Skip to main content
SpringerLink
Log in

Steps Toward Building a Culture of Humanistic Teaching and Medical Practice

  • Chapter
  • First Online:
Humanism and Resilience in Residency Training

Abstract

In this chapter, the authors explore historical perspectives that support the integration of humanism into medicine as well as contemporary challenges to its implementation in medical education. This chapter provides definitions of humanism in medicine, with an emphasis on its application to systems of teaching, care, and institutional culture. The authors also provide practical examples of humanistic curricula, including suggestions for evaluating its outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

Notes

  1. 1.

    Stern and colleagues refer specifically to “evaluation,” a term generally used to describe summative examinations of student knowledge [19]. In this chapter, this term has been replaced with “assessment” due to the growing recognition that skill acquisition is enhanced when student receive frequent and formative feedback.

  2. 2.

    Note that educators often use the same or similar assessment tools to measure professionalism and humanism, likely due to the overlap between the two constructs [5, 21, 43]. While tools that measure professionalism are a good starting point, they may have lower construct validity than tools that measure humanism more directly.

References

  1. Dornan T. Osler, Flexner, apprenticeship and ‘the new medical education’. J R Soc Med. 2005;98(3):91–5.

    PubMed  PubMed Central  Google Scholar 

  2. Gilligan MC, Osterberg LG, Rider EA, Derse AR, Weil AB, Litzelman DK, et al. Views of institutional leaders on maintaining humanism in today’s practice. Patient Educ Couns. 2019;102(10):1911–6.

    Article  PubMed  Google Scholar 

  3. Mezzich JE. Psychiatry for the person: articulating medicine’s science and humanism. World Psychiatry. 2007;6(2):65–7.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Schattner A. The essence of humanistic medicine. QJM. 2020;113:3–4.

    Article  PubMed  Google Scholar 

  5. Cohen JJ. Linking professionalism to humanism: what it means, why it matters. Acad Med. 2007;82(11):1029–32.

    Article  PubMed  Google Scholar 

  6. Vogt H, Ulvestad E, Eriksen TE, Getz L. Getting personal: can systems medicine integrate scientific and humanistic conceptions of the patient? J Eval Clin Pract. 2014;20(6):942–52.

    Article  PubMed  Google Scholar 

  7. Holmboe ES, Edgar L, Hamstra S. ACGME. The milestones guidebook; 2016. https://www.acgme.org/Portals/0/MilestonesGuidebook.pdf. Accessed Dec 30, 2019.

  8. Frank JR, Snell L, Sherbino J. Royal College of Physicians and Surgeons of Canada. CanMEDS 2015 physician competency framework; 2015. http://canmeds.royalcollege.ca/uploads/en/framework/CanMEDS%202015%20Framework_EN_Reduced.pdf. Accessed Dec 30, 2019.

  9. Journal of the American Medical Association. Of science, humanism, and medicine. J Am Med Assoc. 2015;314(7):734.

    Article  Google Scholar 

  10. Schwartz MA, Wiggins O. Science, humanism, and the nature of medical practice: a phenomenological view. Perspect Biol Med. 1985;28(3):331–61.

    Article  CAS  PubMed  Google Scholar 

  11. Rider EA, Gilligan MC, Osterberg LG, Litzelman DK, Plews-Ogan M, Weil AB, et al. Healthcare at the crossroads: the need to shape an organizational culture of humanistic teaching and practice. J Gen Intern Med. 2018;33(7):1092–9.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Engel GL. The clinical application of the biopsychosocial model. Am J Psychiatry. 1980;137(5):535–44.

    Article  CAS  PubMed  Google Scholar 

  13. Ferry-Danini J. A new path for humanistic medicine. Theor Med Bioeth. 2018;39(1):57–77.

    Article  PubMed  Google Scholar 

  14. Bakker D. Humanistic teaching in practice. In: Veugelers W, editor. Education and humanism. Boston: Sense Publishers; 2011.

    Google Scholar 

  15. Cole T, Carlin N. Faculty health and the crisis of meaning: humanistic diagnosis and treatment. In: Cole TR, Goodrich TJ, Gritz ER, editors. Faculty health in academic medicine. Totowa: Humana Press; 2009.

    Chapter  Google Scholar 

  16. Kristeva J, Moro MR, Ødemark J, Engebretsen E. Cultural crossings of care: an appeal to the medical humanities. Med Humanit. 2017;44(1):55–8.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Martimianakis MA, Michalec B, Lam J, Cartmill C, Taylor J, Hafferty F. Humanism, the hidden curriculum, and educational reform: a scoping review and thematic analysis. Acad Med. 2015;90(11):S5–S13.

