Integrating humanities in healthcare: a mixed-methods study for development and testing of a humanities curriculum for front-line health workers in Karachi, Pakistan.

Lady health workers (LHWs) provide lifesaving maternal and child health services to >60% of Pakistan's population but are poorly compensated and overburdened. Moreover, LHWs' training does not incorporate efforts to nurture attributes necessary for equitable and holistic healthcare delivery. We developed an interdisciplinary humanities curriculum, deriving its strengths from local art and literature, to enhance character virtues such as empathy and connection, interpersonal communication skills, compassion and purpose among LHWs. We tested the curriculum's feasibility and impact to enhance character strengths among LHWs.We conducted a multiphase mixed-methods pilot study in two towns of Karachi, Pakistan. We delivered the humanities curriculum to 48 LHWs via 12 weekly sessions, from 15 June to 2 September 2021. We developed a multiconstruct character strength survey that was administered preintervention and postintervention to assess the impact of the training. In-depth interviews were conducted with a subset of randomly selected participating LHWs.Of 48 participants, 47 (98%) completed the training, and 34 (71%) attended all 12 sessions. Scores for all outcomes increased between baseline and endline, with highest increase (10.0 points, 95% CI 2.91 to 17.02; p=0.006) observed for empathy/connection. LHWs provided positive feedback on the training and its impact in terms of improving their confidence, empathy/connection and ability to communicate with clients. Participants also rated the sessions highly in terms of the content's usefulness (mean: 9.7/10; SD: 0.16), the success of the sessions (mean: 9.7/10; SD: 0.17) and overall satisfaction (mean: 8.2/10; SD: 3.3).A humanities-based training for front-line health workers is a feasible intervention with demonstrated impact of nurturing key character strengths, notably empathy/connection and interpersonal communication. Evidence from this study highlights the value of a humanities-based training, grounded in local literature and cultural values, that can ultimately translate to improved well-being of LHWs thus contributing to better health outcomes among the populations they serve.

How literature can help develop a nursing perspective: the contribution of the novel "Mend the Living" / De la littérature pour développer un regard soignant : l'apport du roman « Réparer les vivants ¼

Including the humanities in health sciences training is a means of humanizing healthcare practice. The humanities and social sciences, but also artistic disciplines such as dance, film, theater, and literature make it possible to take into account the complexity of lived experiences and to deepen the notion of caring. In this paper, we revisit the relevance and usefulness of literature in educating healthcare workers. We analyze "Mend the Living", a novel by Maylis de Kerangal that explores the issue of organ harvesting, to show how content of this kind can deepen caregivers' perspectives. Constantly referring to the text as if it were anthropological field data, we open the door to themes of significant phenomenological, ethical, political, and anthropo-sociological interest that could be used as spaces of encounter and pedagogical reflection.

L'intégration des humanités dans les formations en sciences de la santé est un moyen d'humaniser les pratiques soignantes. Des sciences humaines et sociales, mais aussi plusieurs médias artistiques, dont la danse, le cinéma, le théâtre et la littérature permettent notamment de rendre compte de la complexité des expériences vécues et d'approfondir la notion de soin. Dans ce texte, nous revenons sur la place et l'utilité de la littérature dans l'enseignement des soignants. Nous proposons d'analyser le roman de Maylis de Kerangal, « Réparer les vivants ¼, qui porte sur le prélèvement d'organes, pour montrer comment ce type de contenu peut aider à approfondir le regard des soignants. Toujours soutenu par le texte comme si ce dernier était un matériel anthropologique récolté sur un terrain, nous ouvrons des portes à faire des thèmes à fortes valeurs phénoménologiques, éthiques, politiques et anthropo-sociologiques, qui pourraient être des lieux de rencontres et de réflexions pédagogiques.

Advancing Global Health Equity: The Role of the Liberal Arts in Health Professional Education.

