Medical Humanities

Louise Younie

Plan for the day

Food for thoughtPaintingDialogue and reflectionClay-work

Galumph

One, two! One, two! And through and through  The vorpal blade went snicker-snack!He left it dead, and with its head  He went galumphing back.

We don’t see things as they are, we see them as we are

Anais Nin (1903-1977)

Medical Humanities

What are medical humanities?What is their relevance to medical education?How have they been used?How can we use them?What might I try?

Definition

The use of arts and humanities in medical education and research

Deborah Kirklin

Areas

History of medicinePhilosophy of medicineEthicsTheology Visual and performing artsMusicLiterature

Art

Respond to the created work of othersEngage actively with the creative process ourselves

What is happening

Surgeon 1976 AustraliaInternationally since 1970’s Journals 1990’sMedical Humanities 2000Association for medical humanitiesConferences (Glasgow 9-10th July 07)

                                                        

                     

The Times They Are A-Changin’

UK

Tomorrow’s doctors 1993 (2002)Attitude and behaviour that are suitable for a Dr must be developedStudents should have time for personal reflection and personal growthStudents should be able to take account of patients’ own views and beliefs

Examples from literature

Oxford LiteratureGlasgow 2000 artCambridge

Bristol Medical School

Whole Year GroupsYear 1 GP creative writingYear 1 WPC element of HBoMYear 4 COMP2 “creative reflection”

Self Selected ComponentsYear 2 “Doctors in the Movies”Year 2 “Creative Arts in Health Care”Sporadic student-driven SSCsBA in medical humanities

GP Tutor educational development

O lny srmat poelpe can raed tihs.

I cdnuolt blveiee taht I cluod aulaclty  uesdnatnrd waht I was rdanieg. The phaonmneal pweor of the hmuan mnid! Aoccdrnig  to a rscheearch at Cmabrigde Uinervtisy, it deosn't mttaer in waht oredr the  ltteers in a wrod are, the olny iprmoatnt tihng is taht the frist and lsat  ltteer be in the rghit pclae. Tihs is bcuseae the huamn mnid deos not raed ervey  lteter by istlef, but the wrod as a wlohe.

Left Brain

LogicalWords and languageMaths and scienceOrder/pattern perceptionAnalytical Rational Critical thinking

Interpretation, Compassion

“I found it most liberating! It was interesting to see how everyone interpreted someone’s piece of art, poetry or literature” (Male2 diary)

“everyone is very different and… behind any façade there lies a wealth of individual thoughts and experiences… tolerance and compassion” (Female3 diary)

Emotions, Understanding

“The process of writing a poem requires you to be very honest and it stirred up many emotions that have remained dormant” (Male2 diary)“Poetic or artistic expression is a means by which innermost thoughts and feelings are given form so that they can be viewed and interpreted by their creators and by others.” (Female3 diary)

Reflection, Questioning

“…allows you to ..think as a different person..” (Female8 diary) “It has been a long time since I have actually felt ‘educated’. This is what I think this course has achieved, not only in broadening my views but in encouraging me to seek to educate myself and to increase my self-awareness…It has rejuvenated the philosophical part of me that questions life and its meaning” (Female3 diary)

GP Tutors take a Haiku

Its cold outsideShe calmly presents the giftOf tears

GP Tutors take a Haiku

Hard craggy edgeFeeling along the liver edge How do I tell you

GP Tutors take a Haiku

Rushed time chasingGrab jumper front door slamsKeys still inside

Drawing

Hare brain, tortoise mind

See handout

Therapeutic value

We will all be sick, suffer loss and hurt and die. Health is not to do with avoiding these givens but with accepting them, even making sense of them...If health is about adaptation, understanding and acceptance, then the arts may be more potent than anything that medicine has to offer…

Richard Smith BMJ 2002;325:1432-3

Student film

Conceptual ties

Systems thinkingSynthesise as well as analyseChaos theory Mental modelsMetaphor

Education

Education must teach, reach, and vibrate the whole person rather than merely transfer knowledge

Stephen Nachmanovitch

Where are you hoping to get to with GP RegistrarPersonal/professional developmentSelf-awarenessAttitudesAbility to deal with complexity/uncertainty/failureBroaden vision/horizons

Doctor characteristics

AltruismAccountabilityDutyIntegrityRespect for othersLifelong learning

Creativity in medicine and medical education (HEA 2005)

Stimulation – print off from article

Training is for the purpose of passing on specific information necessary to perform a specialised activity. Education is the building of the person.

Stephen Nachmanovitch

The fulcrum of the transformation is mind-at-play, having nothing to gain and nothing to lose….

Stephen Nachmanovitch

Perspective transformation

Importance of using your imagination to try to understand GP reg, esp if you do not have good understanding of each other, if they behave in ways which surprise you, even more important then….

Transformative learning

Development of more integrative and inclusive beliefs (Panda 2004)

Reflective transformation of beliefs, attitudes, opinions and emotional reactions (Imel 1998)

Rational

Centrality of experienceCritical reflectionRational discourse

(Mezirow 1978)

Extra-rational

Creative, emotional engagement (Boyd & Myers 1988)

Enhanced through symbols and imagery (Dirkx 1997)

Listen better rather than longerWhat to listen forTo understand the significance of what is being heardTo know how to respond therapeutically

Clay-work ..meaningful

What have you taken from today?What might you try?

Only get out what you put inTake risksBe yourselfUse material that you can engage withUnderstand the barriers e.g. fear of exposure, feeling of time pressure, not tried before, can’t see the point Develop safe and conducive environment