Transcript Integration of Humanities in a Problem

Integration of
Humanities in a
Problem-based
Curriculum
Amos Pasternack
05.09.05
Abraham Flexner 1910
•…the practitioner deals with facts of two
categories. Chemistry, physics, biology enable
him to apprehend one set; he needs a different
apperceptive and appreciative apparatus to
deal with other, more subtle elements. Specific
preparation is in this direction much more
difficult; one must rely for the requisite insight
and sympathy on a varied and enlarging
cultural experience. Such enlargement of the
physician´s horizon is otherwise important, for
scientific progress has greatly modified his ethical
responsibility… It goes without saying that this
type of doctor is first of all an educated man.
Chen Kenyon (second year
student) 2003
•I have been told that there are two pillars in
medicine – science and humanism. As basic
scientists build up the first pillar during
preclinical years and neglect the
construction and maintenance of the
second, students learn to treat patients as
they might treat an experimental mouse.
Idealistic notions of altruism, honesty and
integrity that attracted many to the calling of
medicine are mentioned in the white coat
ceremony, talked about by deans, and actively
discouraged through the acculturation process.
This is where transformation must take place.
Topics asking for more
and special attention
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Ethics
History of medicine
Philosophy of medicine
Litterature and creative writing
Fine arts, music, theater, movie
Religion
Anthropology
Professionalism and
”multiprofessionalism”
How to teach humanities
to medical students
• No evidence as to method of
choice
• Measures are needed to break
the resistance of faculty
• Needs to be ”smuggled” into the
curriculum
• First to be cut down when
faculty is short of money
Methods of
implementation
• Optional electives
• Compulsory electives
• Compulsory theme-based
modules
• Compulsory integrated modules
– from ten hours to about three
weeks
Choosing the method
• Experience from voluntary elective
”Arts and medicine”, a series of
seminars together with students from
the faculty of humanities: medical
students participating were those
interested in humanities
• Humanities should be offered to all
students as a more or less natural
part of medicine
• Integrate humanities in the medical
curriculum
Integration of
Humanities in the
curriculum
• Moderate amount of humanities
for all students
• Lectures, seminars, discussions,
reading, movies etc
• Topics added to the blocks in a
natural way in order to broaden
the subjects dealt with and to
underline their connection with
humanities
Introduction
Block 1
• Introduction to ethics
– Philosophy and practice
• The significance of humanities
in medicine
• Health and disease as cultural
and social phenomena
• Reading a fragment of a novel
and following discussion
Function of the nervous
system and perception
(Block 3)
• Development of language
• Development of concepts by the
deaf and the blind
Medical knowledge and
research
(Block 4)
• Introduction to the philosophy
of science
• Ethics of research
• Approaches in humanistic and
social sciences
• Principles and methods of
biomedical research
• Approaches of clinical research
Locomotion
(Block 5)
• Encounter of the deceased at
dissections – learning to respect
the historical person
• Students elaborating the facing
of human death
• Body-image – historical aspects
• Use of organs in therapy –
ethical aspects
Nutrition
(Block 7)
• Hunger and famine - global and
social aspects
• Anorexia and bulimia - actual
problems ?
• Food and eating habits in
various cultures and religions
• Historical aspects on eating and
food in Finland
• Vitamins – historical review
Hormonal regulation
(Block 9)
• Endemic goiter and iodine
prophylaxis – historical aspect
• Cortisone – discovery, hopes
and disappointments – a
historical review
• Non-medical use of hormones
Autonomic and
integrative functions of
the nervous sustem
(Block 10)
• Multiprofessional project:
meeting of cultures in health
care
• Cultural and ethnic differences
in communication
• Refugees and immigrants as
patients at the health-care center
Attack and defence
(Block 11)
• Tuberculosis – historical and
social aspect
• Eradication of infectious
diseases – economic aspect and
identification of barriers
• History of epidemics – effects
on population
Ageing
(Block 12)
• Age and rationing in health care
– facts and discussion
• Old people in various cultures
and in changing society
• Multiprofessional project. Care
of the elderly
• Facing death – attitudes of the
elderly
• Ageing in the literature
Prevention
(Block 14)
• Screening and prevention –
ethical aspects
• Smoking – history and scientific
evidence (a model)
Infection
(Block 16)
• Ethics in the light of two cases:
– patient with HIV-infection in
surgery
– SARS and hospital doctors
Chest pain/Shortness of
breath
(Block 17)
• Treatment of myocardial
infarction and heart failure –
historical aspect
• Reading of text and discussion
Diagnostics and therapy
(Block 19)
• Autonomy and rationing in
health care
• Health economy and medical
ethics
• Philosophy of placebo
• Self-induced disease – ethical
aspect
• Evidence-based medicine ethical aspects, applicability and
limimations
Coping
(Block 20)
• Reading about depresssion
followed by discussion
– ”Darkness visible” by William
Styron
• Madness
– historical and anthropological
aspects
Arthralgia
(Block 22)
• Multiprofessional project nurses, physiotherapists, social
workers
• Backpain as a social problem –
social and economic aspects
Emergency situations
(Block 23)
• Ethical aspects on:
– brain death and procurement of
organs
– organs on the market
– intensive care
– end-of-life therapy
– suicide
– euthanasia