Volpe Rebecca L, Adams Nancy E, Thompson Britta M, Simmers Jocelyn, Chen Sonia, Hausman Bernice L
Department of Humanities, Penn State College of Medicine, Hershey, PA, USA.
Penn State Hershey Medical Center and Penn State College of Medicine, Hershey, PA, USA.
J Med Educ Curric Dev. 2025 Aug 21;12:23821205251369949. doi: 10.1177/23821205251369949. eCollection 2025 Jan-Dec.
This study investigates medical students' experiences with a pre-clerkship critical medical humanities (CMH) curriculum that emphasized power, privilege, and inequities in healthcare.
Twenty-six third-year medical students at a semi-rural US medical school were interviewed in Fall-Winter 2023. Semi-structured interviews explored students' reflections on the curriculum's impact, and narrative analysis was used to identify key themes. Validation strategies included reflexivity, triangulation, and analysis of disconfirming cases.
The results revealed 4 themes. First, students valued humanities learning but noted limitations of the classroom setting. Second, the facilitated self-reflection uncovered implicit biases and encouraged critical perspectives on medical knowledge. Third, despite a belief that the humanities were important for future practice, participants deprioritized them in favor of science courses. Finally, learning about diversity and equity concepts was perceived to be limited in racially homogenous groups.
The CMH curriculum encouraged critical thinking and cultural humility, though its full impact was constrained by systemic and cultural tensions in medical education prioritizing scientific knowledge. Embedding health humanities learning into clinical contexts and providing faculty development to address diversity and equity challenges may enhance curricular outcomes. Institutional support and national guidance are needed to align health humanities curricula with broader educational goals.
本研究调查了医学生在临床实习前批判性医学人文(CMH)课程中的经历,该课程强调医疗保健中的权力、特权和不平等。
2023年秋冬对美国一所半农村医学院的26名三年级医学生进行了访谈。半结构化访谈探讨了学生对课程影响的反思,并采用叙事分析来确定关键主题。验证策略包括反思性、三角验证和对矛盾案例的分析。
结果揭示了4个主题。首先,学生重视人文学习,但指出课堂环境存在局限性。其次,引导式自我反思揭示了隐性偏见,并鼓励对医学知识形成批判性观点。第三,尽管参与者认为人文对未来实践很重要,但他们将其置于次要地位,优先选择科学课程。最后,在种族同质化群体中,对多样性和平等概念的学习被认为是有限的。
CMH课程鼓励批判性思维和文化谦逊,但其全面影响受到医学教育中优先考虑科学知识的系统和文化张力的限制。将健康人文学习融入临床环境,并提供教师培训以应对多样性和平等挑战,可能会提高课程效果。需要机构支持和国家指导,以使健康人文课程与更广泛的教育目标保持一致。