Medical humanities
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Medical Humanities. Louise Younie. Plan for the day. Food for thought Painting Dialogue and reflection Clay-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.

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Medical Humanities

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Medical Humanities

Louise Younie


Plan for the day

  • Food for thought

  • Painting

  • Dialogue and reflection

  • Clay-work


Galumph

  • One, two! One, two! And through and throughThe vorpal blade went snicker-snack!He left it dead, and with its headHe 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 medicine

  • Philosophy of medicine

  • Ethics

  • Theology

  • Visual and performing arts

  • Music

  • Literature


Art

  • Respond to the created work of others

  • Engage actively with the creative process ourselves


What is happening

  • Surgeon 1976 Australia

  • Internationally since 1970’s

  • Journals 1990’s

  • Medical Humanities 2000

  • Association for medical humanities

  • Conferences (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 developed

    • Students should have time for personal reflection and personal growth

    • Students should be able to take account of patients’ own views and beliefs


Examples from literature

  • OxfordLiterature

  • Glasgow 2000art

  • Cambridge


Bristol Medical School

  • Whole Year Groups

    • Year 1 GP creative writing

    • Year 1 WPC element of HBoM

    • Year 4 COMP2 “creative reflection”

  • Self Selected Components

    • Year 2 “Doctors in the Movies”

    • Year 2 “Creative Arts in Health Care”

    • Sporadic student-driven SSCs

    • BA 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

  • Logical

  • Words and language

  • Maths and science

  • Order/pattern perception

  • Analytical

  • 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 outside

She calmly presents the gift

Of tears


GP Tutors take a Haiku

Hard craggy edge

Feeling along the liver edge

How do I tell you


GP Tutors take a Haiku

Rushed time chasing

Grab jumper front door slams

Keys 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 thinking

  • Synthesise as well as analyse

  • Chaos theory

  • Mental models

  • Metaphor


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 Registrar

  • Personal/professional development

  • Self-awareness

  • Attitudes

  • Ability to deal with complexity/uncertainty/failure

  • Broaden vision/horizons


Doctor characteristics

  • Altruism

  • Accountability

  • Duty

  • Integrity

  • Respect for others

  • Lifelong 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 experience

  • Critical reflection

  • Rational discourse

    (Mezirow 1978)


Extra-rational

  • Creative, emotional engagement (Boyd & Myers 1988)

  • Enhanced through symbols and imagery (Dirkx 1997)


  • Listen better rather than longer

    • What to listen for

    • To understand the significance of what is being heard

    • To know how to respond therapeutically


Clay-work ..meaningful


  • What have you taken from today?

  • What might you try?


  • Only get out what you put in

  • Take risks

  • Be yourself

  • Use material that you can engage with

  • Understand the barriers e.g. fear of exposure, feeling of time pressure, not tried before, can’t see the point

  • Develop safe and conducive environment


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