050506 Turku 1 Workshop II C IIC Humanities work in basic medical education - What about in GP training? Martina Torppa (Finland) Monica Lindh (Sweden)

050506 Turku 050506 Turku 11Workshop II CWorkshop II C

IICIIC

Humanities work in basic Humanities work in basic medical education - What about medical education - What about

in GP training?in GP training?

Martina Torppa (Finland)Martina Torppa (Finland)Monica Lindh (Sweden) Monica Lindh (Sweden)

Fergus D.O.Kelly (Ireland)Fergus D.O.Kelly (Ireland)+ Aino-Maija Lahtinen, Elisa Laaksamo and + Aino-Maija Lahtinen, Elisa Laaksamo and

Jenny TakalaJenny Takala

050506 Turku 050506 Turku Workshop II CWorkshop II C 22

Workshop structureWorkshop structure

• “Medicine and the essence of humanity” – study module

• International experiences

• Educational agenda

• Group work

• Discussion

• Conclusion


““Medicine and the essence of Medicine and the essence of humanity” – study modulehumanity” – study module

Martina TorppaGP, Adm. competency

Chief physician / Clinical lecturerHealth Centre of Helsinki (Malmi)/

University of Helsinki, Faculty of Medicine, Research & Development Unit for Medical Education


Medical Humanities – is there a Medical Humanities – is there a need for it?need for it?

• Medical education is biomedicine dominated?• biomedicine prepares us well enough for

clinical work?

• The role of art and humanities based knowledge in medical education? in CPD?

Martina Torppa


““MedicineMedicine and the essence of and the essence of humanity” – study modulehumanity” – study module

• autumn 2004• voluntary study module, University of Helsinki, Faculty of

Medicine, Department of Public Health, Section of General Practice

• open for all medical students in the faculty

• 6 seminars, learning journals and reflective essays• 7 students participated• data collected for research purposes

Martina Torppa


’’Principles’Principles’

• To explore medicine and medical practice from multiple perspectives– historical and social contexts of medicine– insights into human being

– experiential learning

Martina Torppa


The six seminarsThe six seminars

• History of medicine• Pastoral theology• Philosophy• Literature• Painting • Drama

Martina Torppa


Two learning experiencesTwo learning experiences

Jenny – DramaJenny – DramaElisa - LiteratureElisa - Literature


Drama and Medicine – What on Drama and Medicine – What on earth do they have in common, earth do they have in common, other than the tv-series ER?other than the tv-series ER?

Jenny Takala Jenny Takala Bachelor of medicineBachelor of medicine

Faculty of Medicine, University of HelsinkiFaculty of Medicine, University of Helsinki

Jenny Takala


Medical Humanities and Medical Humanities and a lesson in Dramaa lesson in Drama

Jenny Takala


Four tasksFour tasks

Jenny Takala


ListeningListening

Jenny Takala


Literature and medicine – to Literature and medicine – to read or not to read?read or not to read?

Elisa LaaksamoElisa Laaksamo

2nd year Medical student2nd year Medical student

Faculty of Medicine, University of HelsinkiFaculty of Medicine, University of Helsinki


How did we start?How did we start?

• Our reading histories

• The texts that we remember are probably the ones which have most affected us.

• A reader can learn much (about the story etc.).

• Reading can be associated with things actual in one’s own life.

Marja-Liisa Vartio

Hänen olivat linnut (1967)Elisa Laaksamo


What did we read?What did we read?

• Kafka – First Sorrow

Elisa Laaksamo


What I learned in this courseWhat I learned in this course and how could it help me in my development as a and how could it help me in my development as a

medical student?medical student?

• Art

• Interpretation skills

• Listening, hearing, dialogue

Elisa Laaksamo


International experiencesInternational experiences

SwedenSweden


Humanities in Medical Humanities in Medical Education – Swedish Education – Swedish

experiences experiences

Presentation at Duodecim/EURACT Conference 5 May 2006, Turku Finland

Dr Monica Lindh Family Practitioner Hofors Health

Centre & Director of Vocational Training in GP/FM Gästrikland, Sweden

E-mail: [email protected]


Medical Humanities – Medical Humanities – Basic Medical EducationBasic Medical Education

Examples

• “Professional development“Ongoing theme from term 1

Ethics, consultation, roles, leadership, philosophy

• Reading literature/novels

• Using hero of novel in MEQ-assessment

• Elective courses “Life, love and death – culture and biology in

medical care”“Text studies and creative writing”

(interdisciplinary) M Lindh-06


Medical Humanities – Medical Humanities – Internship Internship

Examples

• Sessions with hospital priest - “comfort”, ethics

Fixed small group, for 21 months

• Leadership-training

• Consultation skills – use of actors

• “evening events” lecture + social activity eg theatre, museum

M

Lindh-06


Medical Humanities – Medical Humanities – Vocational training (1)Vocational training (1)

Examples

• Leadership-training:ethics & priorities, law, communication, rhetoric

• Consultation-skills: video, role-play, actors

• Seminars: “the personal doctor”body and soul literature and medicine

history of medicine M Lindh-06


Medical Humanities – Medical Humanities – Vocational training (2)Vocational training (2)

Examples

• 3-day mountain trip, annual“lectures”, discussion, reflection, story-telling

• Literature and writing course by Prof Merete Mazzarella, Finland

• Balint-group

• Reading novels M

Lindh-06


Medical Humanities Institution Medical Humanities Institution - Sweden - Sweden

Example

• Humanistic Medicine at Centre for Bioethics

At LIME www.lime.ki.se

Interdisciplinary, inter-and cross-professional

Education and research

History of medical ideas, social science, literature, arts, ethnology, philosophy, ethics, religion

M Lindh-06


HUMANITIES IN MEDICAL EDUCATION IN HUMANITIES IN MEDICAL EDUCATION IN SWEDEN - REFERENCESSWEDEN - REFERENCES

• Ahlzén R. The doctor and the literary text – potentials and pitfall.Med Health Care Philos. 2002;5:147-55.• AhlzenR, Stolt CM. The Humanistic Medicine Program at the Karolinska Institute, Stockholm, Sweden.

Academic Medicine. Special Theme: Humanities Education. 2003 Oct;78(10):1039-42.• Hellquist G, Rödjer S, von Below B, Sveinsdóttir G, Björkelund C. Tidig yrkeskontakt stärker

studenternas professionella utveckling. TYK - en ny kurs i läkarutbildningen i Göteborg. [Early professional contact supports professsional development of medical students. EPC - a new course in

• medical education in Göteborg].Läkartidningen 2005;102:2646-51.

• Håkansson A, Haffling AC, Beckman A, Jakobsson K, Löwenhielm P. Romanfigurer ger liv åt tentans patientfall.Läkartidningen 2003;43:3425-7

• Petersson C. Litteratur och läkekonst. Skönlitteraturen en genväg till den motsägelsefulla människan. Läkartidningen 2005;102:2414-6.

• Stolt CM. Vad är humanistisk medicin? [What is medical humanities?].Ugeskrift for Laeger. 2000;162/51:6995-7.

• Tidsskrift for Den norske laegeforening 2000;30:3736-8. [Danish Med Bull. 2000;162/51:6995-7, also published in J Norwegian Med Association 2000;30:3736-8].

• Stolt CM. "Medicinen och det mänskliga. Vårdkonst och vardagsetik. Humanism och humaniora" [Medicine and the Human. The art of caring and every day ethics, humanism and the arts] Natur och Kultur, Stockholm 2003.

• Stolt CM. Medicin och lyrik. Vetenskapens språk räcker inte. [Medicine and Poetry. Scientific language is not enough].Läkartidningen 2003;51-52:4308-17.

• Stolt CM. Poetry and Medicine.European Journal of Clinical Hypnosis 2005; 6 (3): 38-42• Wachtler C, Lundin S, Troein M. Humanities for medical students? A qualitative study of a medical

humanities curriculum in a medical school program.BMC Med Educ. 2006 Mar 6;6:16. MLindh-06


International experiencesInternational experiences

IrelandIreland


““In my Father’s In my Father’s time”time”

Humanities and medical educationHumanities and medical education

Fergus O’KellyFergus O’Kelly

(EURACT – Ireland)(EURACT – Ireland)


Story TellingStory Telling


SeannachiSeannachi


““Half-Term break”: Half-Term break”: by by Seamus HeaneySeamus Heaney

I sat all morning in the college sick bay I sat all morning in the college sick bay Counting bells knelling classes to a close. Counting bells knelling classes to a close. At two o'clock our neighbors drove me At two o'clock our neighbors drove me home. home.

