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E-raamat: Medical Humanities and Medical Education: How the medical humanities can shape better doctors

(Plymouth University, UK)
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The field of the medical humanities is developing rapidly, however, there has also been parallel concern from sceptics that the value of medical humanities educational interventions should be open to scrutiny and evidence. Just what is the impact of medical humanities provision upon the education of medical students? In an era of limited resources, is such provision worth the investment? This innovative text addresses these pressing questions, describes the contemporary territory comprising the medical humanities in medical education, and explains how this field may be developed as a key medical education component for the future.

Bleakley, a driving force of the international movement to establish the medical humanities as a core and integrated provision in the medical curriculum, proposes a model that requires collaboration between patients, artists, humanities scholars, doctors and other health professionals, in developing medical students’ sensibility (clinical acumen based on close noticing) and sensitivity (ethical, professional and humane practice). In particular, this text focuses upon how medical humanities input into the curriculum can help to shape the identities of medical students as future doctors who are humane, caring, expressive and creative – whose work will be technically sound but considerably enhanced by their abilities to communicate well with patients and colleagues, to empathise, to be adaptive and innovative, and to act as ‘medical citizens’ in shaping a future medical culture as a model democracy where social justice is a key aspect of medicine.

Making sense of the new wave of medical humanities in medical education scholarship that calls for a ‘critical medical humanities’, Medical Humanities and Medical Education incorporates a range of case studies and illustrative and practical examples to aid integrating medical humanities into the medical curriculum. It will be important reading for medical educators and others working with the medical education community, and all those interested in the medical humanities.

List of figures
viii
Acknowledgements ix
Foreword x
Arno K. Kumagai
Introduction 1(1)
Forewarned 1(11)
Shaping the fabric of the sensible through medical education
2(3)
The role of the medical humanities in addressing symptoms of a malfunctioning medical education
5(5)
Realizing Osier's vision
10(2)
1 Where do the medical humanities come from and where are they going?
12(28)
The medical humanities in North America
12(11)
The medical humanities in the United Kingdom
23(10)
The medical humanities internationally
33(7)
2 What are the `medical humanities'? Definitions and controversies
40(20)
Defining the medical humanities: `what's in a name?'
40(5)
A multidisciplinary or interdisciplinary field?
45(6)
Carrying the burden of the medical humanities
51(3)
What does the future hold for the medical humanities?
54(6)
3 The distribution of the sensible
60(18)
Introduction
60(2)
The distribution of the sensible is a historical phenomenon
62(2)
Inattentional blindness
64(2)
The social organization of perception
66(1)
The meeting of aesthetics and politics in the distribution of the sensible
66(2)
The `police', `politics' and `dissensus'
68(4)
The redistribution of the sensible through a new medical education that draws on the medical humanities
72(1)
The production of insensibility can be aligned with authoritarianism and intolerance of ambiguity: Donald Winnicott and Martha Nussbaum
73(3)
The redistribution of the sensible can be aligned with promotion of a tender-minded medicine
76(2)
4 Empathy and its discontents
78(22)
Introduction
78(7)
The death of Hector: pity in Homer, empathy in medical education
85(12)
Conclusions: empathy ancient and modern
97(3)
5 Towards a medical aesthetics: creativity and imagination in medical education
100(32)
Weasel words
100(1)
Think improvisation!
100(5)
Towards a medical aesthetics
105(1)
Reflecting on `creativity'
106(1)
Philosophies of lack versus philosophies of abundance
107(3)
Constructions of creativity
110(6)
A typology of creativities
116(16)
6 Close noticing
132(32)
Sensibility and sensitivity
132(1)
Kinds of reasoning in the senses
133(5)
Arts-educated observation
138(4)
Making sense of diagnosis
142(2)
Can exposure to the arts hone observation?
144(8)
Artists and doctors collaborate in `thinking aloud'
152(3)
Democratizing the medical gaze in medicine
155(1)
Aesthetic ways of knowing in healthcare
156(2)
Abductive judgement
158(2)
Resemblances
160(1)
The poetic imagination
161(2)
The visual rhetoric of clinical practice
163(1)
7 Can narrative medicine take the strain?
164(23)
Essential, not desirable
164(1)
What is a narrative?
164(11)
Against narrative
175(5)
Two kinds of thinking? Narrative and science
180(1)
The subjunctive mood and narrative tension
181(3)
Genres
184(3)
8 Writing out prescriptions: hyper-realism and the chemical regulation of mood
187(19)
Introduction
187(2)
Prescription culture
189(6)
Deconstructing drugs
195(6)
The value of literary deconstruction in understanding health interventions
201(2)
Coda: development of a humanities-based formulary
203(3)
9 Evaluating the impact of medical humanities provision
206(22)
Introduction
206(1)
Measuring the immeasurable?
207(1)
Are there other, more pressing, issues than measurement of impact?
208(3)
William Empson's seven types of ambiguity
211(1)
Empson's seven types of ambiguity transposed to medical education
212(3)
Issues of `impact': seven types of resistance to ambiguity
215(6)
Seven types of ambiguity that question the value of current medical humanities impact studies
221(7)
Bibliography 228(24)
Index 252
Alan Bleakley is Emeritus Professor of Medical Education and Medical Humanities at Plymouth University Peninsula Medical School, UK. He is past President of the Association of Medical Humanities.