Much innovation has taken place in the development of medical schools and licensure exam processes across the African continent. Still, little attention has been paid to education that enables the multidisciplinary, critical thinking needed to understand and help shape the larger social systems in which health care is delivered. Although more than half of medical schools in Canada, the United Kingdom, and the United States offer at least one medical humanities course, this is less common in Africa. We report on the "liberal arts approach" to medical curricula undertaken by the University of Global Health Equity beginning in 2019. The first six-month semester of the curriculum, called Foundations in Social Medicine, includes courses in critical thinking and communication, African history and global political economy, medical anthropology and social medicine, psychology and health, gender and social justice, information technology and health, and community-based training. Additionally, an inquiry-based pedagogy with relatively small classes is featured within an overall institutional culture that emphasizes health equity. We identify key competencies for physicians interested in pursuing global health equity and how such competencies relate to liberal arts integration into the African medical school curriculum and pedagogical approach. We conclude with a call for a research agenda that can better evaluate the impact of such innovations on physicians' education and subsequent practices.

The implementation of a required book club for medical students and faculty.

More medical schools are incorporating wellness activities and the medical humanities into their curriculum. Finding implementable programming that is feasible and enjoyable is challenging. Both student participants and faculty who might facilitate programs are busy with clinical and educational responsibilities. Book club discussions in general are an activity that bring people together and expose groups to literature. In medical education, informal books clubs have been shown to increase camaraderie and expose participants to topics in medicine that they may not have encountered without the structure of the group assignment. At one large private urban medical school, all fourth year medical students were required to participate in a one-time hour-long book discussion with a faculty member one week before Match Day 2021. This paper describes the implementation of that program and discusses survey results from 179 students who broadly indicated that the books were enjoyable, the discussions were enriching, and that the program should continue for future classes of medical students.

How Are the Arts and Humanities Used in Medical Education? Results of a Scoping Review.

PURPOSE: Although focused reviews have characterized subsets of the literature on the arts and humanities in medical education, a large-scale overview of the field is needed to inform efforts to strengthen these approaches in medicine. METHOD: The authors conducted a scoping review in 2019 to identify how the arts and humanities are used to educate physicians and interprofessional learners across the medical education continuum in Canada and the United States. A search strategy involving 7 databases identified 21,985 citations. Five reviewers independently screened the titles and abstracts. Full-text screening followed (n = 4,649). Of these, 769 records met the inclusion criteria. The authors performed descriptive and statistical analyses and conducted semistructured interviews with 15 stakeholders. RESULTS: The literature is dominated by conceptual works (n = 294) that critically engaged with arts and humanities approaches or generally called for their use in medical education, followed by program descriptions (n = 255). The literary arts (n = 197) were most common. Less than a third of records explicitly engaged theory as a strong component (n = 230). Of descriptive and empirical records (n = 424), more than half concerned undergraduate medical education (n = 245). There were gaps in the literature on interprofessional education, program evaluation, and learner assessment. Programming was most often taught by medical faculty who published their initiatives (n = 236). Absent were voices of contributing artists, docents, and other arts and humanities practitioners from outside medicine. Stakeholders confirmed that these findings resonated with their experiences. CONCLUSIONS: This literature is characterized by brief, episodic installments, privileging a biomedical orientation and largely lacking a theoretical frame to weave the installments into a larger story that accumulates over time and across subfields. These findings should inform efforts to promote, integrate, and study uses of the arts and humanities in medical education.

The renaissance nurse: permeating clinical competence with the humanities.

In order to reclaim the "art" of nursing, educators need to prepare their graduates with human caring skills that draw from phenomenology, existentialism, and all segments of the humanities. Nurses of the future will be healers of the body and spirit. The authors discuss, from theoretical perspectives, how the humanities empower the student and offer suggestions for the integration of the humanities into lecture and clinical settings.

The 'medical humanities' in health sciences education in South Africa.

A new masters-level course, 'Medicine and the Arts" will be offered in 2014 at the University of Cape Town, setting a precedent for interdisciplinary education in the field of medical humanities in South Africa. The humanities and social sciences have always been an implicit part of undergraduate and postgraduate education in the health sciences, but increasingly they are becoming an explicit and essential component of the curriculum, as the importance of graduate attributes and outcomes in the workplace is acknowledged. Traditionally, the medical humanities have included medical ethics, history, literature and anthropology. Less prominent in the literature has been the engagement with medicine of the disciplines of sociology, politics, philosophy, linguistics, education, and law, as well as the creative and expressive arts. The development of the medical humanities in education and research in South Africa is set to expand over the next few years, and it looks as if it will be an exciting inter-disciplinary journey.

