A qualitative study exploring self-directed learning in a medical humanities curriculum
Keywords:
Curriculum, Health humanities, Medical education, Student-directed learningAbstract
Introduction: The humanities enrich and transform the practice of medicine. What remains to be seen, however, is how best to integrate humanities into the medical curriculum to optimize both educational and patient-related outcomes. The present study considers the structure of an innovative student-driven humanities curriculum and seeks to understand its strengths and limitations, as well as make recommendations for improvement. Methods: The Penn State College of Medicine, University Park Regional Campus uses an inquiry-based approach to education, whereby students are responsible for creating learning objectives in four core pillars of exploration: Foundational Science, Clinical Science, Health Systems Science, and Health Humanities. This study explores student-derived humanities learning objectives (HLO) across four years of the curriculum. Results: 420 HLOs met criteria for analysis and were coded as instrumental (developing direct clinical skill), non-instrumental (non-skill based), or both. Of these, 125 (30%) were instrumental, 239 (57%) were non-instrumental, and 56 (13%) were coded as both. Most instrumental HLO centered around communication skills. Non-instrumental HLO most commonly focused on bearing witness and critiquing a particular experience within a social and/or political context. Conclusions: Findings from this study contribute to the development of a humanities curriculum in a student-directed learning program. Non-instrumental HLO lacked a theoretical framework to guide student’s investigations to a deeper level of analysis. Student-directed learning offers many strengths, but can be enhanced through external direction from humanities trained faculty, particularly given that many medical students have a limited humanities background.
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Haidet P, Jarecke J, Adams NE, Stuckey HL, Green MJ, Shapiro D, Teal CR, Wolpaw DR. A guiding framework to maximise the power of the arts in medical education: a systematic review and metasynthesis. Med Educ. 2016;50(3):320–31. Available from https://pubmed.ncbi.nlm.nih.gov/26896017/
Perry M, Maffulli N, Willson S, Morrissey D. The effectiveness of arts-based interventions in medical education: a literature review. Med Educ. 2011;45(2):141–8. Available from https://pubmed.ncbi.nlm.nih.gov/21208260/
Dennhardt S, Apramian T, Lingard L, Torabi N, Arntfield S. Rethinking research in the medical humanities: a scoping review and narrative synthesis of qualitative outcome studies. Med Educ. 2016;59(3):285–99. Available from https://pubmed.ncbi.nlm.nih.gov/26896014/
Mangione S, Chakraborti C, Staltari G, Harrison R, Tunkel AR, Liou KT, Cerceo E, Voeller M, Bedwell WL, Fletcher K, Kahn MJ. Medical students’ exposure to the humanities correlates with positive personal qualities and reduced burnout: a multi-institutional U.S. survey. J Gen Intern Med. 2018;33(5):1–7. Available from https://pubmed.ncbi.nlm.nih.gov/29380213/
Schwartz AW, 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(4):372–80. Available from: https://pubmed.ncbi.nlm.nih.gov/19642151/
Ousager J, Johannessen H. Humanities in undergraduate medical education: a literature review. Acad Med. 2010;85(6):988–98. Available from https://pubmed.ncbi.nlm.nih.gov/20505399/
Moniz T, Golafshani M, Gaspar CM, Adams NE, Haidet P, Sukhera J, Volpe RL, de Boer C, Lingard L. How are the arts and humanities used in medical education? Results of a scoping review. Acad Med. 2021;96(8):1213–22. Available from https://pubmed.ncbi.nlm.nih.gov/33830951/
Macnaughton J. The humanities in medical education: context, outcomes and structures. Med Humanit. 2000;26(1):23–30. Available from https://mh.bmj.com/content/26/1/23
Wachtler C, Lundin S, Troein M. Humanities for medical students? A qualitative study of a medical humanities curriculum in a medical school program. BMC Med Educ. 2006;6(1):1–10. Available from https://bmcmededuc.biomedcentral.com/articles/10.1186/1472-6920-6-16
Shapiro J, Coulehan J, Wear D, Montello M. Medical humanities and their discontents: definitions, critiques, and implications. Acad Med. 2009;84(2):192–8. Available from https://pubmed.ncbi.nlm.nih.gov/19174663/
Bardes CL, Gillers D, Herman AE. Learning to look: developing clinical observational skills at an art museum. Med Educ. 2001;35(12):1157–61. Available from https://pubmed.ncbi.nlm.nih.gov/11895244/
Bleakley A, Marshall R. Can the science of communication inform the art of the medical humanities? Med Educ. 2013;47(2):126–33. Available from https://pubmed.ncbi.nlm.nih.gov/23323651/
Bleakley A, Farrow R, Gould D, Marshall R. Making sense of clinical reasoning: judgement and the evidence of the senses. Med Educ. 2003;37(6):544–52. Available from https://pubmed.ncbi.nlm.nih.gov/12787378/
Volpe RL, Hopkins M, Scoy LJ Van, Wolpaw DR, Thompson BM. Does pre-clerkship medical humanities curriculum support professional identity formation? Early insights from a qualitative study. Med Sci Educ. 2019;29(2):515.
Kumagai AK, Wear D. “Making strange”: a role for the humanities in medical education. Acad Med. 2014;89(7):973–7.
Kumagai AK. Beyond “Dr. Feel-Good”: a role for the humanities in medical education. Acad Med. 2017;92(12):1659–60.
Boudreau JD, Fuks A. The humanities in medical education: ways of knowing, doing and being. J Med Humanit. 2014;36(4):321–36. Available from https://link.springer.com/article/10.1007/s10912-014-9285-5
Howley L, Gaufberg E, King B. The fundamental role of the arts and humanities in medical education. AAMC. Washington, DC: AAMC; 2020.
Moniz T, Golafshani M, Gaspar CM, Adams NE, Haidet P, Sukhera J, Volpe RL, de Boer C, Lingard L. The Prism model: advancing a theory of practice for arts and humanities in medical education. Perspect Med Educ. 2021;10(4):207–14.
Laux T, Stephens M, Meka J. Student-generated learning objectives and curricular innovation. J Reg Med Campuses. 2021;4(2). Available from: https://pubs.lib.umn.edu/index.php/jrmc/article/view/3637
Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101. Available from https://www.tandfonline.com/doi/abs/10.1191/1478088706qp063oa
Nowell LS, Norris JM, White DE, Moules NJ. Thematic analysis: striving to meet the trustworthiness criteria. Int J Qual Methods. 2017;16(1). Available from https://journals.sagepub.com/doi/full/10.1177/1609406917733847
Murad M, Coto-Yglesias F, Varkey P, Prokop LJ, Murad A. The effectiveness of self-directed learning in health professions education: a systematic review. Med Educ. 2010;44(11):1057–68.
Eva KW, Cunnington JPW, Reiter HI, Keane DR, Norman GR. How can I know what I don’t know? Poor self assessment in a well-defined domain. Adv Heal Sci Educ. 2004;9(3):211–24.
Patterson M, Johnston J. Theorizing the obesity epidemic: health crisis, moral panic and emerging hybrids. Soc Theory Heal. 2012;10(3):265–91. Available from: https://link.springer.com/article/10.1057/sth.2012.4
Cox SM, Brett-MacLean P, Courneya CA. “My turbinado sugar”: art-making, well-being and professional identity in medical education. Art Heal. 2015;8(1):65–81.
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