Fergus O’Kelly
(EURACT – Ireland)
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Story Telling
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Seannachi
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“Half-Term break”:
by Seamus Heaney
I sat all morning in the college sick bay
Counting bells knelling classes to a close.
At two o'clock our neighbors drove me home.
In the porch I met my father crying-He had always taken funerals in his stride-And Big Jim Evans saying it was a hard blow.
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The baby cooed and laughed and rocked the
pram When I came in, and I was embarrassed
By old men standing up to shake my hand
And tell me they were "sorry for my trouble,"
Whispers informed strangers I was the eldest,
Away at school, as my mother held my hand
In hers and coughed out angry tearless sighs.
At ten o'clock the ambulance arrived
With the corpse, stanched and bandaged by the
nurses.
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Next morning I went up into the room. Snowdrops
And candles soothed the bedside;I saw him
For the first time in six weeks. Paler now,
Wearing a poppy bruise on his left temple, He lay
in the four foot box as in his cot. No gaudy scars,
the bumper knocked him clear.
A four foot box, a foot for every year.
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Educational agenda
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EURACT Educational Agenda background
What is a GP?
• The new European Definition of Family Medicine.
How to become a GP?
• EURACT Educational Agenda, 2005
• Framework and ”manual” for teaching & learning, VT
• Objectives, learning methods, assessment tools
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EURACT Educational Agenda – (1)
Six Core Competences
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Primary Care Management
Person Centredness
Specific Problem Solving Skills
Comprehensive Approach
Community Orientation
Holistic Approach
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EURACT Educational Agenda – (2)
Three Essential Application Features
• Contextual Aspects
• Attitudinal Aspects
• Scientific Aspects
Synthesis and integration,
the unique combination
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Questions for the groups
1) Art and humanities in GP training – is there any need?
-why? or why not?
2) Art and humanities in GP training - how?
3) Educational agenda in relation to art and humanities?
4) Free comments / ideas
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Group 1
Why: understanding patients’ culture, religion, background
– holistic approach
How: experiential learning, evoking feelings in group
members important, best in small groups
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Group 2
• Medicine is an art, built on science.
• There is a need, because you can’t measure everything
• Not everything that counts can be counted and not
everything that can be counted counts.
• Find a way to handle difficult issues in multiprofessional
and safe platform
• Also an aim of medical education: to develop an
integrative personality
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Group 3
• Three E and one C
– Empathy
– Experience
– Empowerment
– Empowerment to help people grow. Culture of
listening relate to our roots.
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Group 4
• What is humanity? The mechanical model versus
humanistic attitude
in training. Students in general assume doctors to be
"biomedical professionals" and that humanistic attitude is
weakness?
• Universities teach mechanical problem solving to future
doctors?
• Students expect to be taught to be experts in
biomedicine…(?)
• Young doctors appear to be uncertain of themeselves ->
they ’escape’ to ’biomedicine’
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Reflections on the workshop
• Positive experience for med students who ‘lectured’ for medical
teachers
• Medical teachers can learn from students - involve them!
• A question: …why do we become doctors…?
• We should not forget the ‘non-believers’! – or is this a matter of
believing…or perhaps a call for philosophical debate…
• What is medicine – how do we define medicine?
• Medical knowledge – how is it constructed?
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Conclusions
(mt)
• There seems to be a need for art and humanities in GP
training.
• Why: holistic approach, tools needed to handle difficult
issues and the ’unmeasurable’ in clinical work
• How: in small groups, experiential learning, evoking and
reflecting feelings, sharing
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Thank you! - Kiitos!
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