ABSTRACT
Discussion surrounding the role of the humanities as an important analytic epistemology within medical education is generally less robust than literature supporting its value in building empathy and promoting personal reflection and wellness. As such, the humanities have not been considered to be as relevant when teaching medical reasoning or technical skills. Yet, might the humanities offer value in emboldening the analytic thinking of medical learners? This article proposes an integrative conceptual model that links the thought process defining medicine-clinical reasoning-with humanistic analysis in an effort to advance the argument that the humanities offer a complementary and innovative platform that can be used within traditional medical education. The article then discusses preliminary findings from a pilot curriculum based on this model, implemented during internal medicine morning report at the University of North Carolina at Chapel Hill School of Medicine. Preliminary qualitative analysis of transcripts from the pilot curriculum demonstrates that a thought process analogous to that of clinical reasoning can be identified within guided group analyses of humanities works. Participants simultaneously used thought processes that were analytic and intuitive. The emergence of ambiguity/intuition as a theme in the pilot curriculum suggests the humanities could be a powerful tool for exploring and embracing ambiguity in clinical practice. Through the development of an integrative conceptual model, this article helps to demonstrate more explicitly the theoretical link between the reasoning pathways of the humanities and clinical medicine. Though a refined curriculum and more rigorous analysis are needed before arguing for the incorporation of the humanities into traditional graduate medical education on a larger scale, the preliminary findings here support the feasibility and promise of a curriculum based on the proposed integrative conceptual model.
Subject(s)
Education, Medical, Undergraduate , Education, Medical , Clinical Reasoning , Curriculum , Education, Medical, Graduate , Humanities/education , HumansABSTRACT
PIP: Of 4087 women (aged 16 to 44 years old; 218 primigravida) subjected to induced abortion during the last 3 years, 762 (18.6%) developed complications. The complications were divided into three groups: group 1 included 64 women who developed complication within the first 7 days after abortion, group 2 included 46 women who developed complications within 7-30 days after abortion, and group 3 included 652 women with late complications. Of 64 women in group 1, 7 had perforation of the uterus, 28 had hematometra, and 29 has incomplete abortion. All 46 women in group 2 has endometritis. Of 652 women in group 3, 4 has placental polyps, 232 has inflammation with associated secondary infertility (hysterosalpingography indicated tubal obstruction in 194 and peritubal adhesions in 38), and 416 had disorders of the menstrual function. In addition to general clinical examination, 50 women with inflammation and tubal infertility underwent immunological examination and allergy testing. Of 50 patients, 35 were found to have skin rush, hives, drug or food hypersensitivity. The patients with allergy manifestations had marked inhibition of cellular immunity seen as decrease in T-lymphocyte count and 2 items increase in null lymphocyte count (B-lymphocyte count did not differ from that in healthy controls). The patients with tubal infertility received combined treatment. Conservative treatment including hydrotherapy, anti-inflammatory agents and electric stimulation was effective 123 of 232 women.^ieng