Sunday, November 11, 2012

Creative Arts in Medical Education Programming Contributes toward Humane Medicine

Cheryl L. McLean, 

Publisher,International Journal of the Creative Arts in Interdisciplinary Practice

Among the fundamental principles of humanistic medicine or values based medicine are open communication, mutual respect and relationship centred care.  The creative arts can play a critical and important role in fostering humane medicine in medical education and in practice.   

"In the US, a recent study found that over half of all US medical schools involved the arts in learning activities (Rodenhauser, Strickland, & Gambala,2004)  to help  foster student well-being, enhance teaching and learning, and improve clinical and relational skills, for example, observation and diagnostic skills, reflection and insight." ( Excerpt from the article by Pamela Brett-MacLean Ph.D. Use of the Arts in Medical and Health Professional Education, University of Alberta Health Sciences Journal • September 2007 • Volume 4 • Issue 1)

Programs integrating the arts and humanities in medical education continue to flourish and gain momentum with leading medical schools and universities offering programming such as Stanford School of Medicine, Arts, Humanities and Medicine, established to “promote creative and scholarly work at the intersections between the arts, humanities and medicine in order to enhance understanding of the contextual meanings of illness, healthcare, and the human condition”,  and The Centre for Medical Humanities at Durham U.K. with a research programme organized around five research clusters,  Imagination and Creativity; Practice and Practitioner; Policy Politics Collective; Transfiguring and Mind Body Affect.

In Canada, Dalhousie University, Halifax, Humanities in Medicine, offers five core initiatives: History of Medicine; Narrative Medicine (oral storytelling film, mass media, and literature); Music; Spirituality; and Visual Arts.  The Arts and Humanities in Health and Medicine Program at the University of Alberta was launched in May 2006. The program is directed to engendering a balance of scientific knowledge and compassionate care with a mission statement that formally acknowledges “the explicit recognition within the Faculty that clinical practice is both an art and a science.”

The arts can offer creative opportunities for learning and a place for self expression and healing. A leader in the field of Narrative Medicine, Dr. Rita Charon, Professor of Clinical Medicine and Director of the Program in Narrative Medicine at Columbia University has long advocated for the use of narrative in medical education to honour stories of illness. Dr. Arthur Frank, Professor of Sociology, University of Calgary, and author of “The Wounded Storyteller, Body, Illness and Ethics”, writes about the meaningful uses of storytelling for those experiencing illness, “The personal issue of telling stories about illness is to give voice to the body, so the changed body can become once again familiar in these stories.”

At the University of Toronto, the Undergraduate Medical Education (UME) Program has begun a systematic integration of different types of narrative into the curriculum with a new Companion Curriculum which offers support to the empathic or “moral imagination”, and allows students to consider the internal experiences of patients,  families, other students and healthcare professional (see Health, Arts and Humanities Programme, University of Toronto,

In the article, "Physicians Speak Out About Arts in Medicine", published in The International Journal of The Creative Arts in Interdisciplinary Practice,  physicians were offered the opportunity to voice their stories and share examples of how they use the arts in medical education.

The article “Stories and Society, Using Literature to Teach Medical Students About Public Health and Social Justice,” was contributed by Martin Donohoe, MD, FACP, Adjunct Associate Professor, School of Community Health, Portland State University and Senior Physician of Internal Medicine at The Kaiser Sunnyside Medical Centre.  Donohoe offered an argument for “enhancing public health education of medical students through the use of literature with the goal of creating activist physicians knowledgeable about, and eager to confront, the social, economic and cultural contributions to illness”.  

In the same issue Dr. Maureen Rappaport reported on the creative writing course she teaches as an elective to fourth year medical students at McGill University, a course that provides an important place for students to express feelings through narratives and poetry.

Physician and Educator Dr. Pippa Hall at The University of Ottawa, has been a palliative care physician for over ten years integrating arts into learning activities for pre-licensure students and in post graduate programs as well as in continuing professional development activities in nursing and spiritual care. She explained how she found the arts in many forms provided opportunities for learning while offering new insights into the human condition.

 The International Journal of the Creative Arts in Interdisciplinary Practice IJCAIP also explored the exciting potential for other innovative and creative technologies incorporated into teaching and medical education. Kim Bullock, MD, family medicine and emergency room physician, and Director of the Community Health Division and Assistant Director of Service Learning in the Department of Family Medicine at Georgetown University, Medical Centre, Washington reported she believes digital storytelling in medical education has the potential to “link the social, environmental, and historical issues that influence health and illness through graphics”. “What emerges,” she writes, “are voices from the community that bear witness to issues that influence health including problems related to the environment, housing, public safety violence, inequities ..”

Human communication,  has been recognized as increasingly important in medical education.  According to a recent article in Family Medicine, "the Association of American Medical Colleges, the US Liaison Committee on Medical Education, the Committee on Accreditation of Canadian Medical Schools, the Accreditation Council for Graduate Medical Education have called for medical educators to carefully define, teach, and evaluate communications skills for physicians in training." (Haq, Steele, Marchand, Seibert, Brody, Family Medicine,Vol. 36)

With new emphasis on communication, mutual respect and relationship building,  be it interprofessionally or between physicians and patients, Creative Arts in Humane Medicine will be a topical resource for  educators in the Medical Humanities, Public Health, Health Promotion, Social Work and the Social Services providing helpful examples for others interested in using the arts in education to help contribute toward a more caring and empathic approach to practice.

 Creative Arts in Humane Medicine, a new text for medical educators, has been developed in response to the growing need for resources in the arts and medicine.  The book explores the field internationally and features illustrative examples of the arts in action in medical education and practice. 
The groundbreaking book, scheduled for release in 2013,  is a project of The International Journal of the Creative Arts in Interdisciplinary Practice IJCAIP edited by Cheryl L. McLean and published by Brush Education Inc.