    Article  PubMed  Google Scholar 

  18. Peters D, Horn C, Gishen F. Ensuring our future doctors are resilient. Br Med J. 2018;362:k2877.

    Article  Google Scholar 

  19. Kilpatrick AO. The health care leader as humanist. J Health Hum Serv Adm. 2009;31(4):451–65.

    PubMed  Google Scholar 

  20. Kitson A, Marshall A, Bassett K, Zeitz K. What are the core elements of patient-centred care? A narrative review and synthesis of the literature from health policy, medicine and nursing. J Adv Nurs. 2013;69(1):4–15.

    Article  PubMed  Google Scholar 

  21. Stern DT, Cohen JJ, Bruder A, Packer B, Sole A. Teaching humanism. Perspect Biol Med. 2008;51(4):495–507.

    Article  PubMed  Google Scholar 

  22. Weissmann PF, Branch WTJ, Gracey CF, Haidet P, Frankel RM. Role modeling humanistic behavior: learning beside manner from the experts. Acad Med. 2006;81(7):661–7.

    Article  PubMed  Google Scholar 

  23. Lin KY, Anspach RR, Crawford B, Parnami S, Fuhrel-Forbis A, De Vries RG. What must I do to succeed? Narratives from the US premedical experience. Soc Sci Med. 2014;119:98–105.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Gawande A. Complications: a surgeon’s notes on an imperfect science. New York: Picador; 2010.

    Google Scholar 

  25. Freud S. Fragments of an analysis of a case of hysteria. London: Vintage; 1905.

    Google Scholar 

  26. Wald HS, Anthony D, Hutchinson TA, Liben S, Smilovitch M, Donato AA. Professional identity formation in medical education for humanistic, resilient physicians: pedagogic strategies for bridging theory to practice. Acad Med. 2015;90(6):753–60.

    Article  PubMed  Google Scholar 

  27. Branch WTJ, Frankel RM, Hafler JP, et al. A multi-institutional longitudinal faculty development program in humanism supports the professional development of faculty teachers. Acad Med. 2017;92(12):1680–6.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Cox SM, Brett-MacLean P, Courneya CA. “My turbinado sugar”: art-making, well-being and professional identity in medical education. Arts Health. 2016;8(1):65–81.

    Article  Google Scholar 

  29. Zazulak J, Halgren C, Tan M, Grierson LEM. The impact of an arts-based programme on the affective and cognitive components of empathic development. Med Humanit. 2015;41(1):69–74.

    Article  PubMed  Google Scholar 

  30. Zazulak J, Sanaee M, Frolic A, et al. The art of medicine: arts-based training in observation and mindfulness for fostering the empathic response in medical residents. Med Humanit. 2017;43(3):192–8.

    Article  PubMed  Google Scholar 

  31. des Ordons ALR, de Groot JM, Rosenal T, Viceer N, Nixon L. How clinicians integrate humanism in their clinical workplace—‘just trying to put myself in their human being shoes’. Perspect Med Educ. 2018;7(5):318–24.

    Article  Google Scholar 

  32. Bevan MT. A method of phenomenological interviewing. Qual Health Res. 2014;24(1):136–44.

    Article  PubMed  Google Scholar 

  33. Davidsen AS. Phenomenological approaches in psychological and health sciences. Qual Res Psychol. 2013;10(3):318–39.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Öhlen J. Evocation of meaning through poetic condensation of narratives in empirical phenomenological inquiry into human suffering. Qual Health Res. 2003;13(4):557–66.

    Article  PubMed  Google Scholar 

  35. Englander M. The phenomenological method in qualitative psychology and psychiatry. Int J Qual Stud Health Well-being. 2016;11:30682.

    Article  PubMed  Google Scholar 

  36. American Psychiatric Association. Resource document: advocacy teaching in psychiatry residency training programs; 2018.

    Google Scholar 

  37. Minkovitz CS, Goldshore M, Solomon BS, Guyer B, Grason H. Five-year follow-up of community pediatrics training initiative. Pediatrics. 2014;134(1):83–90.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Miller SZ, Schmidt HJ. The habit of humanism: a framework for making humanistic care a reflexive clinical skill. Acad Med. 1999;74(7):800–3.

    Article  CAS  PubMed  Google Scholar 

  39. Pfeiffer S, Chen Y, Tsai D. Progress integrating medical humanities into medical education: a global overview. Curr Opin Psychiatry. 2016;29(5):298–301.

    Article  PubMed  Google Scholar 

  40. Swendiman RA, Marcaccio CL, Han J, et al. Attitudes and habits of highly humanistic surgeons: a single-institution, mixed-methods study. Acad Med. 2019;94(7):1027–32.

