Enews393 藝術與人文在醫學教育中的基本角色- AAMC出版的目的

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高雄醫學大學e快報 第393期  分享園地

藝術與人文在醫學教育中的基本角色-AAMC出版的目的

本校醫學院 劉克明名譽教授


  繼前一篇 “美國醫學院學會 (AAMC) 出版 ”藝術與人文在醫學教育中的基本角色 (Fundamental Role of the Arts and Humanities in Medical Education)” 報告的執行出版摘要,本篇敘述出版該報告的目的 (Purpose of the Fundamental Role of the Arts and Humanities in Medical Education) 。

藝術與人文在醫學教育中的基本角色 - 報告的目的:

  美國醫學院學會 (AAMC) 致力於闡明未來醫師教育的關鍵基礎,以及醫學教育中新的教學能力和教學方法實踐的連貫。 而現在正是定義藝術和人文在醫師教育的初步和持續發展中所扮演的角色的時候了。

  2009年,美國醫學院學會 (AAMC) 與霍華德·休斯醫學研究所(Howard Hughes Medical Institute,簡稱HHMI)合作出版第一本基金會專書 “未來醫師的科學基礎 (The Scientific Foundations for Future Physicians)”。 隨之,美國醫學院學會 (AAMC) 於2011年出版第二本基金會專書 “未來醫師的行為和社會科學基礎 (Behavioral and Social Science Foundations for Future Physicians)”。這些基金會專書被廣泛地分送給醫學教育者,提供指導課程的規劃和執行。

  在2017年,美國醫學院學會 (AAMC) 決定要出版第三本專書,以建立關於醫師教育的重要基礎之更完整的畫像。與前兩本專書論述醫師在醫學院教育的發展不同,本專書還論述了醫師在住院醫師訓練和臨床執業的發展。該出版計劃是美國醫學院學會 (AAMC) 要啟發一項更廣泛的策略計劃 “藝術與人文在醫學教育中的基本角色 (Fundamental Role of the Arts and Humanities in Medical Education,簡稱FRAHME)” 的一部分。此縱向的、跨連續教育的計劃的主要目的是,藉透過與藝術和人文的更深層次的融合體驗,以改善醫師的教育、執業和福祉。這項廣泛的計劃包括設計和附帶有實用工具的數位指南出版物 (Digital guidebook),該實用指南將藝術和人文整合於醫學教育課程和經驗中。

  與前兩本專書相似,本專書並不是強迫醫學院課程或學程改革的指令。相反的,它是幫助醫學教育者和臨床醫師們了解進一步將藝術和人文融入他們的臨床教學的價值之指南。美國醫學院學會 (AAMC) 確定基於藝術和人文的教學法,可以幫助支持教學的能力與成果、探索藝術和人文融合於醫學教育的挑戰和如何實踐的最佳機會,並確定需要進一步發展的領域研究。該報告還提供了一些運用富於創意與有效的途徑,將藝術與人文融合,以獲得不同成果的課程實例。美國醫學院學會 (AAMC) 策略計劃 “藝術與人文在醫學教育中的基本作用 (FRAHME)” 所倡議的方法和策略列在附錄A。

  根據最近的“國家科學、工程和醫學研究院(National Academics of Sciences, Engineering, and Medicine,簡稱NASEM)” 的報告,藝術教導創造性的表達方式、對不同觀點的理解、透過人類的經驗中對知識和情感的認識、以及透過表達世界中的藝術創作和實踐來塑造和分享認知。

— NASEM 2018


  然而範疇不同,人文傾向於包括例如 “文學、歷史、哲學,以及藝術評論和理論” 等學科,而藝術則 “透過視覺和表演藝術、手工藝以及文學和媒體藝術,具體化表現創意的表達”。人文往往探索並參與人類世界的生活經驗。 (儘管倫理學被認為是一門人文學科,但由於我們將其納入了 “未來醫師的行為和社會科學基礎”中,因此我們在此不予討論)。

  “國家科學,工程和醫學研究院(NASEM)” 報告,人文教導密集的閱讀實踐是基本的工具、是對跨時空環境的理解、對社會結構和關係的質性分析、觀點的重要性、同理心的理解能力、對論點結構的分析...。

