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Thursday Review: “The Long-Term Impact Of A Comprehensive Scholarly Concentration Program In Biomedical Ethics And Medical Humanities”

The authors admit that their article is a first step, but it’s an important first step to take. Writing in BMC Medical Education, Liu and coauthors set out to determine whether biomedical ethics and medical humanities education have any lasting impact on physicians.

As might be expected in a discipline which is decades old instead of millennia, there’s disagreement about nearly everything involving “BEMH“, although there is a refreshing agreement about what these areas are supposed to accomplish:

…there is strong consensus around its fundamental aims: encouraging key components of medical professionalism (e.g., empathy, altruism) and ethics, honing clinical communication and observational skills (focusing on emotional and non-verbal cues, the cultural context of care, and elucidating patient values), and developing self-care and reflective practices—foundational skills for physicians.

Liu et al. conducted interviews of MDs who graduated from Stanford’s medical school with a Scholarly Concentration in BEMH. The good news is that based on the stated fundamental aims, it works.

The word “longitudinal” comes up several times in the article. Several different interviewees mentioned that the sustained focus in BEMH throughout their medical education was important. They also reported that the program and its educators valued how these ideas would be carried forward into the students’ practice. One student mentioned that there is a strong individualized interest in students, not only in their…research but in their careers… as well as them as individual people. The connections the BEMH concentration fostered in research, career, and person was echoed by another student: that it is non-negotiable…to put your best clinical work forward, best research work forward, best kind of…self forward.

When a program which includes the medical humanities is correctly connected to medical practice, BEMH ceases to be about “the human side of medicine”. Biomedical ethics and medical humanities can go beyond that, and show us that it is human beings that practice medicine, that seek medical care, and that both sides can benefit from the other’s humanity.

As the authors note, in nearly every discussion of how to implement BEMH, there have been apprehensions regarding the integration of the humanities within a traditionally hard science and technical curriculum. This is consistent with the viewpoint that a student can study medicine, and BEMH is somehow tacked on. Instead, BEMH helps us understand that the student as a person is at the center of the study of medicine: they will be interacting with other people who are patients, and the distinction between “hard” and “soft” skills disappears.

“The human side of medicine” becomes human beings practicing medicine.

Sources

The article reviewed: Liu, Emily Yang, Jason Neil Batten, Sylvia Bereknyei Merrell, and Audrey Shafer. 2018. “The Long-Term Impact Of A Comprehensive Scholarly Concentration Program In Biomedical Ethics And Medical Humanities”. BMC Medical Education 18 (1). https://doi.org/10.1186/s12909-018-1311-2.

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