We propose an interesting paper written by Jane Macnaughton in 2000, and published by BMJ P “The humanities in medical education: context, outcomes and structures”. This article was the fuel for the spreading of Medical Humanities in the Academies.
Some universities in the United Kingdom are hosting lecturers in the medical humanities and a Centre for the Arts and Humanities in Health and Medicine (CAHHM) has been set up at the University of Durham. The centre is involved in all aspects of the arts in health but there is a major emphasis on medical education and on the evaluation of educational activities involving the arts.
Doctors need to understand their patients through a robust scientific knowledge and to appreciate how scientific research can help them to make decisions about the best treatment for their patients. Beyond a “technical doctor”, a “humane” doctor is required, with the understanding, assisted by interpretative ability and insight, and governed by ethical sensitivity, to apply this scientific evidence and skills to the individual patient. Doctors need then to be able to learn the scientific knowledge of disease and treatments with the understanding of the individual patient’s needs, thoughts, feelings.
Humanities subjects, particularly literature, can be seen as a source of case stories for medical students; and the humanities can teach students certain skills which may be of benefit to them in the clinical situation. Literature teaches about written communication, but, more importantly for health care, drama demonstrates the nuances of communication between people, both verbal and non-verbal. History and philosophy may also train the students in useful skills. If history provides the importance of evidence and how it can be manipulated by individuals to give a fraudulent view of the truth, philosophy gives to students order to their thoughts, for constructing an argument and reach a logical conclusion. These skills are essential in diagnosis, where the doctor must gather information to support a thesis and go through logical steps to reach a conclusion.
Almost twenty years ago, in 1998, medical students were offered a module in philosophy entitled “the individual in society; an introduction to social and political philosophy”. This module was the product of a collaboration between the departments of general practice and philosophy and enabled the medical students to take part in a course which was being taught to first year students of philosophy.
The course had three main aims:
- To read and discuss Plato‘s Republic;
- To encourage the students to adopt the techniques of philosophical analysis in their approach to an argument, and
- To expose them to the broadening experience of an academic culture different from their own.
The justification of the first aim is that The Republic deals with fundamental issues relating to society, such as the reasons why people live together in communities in the first place. The future physicians had just completed their family project in the medical course, so they were challenged by Plato’s rejection of the family as the basic social unit.
The justification of the second aim was in terms of its use in developing transferable skills and attitudes. Clinical diagnosis requires that doctors be able to sort out information about a patient, order it and construct arguments for or against certain conclusions (diagnoses). Philosophy can teach students how to go about this; a major part of the module focused on learning about argument, and students were taught the steps to take in constructing arguments. Most of the students commented that by the end of the module, they had begun to question received know how more confidence.
The justification of the third aim is that it distanced the students from the pervading culture of their medical education and medical class and placed them in the arts faculty (physically and intellectually) and amongst philosophy students and teachers. This provided a broadening academic experience, a “counter culture”.
Is this study still valid? Now, when technocracy is overwhelming, this approach is definitely valid to counteract the stiffness of oversimplified protocols of care. we can also make use of skills and ideas from philosophy, history and literature to illustrate and illuminate teaching in other areas of medical education —such as in communication skills and behavioural science—and thus suggest their instrumental value to all medical students. Medical practice consists of a wide range of different competences and the educational benefits.