— NASEM 2018


  精緻與表現藝術的範圍可能包括 “音樂、戲劇、舞蹈、創意寫作、視覺藝術、設計、新媒體和電影。

  醫學教育中人文與藝術的工作定義:源於人文與藝術並融合到醫學生、實習醫師和執業醫師們的教與學的內容或教學法。此教育方法和經驗通常是跨專業的、跨學科的、並且是共同設計的,目的是教授和維持各種能力,從而為患者、社區和群眾帶來更好的健康成果。


致謝:

  筆者非常感謝美國醫學院學會Ms. Virginia Bush, PMP. (Project Manager, Medical Education Projects, Association of American Medical Colleges (AAMC), Washington, District of Columbia, USA.) 同意翻譯 ”The Fundamental Role of the Arts and Humanities in Medical Education” ,並依規定註明 “ AAMC has not reviewed or approved the translated version for accuracy”。


參考文獻:

1. 劉克明。藝術與人文在醫學教育中的基本角色-執行出版摘要。高雄醫學大學e快報 第392期。 2021年1月27日。http://enews2.kmu.edu.tw/index.php/Enews392_%E8%97%9D%E8%A1%93%E8%88%87%E4%BA%BA%E6%96%87%E5%9C%A8%E9%86%AB%E5%AD%B8%E6%95%99%E8%82%B2%E4%B8%AD%E7%9A%84%E5%9F%BA%E6%9C%AC%E8%A7%92%E8%89%B2-%E5%9F%B7%E8%A1%8C%E5%87%BA%E7%89%88%E6%91%98%E8%A6%81

2. Howley L, Gaufberg E, King B. The Fundamental Role of the Arts and Humanities in Medical Education. Washington, DC: AAMC; 2020. https://store.aamc.org/the-fundamental-role-of-the-arts-and-humanities-in-medical-education.html.


附件A. 藝術與人文在醫學教育中的基本角色方法與策略 (Appendix A. FRAHME Methods and Strategy)

  美國醫學院學會 (AAMC) 在國家人文基金會(National Endowment for the Humanities ,簡稱 NEH)的支持下,於 2017年 7月11日至12日,在華盛頓特區舉行的思想領袖論壇上,開始了藝術和人文在醫學教育中的角色的探索。該論壇的與會者包括醫學教育者、受教育者以及來自藝術和人文的專業人士。 這次會議達到的目標是:更好地了解醫學領域中的藝術和人文現狀,並考慮如何最好地開展更廣泛的努力,包括出版《基金會》系列的第三本專書。該倡議的後續階段的活動可從該論壇的成果中獲悉。

  2019年3月,美國醫學院學會 (AAMC) 委託並資助了範疇界定的審查,本報告第四章對此已進行了詳細介紹。它提供了範圍廣泛的文獻資料,同時對它們與以下基礎廣泛的研究問題的相關性做出了判斷:如何以及為什麼將藝術和人文應用於教育醫師與跨學科的專業學習者?被挑選進行審查的團隊來自西安大略大學 (University of Western Ontario)、賓夕法尼亞州立醫學院 (Penn State College of Medicine) 和聖文森特大學 (Mount Saint Vincent University)。該團隊由西安大略大學的 Lorelei Lingard 博士 (Lorelei Lingard, PhD, University of Western Ontario)、聖文森特大學的 Tracy Moniz 博士 (Tracy Moniz, PhD, Mount Saint Vincent University)、Maryam Golafshani 博士 (Maryam Golafshani , PhD, University of Western Ontario), 和賓夕法尼亞州立醫學院 Paul Haidet 博士(Paul Haidet, MD, MPH, Penn State College of Medicine)領導,在這一領域的學術成績斐然。範疇審查的基礎是團隊以前的文獻回顧、關鍵分析和概念架構。第四章還概述了一些範疇界定性的回顧發現,這是將藝術和人文整合到醫學教育中的一系列方法。

  從2019年9月開始,美國醫學院學會 (AAMC) 連續召集了來自美國各地代表性會員和附屬機構的教育工作者、臨床醫師、研究人員、歷史學家、人文學者、藝術家、和傳播專家,稱為藝術與人文整合委員會(Arts and Humanities Integration Committee,簡稱 IC) (有關成員,請參閱附件B)。 範圍審查小組 (Scoping Review Team,簡稱 SRT) 的代表們也參加了會議。 該小組的職責是:

  1.就整體倡議提供建議。

  2.為未來的醫師教育闡明重要的藝術和人文基礎。

  3.建議將藝術和人文整合到醫師的專業發展教育中,特別是在臨床技能和以患者為中心的移情治療、適應力、溝通能力、對歧義的容忍度以及透過範圍界定審查過程確定的其他領域。

  4.提出策略,以實現建議在繼續進行醫師學位和執業醫師的醫學生教育和臨床專業發展經驗中,融合藝術和人文的需求。

  5.考慮如何去陳述該建議,以及陳述該建議對美國醫學院學會 (AAMC) 成員機構的成果。

  6.為新的教師發展計劃,擔任或推薦教師,以促進藝術與人文融合於醫學教育的設計和評估。

  在國家人文基金會(NEH)的支持下,美國醫學院學會 (AAMC) 還為那些開始考慮在其教學中,將採用藝術和人文,以及需要進一步培訓,以評估各種教學方法和制定課程的醫學教育者,創建了數位指南 (Digital guidebook) 和教師發展計劃。 並為教師提供一個小額的獎助計劃基金,以尋求申請教育獎學金,並促進對現有整合藝術和人文課程的研究和評估。 美國醫學院學會 (AAMC) 還啟動了新的 “藝術與人文在醫學教育中的基本角色 (FRAHME)” 項目,以支持其成員創作和分享故事和創意作品。這些努力將包括提供管道,在不確定的時期,探索和尊重醫療照護專業人員的經驗。


附件 B. “藝術與人文在醫學教育中的基本角色之成員名冊 (Appendix B. FRAHME Roster)”
1. Arts and Humanities Integration Committee
Laurie Baefsky, DMA
Associate Dean of Research and Strategic Partnerships, College of Arts and Media
University of Colorado Denver
Joanne Braxton, PhD, MDiv
Chief Executive Officer and President, The Braxton Institute for Sustainability,
Resiliency and Joy Adjunct Professor, Family and Community Medicine Eastern Virginia Medical School


Carlyle H. Chan, MD
Professor of Psychiatry and the Institute for Health and Equity (Bioethics and Medical Humanities), Medical College of Wisconsin


Rita Charon, MD, PhD
Professor of Medicine and Medical Humanities and Ethics,
Columbia University Vagelos College of Physicians and Surgeons


Issa Lara Combs, MS
Director of Finance and Administration Chance Academy


Horace DeLisser, MD
Associate for Dean for Diversity and Inclusion, Perelman School of Medicine at the
University of Pennsylvania


Quentin Eichbaum, MD, PhD, MPH, MFA
Professor of Medical Education and Administration, Professor of Pathology, Microbiology,and Immunology, Vanderbilt University Medical Center


Cheryl Woods Giscombe, PhD, PMHNP, FAAN
LeVine Distinguished Associate Professor of Quality of Life, Health Promotion, and Wellness, University of North Carolina at Chapel :Hill School of Nursing


Deepu Gowda, MD, MPH
Assistant Dean for Medical Education, Associate Professor,
Kaiser Permanente School of Medicine


Jeremy Greene, MA, MD, PhD
William H. Welch Professor of Medicine and the History of Medicine,
Director, Institute of the History of Medicine Johns Hopkins University


Terese Jones, PhD
Associate Director of the Center for Bioethics and Humanities,
Director of the Arts and Humanities in Healthcare Program,
University of Colorado School of Medicine at the Anschutz Medical
Campus


Evonne Kaplan-Liss, MD, MPH
Assistant Dean of Narrative Refection and Patient Communication,
TCU and UNTHSC School of Medicine


Catherine Kuhn, MD
Professor of Anesthesiology, Duke University Medical School


Julia Langley
Faculty Director, Georgetown Lombardi Arts and Humanities Program


Jerry Lazarus, MD
Professor of Dermatology, Duke University School of Medicine, National Trust for the
Humanities


Daniel Marchalik, MD
Medical Director for Physician Well-being MedStar Health,
Director of the Literature and Medicine Track, Georgetown University School of
Medicine


Maren Monsen, MD
Director of the Program in Bioethics and Film, Stanford University