The challenge of promoting professionalism through medical ethics and humanities education.

Given recent emphasis on professionalism training in medical schools by accrediting organizations, medical ethics and humanities educators need to develop a comprehensive understanding of this emphasis. To achieve this, the Project to Rebalance and Integrate Medical Education (PRIME) II Workshop (May 2011) enlisted representatives of the three major accreditation organizations to join with a national expert panel of medical educators in ethics, history, literature, and the visual arts. PRIME II faculty engaged in a dialogue on the future of professionalism in medical education. The authors present three overarching themes that resulted from the PRIME II discussions: transformation, question everything, and unity of vision and purpose.The first theme highlights that education toward professionalism requires transformational change, whereby medical ethics and humanities educators would make explicit the centrality of professionalism to the formation of physicians. The second theme emphasizes that the flourishing of professionalism must be based on first addressing the dysfunctional aspects of the current system of health care delivery and financing that undermine the goals of medical education. The third theme focuses on how ethics and humanities educators must have unity of vision and purpose in order to collaborate and identify how their disciplines advance professionalism. These themes should help shape discussions of the future of medical ethics and humanities teaching.The authors argue that improvement of the ethics and humanities-based knowledge, skills, and conduct that fosters professionalism should enhance patient care and be evaluated for its distinctive contributions to educational processes aimed at producing this outcome.

Entorno virtual de desarrollo socio-humanístico para profesionales de la salud en Guantánamo / Virtual environment and socio-humanistic development for health professionals in Guantánamo

Este trabajo es resultado parcial de la investigación realizada dentro del Proyecto Investigativo Institucional para el desarrollo del capital intelectual de la Universidad de Ciencias Médicas Guantánamo entre los años 2012 y 2014. La población la constituyó una selección de 150 profesionales de la salud de las diversas sedes en la UCMG; la muestra la constituyen 129 cursistas que vencieron los 5 cursos de postgrado desarrollados durante la investigación. La metodología seguida en esta investigación se corresponde con la de una investigación cualitativa en tanto diseña una propuesta metodológica que emerge como línea rectora en el proceso de desarrollo postgraduado en las disciplinas de ciencias sociales, políticas y humanísticas de los profesionales de la Salud. El problema detectado fue la ineficiencia en el desarrollo socio-humanístico de profesionales de la salud que incide negativamente en la calidad del servicio que prestan. El objetivo que se cumplió fue el de elaborar un software informático con actividades docentes de postgrado que permitan, mediante la autogestión de conocimientos, lograr la eficiente superación postgraduada en Ciencias Sociales, Políticas y Humanísticas de los profesionales de la Salud. En la investigación tuvimos como resultados fundamentales la respuesta a necesidades muy concretas del desarrollo de los profesionales de la Salud en ciencias sociales, políticas y humanísticas, en particular el aumento de la calidad en la preparación académica y docente, política y ética de los estudiantes(AU)

This work is partially a result of research conducted within the Institutional Investigative Project to develop the intellectual capital of the University of Medical Sciences Guantánamo between 2012 and 2014. The population was a selection of 150 health professionals of the various locations in UCMG; The sample population was 129 investigators whom finished 5 postgraduate courses developed during the investigation. The methodology used in this study corresponds to a qualitative research design as a methodology emerges as a guiding line in the development process and postgraduate degree in the disciplines of social, political and humanistic professionals Health sciences. The problem was detected, inefficiency in the socio-humanistic development of health professionals that adversely affects the quality of their service. The objective was accomplished in the develop a computer software with postgraduate teaching activities, through self-management skills, achieving efficient, postgraduate in Social, Political and Humanities in Health Sciences professionals. In the research had obtained the results as key and responses to very specific needs of the development of health professionals in social sciences, political and humanistic, including quality in academic and teacher education, politics and ethics of students(AU)