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      Medical Humanities Education and Its Influence on Students' Outcomes in Taiwan: A Systematic Review

      systematic-review

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          Abstract

          Background

          Medical education has emphasized the importance of integrating medical humanities training into the curriculum to benefit medical and nursing students' future practice, featuring in the list of national funding priorities for healthcare education research in Taiwan for many years. However, the extent to which this drive has resulted in medical humanities training, what rationales underpin its inclusion, and its efficacy is largely unknown. This study aims to address these issues across medical humanities programs within the Taiwanese context.

          Methods

          We conducted a systematic review. Inclusion criteria included studies in English or Mandarin reporting outcomes of medical humanities courses in healthcare education settings in Taiwan between 2000 and 2019. We searched across five electronic databases (PubMed, Embase, ERIC, PsycInfo, Web of Science), following PRISMA guidelines. The Best Evidence Medical Education (BEME) Global Scale and Kirkpatrick Levels are used for identifying the strength of evidence.

          Results

          17 articles were extracted from the 134 identified. Intrinsic and instrumental rationales for the inclusion of medical humanities education were common, compared with epistemological-based and critical-based approaches. Several positive impacts were identified in relation to participation including modification of attitudes, knowledge, and skills. However, the highest level (i.e., unequivocal) of evidence characterized by effects on students' behaviors or ongoing interaction with colleagues and patients is lacking.

          Conclusion

          Findings suggest that although medical humanities education is widely implemented in Taiwan, no clear consensus has been reached regarding the rationale for inclusion or how it is localized from Western to Asian contexts. Future research still needs to explore the long-term impact of medical humanities education for medical and nursing students and its impact on patient care.

          Systematic Review Registration

          https://www.crd.york.ac.uk/PROSPERO, identifier: CRD42019123967.

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          Most cited references53

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          The Kirkpatrick model: A useful tool for evaluating training outcomes.

          Services employing staff to support people with disability usually provide training in a range of areas including communication and managing challenging behaviour. Given that such training can be costly and time-consuming, it is important to evaluate the evidence presented in support of such programs. Efficacy in clinical practice is measured using evidence-based practice. However, there is currently no model that is widely used to compare and evaluate training programs despite the large number of training programs reported each year.
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            Humanities in undergraduate medical education: a literature review.

            Humanities form an integral part of undergraduate medical curricula at numerous medical schools all over the world, and medical journals publish a considerable quantity of articles in this field. The aim of this study was to determine the extent to which the literature on humanities in undergraduate medical education seeks to provide evidence of a long-term impact of this integration of humanities in undergraduate medical education. Medline was searched for publications concerning the humanities in undergraduate medical education appearing from January 2000 to December 2008. All articles were manually sorted by the authors. Two hundred forty-five articles were included in the study. Following a qualitative analysis, the references included were categorized as "pleading the case," "course descriptions and evaluations," "seeking evidence of long-term impact," or "holding the horses." Two hundred twenty-four articles out of 245 either praised the (potential) effects of humanities on medical education or described existing or planned courses without offering substantial evidence of any long-term impact of these curricular activities on medical proficiency. Only 9 articles provided evidence of attempts to document long-term impacts using diverse test tools, and 10 articles presented relatively reserved attitudes toward humanities in undergraduate medical education. Evidence on the positive long-term impacts of integrating humanities into undergraduate medical education is sparse. This may pose a threat to the continued development of humanities-related activities in undergraduate medical education in the context of current demands for evidence to demonstrate educational effectiveness.
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              • Article: not found

              Assessing empathy development in medical education: a systematic review.

              Empathy in doctor-patient relationships is a familiar topic for medical scholars and a crucial goal for medical educators. Nonetheless, there are persistent disagreements in the research literature concerning how best to evaluate empathy among physicians, and whether empathy declines or increases across medical education. Some researchers have argued that the instruments used to study 'empathy' may not measure anything meaningful to clinical practice or patient satisfaction.
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                Author and article information

                Contributors
                Journal
                Front Med (Lausanne)
                Front Med (Lausanne)
                Front. Med.
                Frontiers in Medicine
                Frontiers Media S.A.
                2296-858X
                16 May 2022
                2022
                : 9
                : 857488
                Affiliations
                [1] 1Chang Gung Medical Education Research Centre (CG-MERC), Chang Gung Memorial Hospital , Linkou, Taiwan
                [2] 2Faculty of Medicine and Health, Susan Wakil Health Building, The University of Sydney , Sydney, NSW, Australia
                [3] 3Department of Nephrology, Chang Gung Memorial Hospital , Keelung, Taiwan
                [4] 4Department of Medical Humanities and Social Sciences, Chang Gung University College of Medicine , Taoyuan, Taiwan
                [5] 5Department of Pathology, Chang Gung Memorial Hospital , Linkou, Taiwan
                [6] 6Australian Council for Educational Research , Melbourne, VIC, Australia
                [7] 7Department of Medical Education and Thoracic Medicine, Chang Gung Memorial Hospital, Chang Gung University , Taipei, Taiwan
                Author notes

                Edited by: Hope Ricciotti, Harvard Medical School, United States

                Reviewed by: Siti Nurma Hadie Hadie, Universiti Sains Malaysia Health Campus, Malaysia; Janeane Dart, Monash University, Australia

                *Correspondence: Chien-Da Huang cdhuang@ 123456adm.cgmh.org.tw

                This article was submitted to Healthcare Professions Education, a section of the journal Frontiers in Medicine

                Article
                10.3389/fmed.2022.857488
                9150274
                35652071
                bce386e9-dcb3-47df-9af2-156ddd29d0a3
                Copyright © 2022 Hoang, Monrouxe, Chen, Chang, Chiavaroli, Mauludina and Huang.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 18 January 2022
                : 20 April 2022
                Page count
                Figures: 1, Tables: 4, Equations: 0, References: 53, Pages: 13, Words: 9711
                Categories
                Medicine
                Systematic Review

                medical humanities,medical students,nursing students,medical education,systematic review,curriculum

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