IIC Humanities work in basic medical education - What about in GP training?

1. IICHumanities work in basic medical education - What about in GP training? Martina Torppa (Finland) Monica Lindh (Sweden) Fergus D.O.Kelly (Ireland) + Aino-Maija Lahtinen, Elisa Laaksamo and Jenny Takala Workshop II C

2. Workshop structure • “Medicine and the essence of humanity” – study module • International experiences • Educational agenda • Group work • Discussion • Conclusion Workshop II C

3. “Medicine and the essence of humanity” – study module Martina Torppa GP, Adm. competency Chief physician / Clinical lecturer Health Centre of Helsinki (Malmi)/ University of Helsinki, Faculty of Medicine, Research & Development Unit for Medical Education Workshop II C

4. Medical Humanities – is there a 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? Workshop II C Martina Torppa

5. “Medicineand the essence of humanity” – 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 Workshop II C Martina Torppa

6. ’Principles’ • To explore medicine and medical practice from multiple perspectives • historical and social contexts of medicine • insights into human being • experiential learning Workshop II C Martina Torppa

7. The six seminars • History of medicine • Pastoral theology • Philosophy • Literature • Painting • Drama Workshop II C Martina Torppa

8. Two learning experiencesJenny – DramaElisa - Literature Workshop II C

9. Drama and Medicine – What on earth do they have in common, other than the tv-series ER? Jenny Takala Bachelor of medicine Faculty of Medicine, University of Helsinki Workshop II C Jenny Takala

10. Medical Humanities and a lesson in Drama Workshop II C Jenny Takala

11. Four tasks Workshop II C Jenny Takala

12. Listening Workshop II C Jenny Takala

13. Literature and medicine – to read or not to read? Elisa Laaksamo 2nd year Medical student Faculty of Medicine, University of Helsinki Workshop II C

14. 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) Workshop II C Elisa Laaksamo

15. What did we read? • Kafka – First Sorrow Workshop II C Elisa Laaksamo

16. What I learned in this courseand how could it help me in my development as a medical student? • Art • Interpretation skills • Listening, hearing, dialogue Workshop II C Elisa Laaksamo

17. International experiences Sweden Workshop II C

18. Humanities in Medical Education – Swedish 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: monica.lindh@lg.se Workshop II C

19. Medical Humanities – Basic 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 Workshop II C

20. Medical Humanities – 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 Workshop II C

21. Medical Humanities – 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 medicineM Lindh-06 Workshop II C

22. Medical Humanities – 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 novelsM Lindh-06 Workshop II C

23. Medical Humanities Institution - 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, religionM Lindh-06 Workshop II C

24. HUMANITIES IN MEDICAL EDUCATION IN SWEDEN - 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 thearts] 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 Workshop II C

25. International experiences Ireland Workshop II C

26. “In my Father’s time” Humanities and medical education Fergus O’Kelly (EURACT – Ireland) Workshop II C

27. Story Telling Workshop II C

28. Seannachi Workshop II C

29. “Half-Term break”: by Seamus Heaney I sat all morning in the college sick bay Counting bells knelling classes to a close. At two o'clock our neighbors drove me home. In the porch I met my father crying-- He had always taken funerals in his stride-- And Big Jim Evans saying it was a hard blow. Workshop II C

30. The baby cooed and laughed and rocked the pram When I came in, and I was embarrassed By old men standing up to shake my hand And tell me they were "sorry for my trouble," Whispers informed strangers I was the eldest, Away at school, as my mother held my hand In hers and coughed out angry tearless sighs. At ten o'clock the ambulance arrived With the corpse, stanched and bandaged by the nurses. Workshop II C

31. Next morning I went up into the room. Snowdrops And candles soothed the bedside;I saw him For the first time in six weeks. Paler now, Wearing a poppy bruise on his left temple, He lay in the four foot box as in his cot. No gaudy scars, the bumper knocked him clear. A four foot box, a foot for every year. Workshop II C

32. Educational agenda Workshop II C

33. EURACT Educational Agenda - 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 Workshop II C

34. EURACT Educational Agenda – (1) Six Core Competences • Primary Care Management • Person Centredness • Specific Problem Solving Skills • Comprehensive Approach • Community Orientation • Holistic Approach M Lindh-06 Workshop II C

35. EURACT Educational Agenda – (2) Three Essential Application Features • Contextual Aspects • Attitudinal Aspects • Scientific Aspects Synthesis and integration, the unique combination M Lindh-06 Workshop II C

36. Questions for the groups • Art and humanities in GP training – is there any need? -why? or why not? • Art and humanities in GP training - how? • Educational agenda in relation to art and humanities? 4) Free comments / ideas Workshop II C

37. Group 1 Why: understanding patients’ culture, religion, background – holistic approach How: experiential learning, evoking feelings in group members important, best in small groups Workshop II C

38. Group 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 Workshop II C

39. Group 3 • Three E and one C • Empathy • Experience • Empowerment • Empowerment to help people grow. Culture of listening relate to our roots. Workshop II C

40. Group 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’ Workshop II C

41. Reflections 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? Workshop II C

42. Conclusions(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 Workshop II C

43. Thank you! - Kiitos! Workshop II C