Justin Mutter, MD
Assistant Professor, UVA Center for Health Humanities and Ethics University of Virginia


Johanna Rian, PhD
Program Director, Dolores Jean Lavins Center for Humanities in Medicine, Mayo Clinic


Robert Rock, MD
Family Medicine Resident, Montefiore Health System


Pamela Schaff, MD, PhD
Associate Professor of Medical Education, Family Medicine, and Pediatrics, Director, Humanities, Ethics/Economics, Art, and the Law (HEAL) Program, Keck School of Medicine of the University of Southern California


Vidya Viswanathan, MD
Founder, Doctors Who Create, Pediatrics Resident, Children’s Hospital of Philadelphia


Colleen Wallace, MD
Associate Professor of Pediatrics, Hospitalist Medicine Program for Humanities in
Medicine, Washington University School of Medicine in St. Louis


Katie Watson, JD
Associate Professor of Medical Social Sciences, Medical Education, and Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine


Ray Williams, MA, EdM
Director of Education and Academic Affairs, Blanton Museum of Art, University of Texas at Austin


2. Association Advisors
Sunil Iyengar, MA
Research and Analysis Director,
National Endowment for the Arts


Tom Rudin
Director of the Board on Higher
Education and Workforce,
Director of the Committee on Women in Science, Engineering, and Medicine,
National Academy of Sciences


Victoria Sams, PhD
Program Officer, Division of Education,
National Endowment for the
Humanities


3. Scoping Review Team
Tracy Moniz, MA, PhD
Associate Professor, Department of Communication Studies,
Mount Saint Vincent University,
Adjunct Professor, Department of Pediatrics, Faculty of Medicine,
Dalhousie University


Maryam Golafshani, MA
Medical Student University of Toronto


Carolyn M. Gaspar, MSc
PhD student, Faculty of Health Dalhousie University


Nancy E. Adams, MLIS, EdD
Associate Librarian and Assistant Dean of Foundational Sciences,
Penn State College of Medicine


Paul Haidet, MD, MPH
Director of Medical Education Research,
Woodward Center for Excellence in Health Sciences Education,
Penn State College of Medicine


Javeed Sukhera, MD, PhD
Associate Professor
Departments of Psychiatry/Pediatrics Scientist, Centre for Education Research and Innovation,
Schulich School of Medicine and Dentistry, Western University


Rebecca L. Volpe, PhD
Assistant Professor and Vice Chair for Education Department of Humanities,
Penn State College of Medicine,
Director of the Clinical Ethics Consultation Service, Milton S. Hershey Medical Center


Claire de Boer, MS
Director of the Doctors Kienle Center for Humanistic Medicine,
Founding Director of Center Stage Arts in Health Penn State College of Medicine and Penn State Health, Milton S. Hershey Medical :Center,
President of the National Organization for Arts in Health


Lorelei Lingard, MA, PhD
Professor, Department of Medicine Scientist, Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University


4. AAMC Core Project Team
Virginia Bush, PMP
Project Manager, Strategic Initiatives and Partnerships in Medical Education


Elizabeth Gaufberg, MD, MPH
Senior Consultant, AAMC
Associate Professor of Medicine and Psychiatry, Harvard Medical School
Director, Center for Professional and Academic Development, The Cambridge Health Alliance


Lisa Howley, PhD, MEd
Senior Director, Strategic Initiatives and Partnerships in Medical Education, AAMC
Adjunct Associate Professor, UNC School of Medicine


Brandy King, MLIS
Senior Consultant, AAMC Librarian, Knowledge Linking


Mallory Lee, MA
Administrative Support Specialist,
Strategic Initiatives and Partnerships in Medical Education


Beatrice Schmider, MA
Executive Assistant II, Office of Medical Education


Alison Whelan, MD
Chief Medical Education Officer


5. AAMC Supporting Staff
Amy Addams
Director, Student Affairs Alignment and Holistic Review


Deric Corlew, PhD
Director, Business Development


Jennifer Faerberg, MHSA
Director, Advancing Clinical Leadership and Quality


Anne Farmakidis, MPS
Senior Director, Educational Resources and Scholarship


Toni Gallo, MA
Senior Staff Editor, Academic Medicine,
Lead, Education Resources and Scholarship


John Nash
Operations Manager,
Education Resources and Scholarship


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