    Article  PubMed  Google Scholar 

  41. Chou CM, Kellom K, Shea J. Attitudes and habits of highly humanistic physicians. Acad Med. 2014;89(9):1252–8.

    Article  PubMed  Google Scholar 

  42. Beresin EV, Milligan TA, Balon R, Coverdale JH, Louie AK, Roberts LW. Physician wellbeing: a critical deficiency in resilience education and training. Acad Psychiatry. 2016;40(1):9–12.

    Article  PubMed  Google Scholar 

  43. Buck E, Holden M, Szauter K. A methodological review of the assessment of humanism in medical students. Acad Med. 2015;90(11):S14–23.

    Article  PubMed  Google Scholar 

  44. Eva KW, Regehr G. Self-assessment in the health professions: a reformulation and research agenda. Acad Med. 2005;80(10 Suppl):S46–54.

    Article  PubMed  Google Scholar 

  45. Cohen LG, Sherif YA. Twelve tips on teaching and learning humanism in medical education. Med Teach. 2014;36(8):680–4.

    Article  PubMed  Google Scholar 

  46. Frank JR, Snell LS, Ten Cate O, et al. Competency-based medical education: theory to practice. Med Teach. 2010;32(8):638–45.

    Article  PubMed  Google Scholar 

  47. Friedman HL, MacDonald DA. Humanistic teaching and assessment. J Humanist Psychol. 2006;46(4):510–29.

    Article  Google Scholar 

  48. Schut S, Driessen E, van Tartwijk J, van der Vleuten C, Heeneman S. Stakes in the eye of the beholder: an international study of learners’ perceptions within programmatic assessment. Med Educ. 2018;52(6):654–63.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Driessen E. Do portfolios have a future? Adv Health Sci Educ. 2017;22(1):221–8.

    Article  Google Scholar 

  50. Driessen E, Van Tartwijk J, Van Der Vleuten C, Wass V. Portfolios in medical education: why do they meet with mixed success? A systematic review. Med Educ. 2007;41(12):1224–33.

    Article  PubMed  Google Scholar 

  51. Canales C, Strom S, Anderson CT, et al. Humanistic medicine in anaesthesiology: development and assessment of a curriculum in humanism for postgraduate anaesthesiology trainees. Br J Anaesth. 2019;123:887–97.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Yardley S, Dornan T. Kirkpatrick’s levels and education ‘evidence’. Med Educ. 2011;46(1):97–106.

    Article  Google Scholar 

  53. Frye AW, Hemmer PA. Program evaluation models and related theories: AMEE guide no. 67. Med Teach. 2012;34(5):e288–e99.

    Article  PubMed  Google Scholar 

  54. Haji F, Morin M-P, Parker K. Rethinking programme evaluation in health professions education: beyond ‘did it work?’. Med Educ. 2013;47(4):342–51.

    Article  PubMed  Google Scholar 

  55. Fornari A, Tortez LM, Lay M, et al. A mixed-methods approach to humanistic interprofessional faculty development. J Contin Educ Health Prof. 2018;38(1):66–72.

    Article  PubMed  Google Scholar 

  56. Blatt B, Plack M, Simmens S. Preparing interprofessional faculty to be humanistic mentors for medical students: the GW-Gold mentor development program. J Contin Educ Health Prof. 2018;38(2):117–25.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. McMaster Children’s Hospital, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada

    Sheila Harms

  2. Department of Psychology, Neuroscience & Behaviour and Office of Education Science, Department of Surgery, Hamilton, ON, Canada

    Anita Acai

Authors
  1. Sheila Harms
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anita Acai
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sheila Harms .

Editor information

Editors and Affiliations

  1. Department of Psychiatry and Behavioural Neurosciences, Division of Geriatric Psychiatry, Michael G. DeGroote School of Medicine, Faculty of Health Sciences, McMaster University, St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada

    Ana Hategan

  2. Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada

    Karen Saperson

  3. McMaster Children’s Hospital, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada

    Sheila Harms

  4. Faculty of Health Sciences, McMaster University, Department of Family Medicine, Hamilton, ON, Canada

    Heather Waters

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Harms, S., Acai, A. (2020). Steps Toward Building a Culture of Humanistic Teaching and Medical Practice. In: Hategan, A., Saperson, K., Harms, S., Waters, H. (eds) Humanism and Resilience in Residency Training. Springer, Cham. https://doi.org/10.1007/978-3-030-45627-6_16

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-45627-6_16

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-45626-9

  • Online ISBN: 978-3-030-45627-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation