Cheryl L. McLean,
Among the fundamental principles of humanistic medicine or values based medicine are open communication, mutual respect and relationship centred care. There is a growing trend toward integrating the arts in medical education and programming to help address these humanistic needs."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)
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.”
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, http://health-humanities.com/ )
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. At Yale School of Medicine, The Yale Medical Humanities and the Arts Council is committed to fostering the use of the humanities, social sciences, and the arts as a lens for examining issues in health, medicine, and healing. Arts& Humanities at Harvard Medical School aims to promote the role of the humanities in medical education, clinical care and research. A recent survey of the Harvard Medical School Community assessed the level of interest in the role of art, literature, music and theatre in medical education and patient care. After obtaining IRB approval, the survey was sent out to 13,512 faculty, trainees and students. Preliminary student responses were presented at the Harvard Academy Medical Education Day and showed that 72 percent of students who responded participate in the arts and 69 percent would support a formal program to integrate the arts into the medical school curriculum."
The Centre for Medical Humanities at Durham U.K. offers a research programme organized around five research clusters, Imagination and Creativity; Practice and Practitioner; Policy Politics Collective; Transfiguring and Mind Body Affect.
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.”
The International Journal of The Creative Arts in Interdisciplinary Practice IJCAIP Published by Cheryl L. McLean is an international open access journal with a mission to publish and disseminate worldwide, quality information, research and knowledge about the creative arts in interdisciplinary research and practice. The web based open access academic journal is accessible to researchers, educators and students in over 15,000 libraries in 60 countries around the world including developing nations and has published several textbooks, among them the upcoming text book Creative Arts in Humane Medicine edited by McLean with publisher Brush Education, a provocative new text for medical educators developed in response to the growing need for resources in the arts and medicine. The edited volume explores the field internationally featuring illustrative examples of the arts in action in medical education and practice.
The IJCAIP journal frequently publishes peer reviewed research and articles featuring leaders active in the arts and medicine. In the issue, "Physicians Speak Out About Arts in Medicine", 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 ..”
There are other international events that demonstrate growing support and advocacy for educational programming at the intersections of the arts and medicine. The AMSA (American Medical Students' Association) Academy has been established by and for students, a training ground for physician leaders empowering medical students to affect change in medicine. AMSA has over 150 chapters in medical schools across the country and an estimated 350 pre-med chapters. This translates into more than 68,000 members, including medical and premedical students, residents and practicing physicians. In a recent interview for the upcoming book, "Creative Arts in Humane Medicine" Aliye Runyan M.D., Education and Research Fellow, American Medical Student Association, reported The AMSA has a history of leadership advocating for the humanities in medical education. Just one example is The Medical Humanities Scholars' Program. "The Medical Humanities Scholars' Program," reports Runyan, "exposes students to lead faculty in narrative medicine, humanities and the arts as they explore reflective capacity, communication, self care and the art of listening to their patients' stories. Cheryl McLean will be a guest facilitator for the upcoming AMSA webinar, March 21, "Arts Alive and Thriving in Medical Education", part of the AMSA Medical Humanities Scholars' "Perceptions of Physicians in Literature and the Arts" series.
Generally speaking many of these trends in programming reflect a renewed interest in the arts and medicine as it relates to human communication.
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 the upcoming book 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 educators, students and others interested in using the arts in education to help contribute toward a more caring and empathic approach to medicine and practice.
Cheryl L. McLean, Editor