KeyLIME Podcast #188: Let’s admit students and residents who are poets, violinists, actors or painters.

Do medical students with higher exposure to the humanities exhibit higher levels of positive physician qualities such as wisdom, empathy, self-efficacy, emotional appraisal, and spatial skills? Read on, and check out the podcast here (or on iTunes!)

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KeyLIME Session 188:

Listen to the podcast.

Reference:

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Mangione S et al Medical Students’ Exposure to the Humanities Correlates with Positive Personal Qualities and Reduced Burnout: A Multi-Institutional U.S. Survey. J Gen Intern Med. 2018 May;33(5):628-634. Epub 2018 Jan 29.

Reviewer: Linda Snell (@LindaSMedEd)

Background

For 100 years, the arts and sciences have diverged due to different ‘cultures, and because of medicine’s skepticism of the humanities as being hard to define, and incompatible with an evidence-based approach.
Today, as a profession medicine is ‘successful’, however there is a high suicide rate, burnout of > 50%, prevalent depression, decreased empathy, & a tendency for physicians to leave.
Some med schools have added humanities to the curriculum, or dropping MCAT scores. Medical students with a humanistic background perform as well academically as others, but there has not been an assessment of whether they might have advantages in more personal domains, e.g. wisdom, empathy, tolerance for ambiguity, skilled observation, and emotional resilience. These factors may contribute to being a well-rounded doctor. Some of these are found in competency frameworks (ACGME, CanMEDS).

Purpose

To test the hypothesis that medical students with higher exposure to the humanities would report higher levels of positive physician qualities (e.g., wisdom, empathy, self-efficacy, emotional appraisal, spatial skills), while reporting lower levels of negative qualities that are detrimental to physician well-being (e.g., intolerance of ambiguity, physical fatigue, emotional exhaustion, and cognitive weariness).

Key Points on Method

An online survey. Sent to all students in all years at 5 U.S. medical schools in 2014–2015. Students reported demographic and background information; their exposure to the humanities ((both active and passive involvement: engaging in visual arts, singing, playing musical instruments, listening to music, dancing, writing for pleasure, reading for pleasure, attending theater, going to museums/galleries, and attending concerts. Response was 0 (never) to 4 (daily). Unclear if this part was validated) and completed measurement scales for personal qualities (Wisdom, Empathy, Tolerance for Ambiguity, EI, Self-Efficacy, Burnout and spatial skills).
Multivariate analysis was done.


Key Outcomes

Of 3100 students, RR of those who completed >80% was 24%. Varying age, ethnicity, but no comparison to nonrespondents done.

  • Humanities exposure significantly predicted all personal qualities.
  • Humanities exposure was a significant negative predictor of the various components of burnout.
  • Humanities exposure was significantly associated with openness & predicted tolerance for ambiguity and was associated with spatial skills.
  • No difference between active and passive exposure.

 

Key Conclusions

The authors conclude “their study empirically confirms what many have intuitively suspected for years: exposure to the humanities is associated with both important personal qualities and prevention of burnout. … some of the qualities measured (tolerance for ambiguity, empathy, emotional appraisal of self and others, resilience) are, together with wisdom, fundamental components of professionalism. Hence, if we wish to create wiser, more tolerant, empathetic, and resilient physicians, we might want to reintegrate the humanities in medical education.”

Spare Keys- other take home points for clinician educators

The conclusions drawn about incorporating humanities in the curriculum are not supported by this design…BUT these findings are applicable to admissions.

There are issues with design and threats to validity:

  • part of survey not validated
  • low response rate
  • no data about non-respondents may lead to a response bias
  • correlation is not causation
  • the correlation could be opposite (does empathy lead to more humanities exposure or vice versa?)

As well, what about other ‘extracurricular activities … sports, religion?

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