Transcript Poster Final

Teaching the Art of Medicine:
A Changing Portrait in Today’s Medical Schools
Aaron Lambert, Todd Gress, Marie Veitia
Office of Student Affairs & Department of Internal Medicine
Joan C. Edwards School of Medicine, Huntington, WV
Abstract
Objective: The purpose of the present study was to assess attitudes toward
the value of the “art of medicine” in medical education, beliefs regarding
whether it can be taught and, if so, the methods of teaching that would be
most effective.
Method: As described by the British Medical Journal (2006), the “art of
medicine” is defined in the present study as “the way in which knowledge is
related to advice and treatment.1” Data was gathered via 278 anonymous
surveys distributed to all Marshall-affiliated physicians, fellows, residents, and
entering first-year medical students using a 5-point Likert Scale. Surveys were
then analyzed by demographics including age, gender, medical school
attended, and field of specialty.
Results: Out of 278 surveys, 218 were returned resulting in a 78% response
rate. Ninety percent of respondents believe that the art of medicine is as
important to medical practice as the basic sciences and ninety-two percent
believe it to be a critical component of medical education. Eighty-one percent
believe that the art of medicine can be taught, and seventy-six percent would
support finding more time in the curriculum for teaching the art of medicine.
Out of options given, most respondents seemed to favor role-modeling by
preceptors (68%), reviewing experiences of physicians (59%), and small-group
discussions (56%) as the most effective methods of teaching the art of
medicine.
Discussion: The faculty, residents, and first-year students of Marshall
University School of Medicine clearly support teaching the art of medicine and
believe it can, in fact, be taught and is not just something inherent to certain
individuals. Several methods of teaching were identified as important by
those surveyed, and action must be taken to ensure the art of medicine is not
lost in the shuffle or removed from the undergraduate medical curriculum.
Introduction
 No one to date has ever asked the question “Can the ‘art of medicine’ be
taught?” in a scientific study
 The art of medicine is slowly being eliminated from medical curriculum –
why?
 More time for basic science education
 Disillusionment in ability to teach intangibles
 Disagreement of importance of intangibles in education and
patient care
 Students who lack education in professionalism and are reprimanded in
medical school are 3-8x more likely to be sanctioned in practice2.
 The foundations of the science and the manner in which they are utilized in
patient care are, in fact, two parts of one body, not separate conflicting entities
 This study poses three main questions:
1.Can the art of medicine be taught?
2.Is the art of medicine important in undergraduate medical
education?
3.If so, what is the most effective method of teaching the art of
medicine?
Methods
 The “art of medicine” was defined as “the way in which knowledge is
related to advice and treatment.1”
 Surveys were created with 13 total questions:
• 8 questions on a 5-point Likert scale
• 4 multiple-choice questions
• 1 short-answer question
• all surveys were anonymous
 Distribution involved two parts:
• Distributed to all faculty attending physicians, fellows, and
residents of MUSOM
• Distributed to all MS-I students with 3 omitted questions
regarding application of art in practice
• Surveys were returned via campus mail
 Surveys were analyzed by: age, gender, medical school attended, field of
specialty, and years in practice
“Is/Does the art of medicine…”
“Regarding the art of medicine, I…”
Percent Agree the Art of Medicine Can
Be Taught, by Years in Practice
Study Group Characteristics
 Total Surveyed – 278
 Response Rate 78.4% (218 surveys returned)
 Mean Age – 33.6 yrs, SD – 11.7 yrs
 Gender – 86 females (41.1%), 123 males (58.9%)
 Status – 58 attendings, 12 fellows, 73 residents, 75 students
 84.5% US Graduates vs. 15.5% International Medical
Graduates
 Years in Practice –
• 0 yrs: 76
• 1-5 yrs: 47
• 6-10 yrs: 25
• 11-20 yrs: 20
• >20 yrs: 50
Implications
 With 81% believing it can be taught and the belief increasing
with increasing years of practice, perhaps the more experienced
have a better grasp of what the art is, and therefore a better idea
of how to teach it.
 If 92% believe it is critical and 90% think it is as important as
basic science, these results go against the popular trend of
today’s evidence-based curriculum.
• Perhaps we need to rethink our curriculum – are
a few more facts worth not being taught how to
use them?
 The majority opinion on how to teach it seems to be rolemodeling and reviewing experiences of doctors. Are we holding
our preceptors accountable for their actions?
 “…most of us would rather be treated by a doctor who is not
only an expert on disease, but also has a feel for people.3”
Limitations:
1. Single-institution study
2. Small sample size
3. Self-made questionnaire
References:
1. Cook Harold J. What stays constant at the heart of medicine.
BMJ 2006;333:1281-82.
2. Pelofsky S. The voice of art and the art of medicine. J
Neurosurgery 2002;97:1261-1268.
3. Macgregor Roy. The art of medicine:striving for a more holistic
view of our patients. The Lancet 2001;358:250-51.