medical humanities louise younie. plan for the day food for thought painting dialogue and reflection...
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Medical Humanities
Louise Younie
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Plan for the day
Food for thoughtPaintingDialogue and reflectionClay-work
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Galumph
One, two! One, two! And through and through The vorpal blade went snicker-snack!He left it dead, and with its head He went galumphing back.
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We don’t see things as they are, we see them as we are
Anais Nin (1903-1977)
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Medical Humanities
What are medical humanities?What is their relevance to medical education?How have they been used?How can we use them?What might I try?
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Definition
The use of arts and humanities in medical education and research
Deborah Kirklin
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Areas
History of medicinePhilosophy of medicineEthicsTheology Visual and performing artsMusicLiterature
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Art
Respond to the created work of othersEngage actively with the creative process ourselves
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What is happening
Surgeon 1976 AustraliaInternationally since 1970’s Journals 1990’sMedical Humanities 2000Association for medical humanitiesConferences (Glasgow 9-10th July 07)
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The Times They Are A-Changin’
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UK
Tomorrow’s doctors 1993 (2002)Attitude and behaviour that are suitable for a Dr must be developedStudents should have time for personal reflection and personal growthStudents should be able to take account of patients’ own views and beliefs
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Examples from literature
Oxford LiteratureGlasgow 2000 artCambridge
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Bristol Medical School
Whole Year GroupsYear 1 GP creative writingYear 1 WPC element of HBoMYear 4 COMP2 “creative reflection”
Self Selected ComponentsYear 2 “Doctors in the Movies”Year 2 “Creative Arts in Health Care”Sporadic student-driven SSCsBA in medical humanities
GP Tutor educational development
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O lny srmat poelpe can raed tihs.
I cdnuolt blveiee taht I cluod aulaclty uesdnatnrd waht I was rdanieg. The phaonmneal pweor of the hmuan mnid! Aoccdrnig to a rscheearch at Cmabrigde Uinervtisy, it deosn't mttaer in waht oredr the ltteers in a wrod are, the olny iprmoatnt tihng is taht the frist and lsat ltteer be in the rghit pclae. Tihs is bcuseae the huamn mnid deos not raed ervey lteter by istlef, but the wrod as a wlohe.
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Left Brain
LogicalWords and languageMaths and scienceOrder/pattern perceptionAnalytical Rational Critical thinking
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Interpretation, Compassion
“I found it most liberating! It was interesting to see how everyone interpreted someone’s piece of art, poetry or literature” (Male2 diary)
“everyone is very different and… behind any façade there lies a wealth of individual thoughts and experiences… tolerance and compassion” (Female3 diary)
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Emotions, Understanding
“The process of writing a poem requires you to be very honest and it stirred up many emotions that have remained dormant” (Male2 diary)“Poetic or artistic expression is a means by which innermost thoughts and feelings are given form so that they can be viewed and interpreted by their creators and by others.” (Female3 diary)
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Reflection, Questioning
“…allows you to ..think as a different person..” (Female8 diary) “It has been a long time since I have actually felt ‘educated’. This is what I think this course has achieved, not only in broadening my views but in encouraging me to seek to educate myself and to increase my self-awareness…It has rejuvenated the philosophical part of me that questions life and its meaning” (Female3 diary)
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GP Tutors take a Haiku
Its cold outsideShe calmly presents the giftOf tears
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GP Tutors take a Haiku
Hard craggy edgeFeeling along the liver edge How do I tell you
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GP Tutors take a Haiku
Rushed time chasingGrab jumper front door slamsKeys still inside
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Drawing
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Hare brain, tortoise mind
See handout
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Therapeutic value
We will all be sick, suffer loss and hurt and die. Health is not to do with avoiding these givens but with accepting them, even making sense of them...If health is about adaptation, understanding and acceptance, then the arts may be more potent than anything that medicine has to offer…
Richard Smith BMJ 2002;325:1432-3
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Student film
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Conceptual ties
Systems thinkingSynthesise as well as analyseChaos theory Mental modelsMetaphor
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Education
Education must teach, reach, and vibrate the whole person rather than merely transfer knowledge
Stephen Nachmanovitch
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Where are you hoping to get to with GP RegistrarPersonal/professional developmentSelf-awarenessAttitudesAbility to deal with complexity/uncertainty/failureBroaden vision/horizons
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Doctor characteristics
AltruismAccountabilityDutyIntegrityRespect for othersLifelong learning
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Creativity in medicine and medical education (HEA 2005)
Stimulation – print off from article
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Training is for the purpose of passing on specific information necessary to perform a specialised activity. Education is the building of the person.
Stephen Nachmanovitch
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The fulcrum of the transformation is mind-at-play, having nothing to gain and nothing to lose….
Stephen Nachmanovitch
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Perspective transformation
Importance of using your imagination to try to understand GP reg, esp if you do not have good understanding of each other, if they behave in ways which surprise you, even more important then….
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Transformative learning
Development of more integrative and inclusive beliefs (Panda 2004)
Reflective transformation of beliefs, attitudes, opinions and emotional reactions (Imel 1998)
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Rational
Centrality of experienceCritical reflectionRational discourse
(Mezirow 1978)
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Extra-rational
Creative, emotional engagement (Boyd & Myers 1988)
Enhanced through symbols and imagery (Dirkx 1997)
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Listen better rather than longerWhat to listen forTo understand the significance of what is being heardTo know how to respond therapeutically
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Clay-work ..meaningful
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What have you taken from today?What might you try?
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Only get out what you put inTake risksBe yourselfUse material that you can engage withUnderstand the barriers e.g. fear of exposure, feeling of time pressure, not tried before, can’t see the point Develop safe and conducive environment