In the porch I met my father crying-- In the porch I met my father crying-- He had always taken funerals in his stride-- He had always taken funerals in his stride-- And Big Jim Evans saying it was a hard And Big Jim Evans saying it was a hard blow.blow.


The baby cooed and laughed and rocked The baby cooed and laughed and rocked the pram When I came in, and I was the pram When I came in, and I was embarrassed embarrassed By old men standing up to shake my handBy old men standing up to shake my hand

And tell me they were "sorry for my And tell me they were "sorry for my trouble," Whispers informed strangers I trouble," Whispers informed strangers I was the eldest,was the eldest,Away at school, as my mother held my Away at school, as my mother held my hand hand

In hers and coughed out angry tearless In hers and coughed out angry tearless sighs.sighs.At ten o'clock the ambulance arrived At ten o'clock the ambulance arrived With the corpse, stanched and bandaged With the corpse, stanched and bandaged by the nurses. by the nurses.


Next morning I went up into the room. Next morning I went up into the room. Snowdrops Snowdrops And candles soothed the bedside;I saw him And candles soothed the bedside;I saw him For the first time in six weeks. Paler now, For the first time in six weeks. Paler now,

Wearing a poppy bruise on his left temple, Wearing a poppy bruise on his left temple, He lay in the four foot box as in his cot. No He lay in the four foot box as in his cot. No gaudy scars, the bumper knocked him gaudy scars, the bumper knocked him clear. clear.

A four foot box, a foot for every year.A four foot box, a foot for every year.


Educational agendaEducational agenda


EURACT Educational Agenda - EURACT Educational Agenda - background background

What is a GP?• The new European Definition of Family Medicine.

How to become a GP?• EURACT Educational Agenda, 2005• Framework and ”manual” for teaching & learning,

VT• Objectives, learning methods, assessment tools

M Lindh-06


EURACT Educational Agenda – EURACT Educational Agenda – (1)(1)

Six Core Competences

• Primary Care Management • Person Centredness • Specific Problem Solving Skills• Comprehensive Approach• Community Orientation• Holistic Approach

M

Lindh-06


EURACT Educational Agenda – EURACT Educational Agenda – (2)(2)

Three Essential Application Features

• Contextual Aspects• Attitudinal Aspects• Scientific Aspects

Synthesis and integration,

the unique combination M

Lindh-06


Questions for the groupsQuestions for the groups

1) Art and humanities in GP training – is there any need? -why? or why not?

2) Art and humanities in GP training - how?

3) Educational agenda in relation to art and humanities?

4) Free comments / ideas


Group 1Group 1

Why: understanding patients’ culture, religion, background – holistic approach

How: experiential learning, evoking feelings in group members important, best in small groups


Group 2Group 2

• Medicine is an art, built on science.• There is a need, because you can’t measure everything• Not everything that counts can be counted and not

everything that can be counted counts.• Find a way to handle difficult issues in multiprofessional

and safe platform

• Also an aim of medical education: to develop an integrative personality


Group 3Group 3

• Three E and one C – Empathy– Experience– Empowerment

– Empowerment to help people grow. Culture of listening relate to our roots.


Group 4Group 4

• What is humanity? The mechanical model versus humanistic attitude in training. Students in general assume doctors to be "biomedical professionals" and that humanistic attitude is weakness?

• Universities teach mechanical problem solving to future doctors?

• Students expect to be taught to be experts in biomedicine…(?)

• Young doctors appear to be uncertain of themeselves -> they ’escape’ to ’biomedicine’


Reflections on the workshopReflections on the workshop

• Positive experience for med students who ‘lectured’ for medical teachers

• Medical teachers can learn from students - involve them!

• A question: …why do we become doctors…?

• We should not forget the ‘non-believers’! – or is this a matter of believing…or perhaps a call for philosophical debate…

• What is medicine – how do we define medicine?• Medical knowledge – how is it constructed?


ConclusionsConclusions (mt)(mt)

• There seems to be a need for art and humanities in GP training.

• Why: holistic approach, tools needed to handle difficult issues and the ’unmeasurable’ in clinical work

• How: in small groups, experiential learning, evoking and

reflecting feelings, sharing


Thank you! - Kiitos!Thank you! - Kiitos!

Documents

050506 Turku 1 Workshop II C IIC Humanities work in basic medical education - What about in GP training? Martina Torppa (Finland) Monica Lindh (Sweden)