Hoang Bao Lan, Monrouxe Lynn Valerie, Chen Kuo-Su, Chang Shu-Ching, Chiavaroli Neville, Mauludina Yosika Septi, Huang Chien-Da
Chang Gung Medical Education Research Centre (CG-MERC), Chang Gung Memorial Hospital, Linkou, Taiwan.
Faculty of Medicine and Health, Susan Wakil Health Building, The University of Sydney, Sydney, NSW, Australia.
Front Med (Lausanne). 2022 May 16;9:857488. doi: 10.3389/fmed.2022.857488. eCollection 2022.
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.
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.
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.
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.
https://www.crd.york.ac.uk/PROSPERO, identifier: CRD42019123967.
医学教育一直强调将医学人文培训纳入课程的重要性，以造福医学和护理专业学生的未来实践，多年来一直是台湾医疗保健教育研究国家资助重点项目之一。然而，这一举措在多大程度上带来了医学人文培训、其纳入的依据是什么以及其效果如何，在很大程度上尚不清楚。本研究旨在探讨台湾背景下医学人文项目中的这些问题。
我们进行了一项系统综述。纳入标准包括2000年至2019年间在台湾医疗保健教育环境中报道医学人文课程成果的英文或中文研究。我们按照PRISMA指南在五个电子数据库（PubMed、Embase、ERIC、PsycInfo、Web of Science）中进行了检索。使用最佳证据医学教育（BEME）全球量表和柯克帕特里克层次来确定证据的强度。
从134篇被识别的文献中提取了17篇文章。与基于认识论和批判性的方法相比，纳入医学人文教育的内在和工具性依据较为常见。在参与方面发现了一些积极影响，包括态度、知识和技能的改变。然而，缺乏以对学生行为或与同事及患者的持续互动产生影响为特征的最高水平（即明确无误）的证据。
研究结果表明，尽管医学人文教育在台湾广泛实施，但在纳入的依据或如何从西方背景本地化到亚洲背景方面尚未达成明确共识。未来的研究仍需探索医学人文教育对医学和护理专业学生的长期影响及其对患者护理的影响。
