Exploring the Impact of Book Club Participation on Clinicians' Empathy and Reflection on Empathetic Practice: A Wake-Up Call.

INTRODUCTION:  Empathy is associated with desirable outcomes in healthcare, including improved patient-clinician rapport, fewer patient complications, and reduced clinician burnout. Despite these benefits, research suggests empathy declines during professional training. This study aimed to explore the impact of book club participation on clinicians' and trainees' empathy and perspectives on empathetic patient care. METHODS:  In this mixed-methods study, anesthesiology clinicians and trainees were invited to respond to a baseline online empathy survey followed by an invitation to read a book and to participate in one of four facilitated book club sessions. Post-intervention empathy was measured. The primary outcome of the quantitative analysis was a change in empathy scores as measured by the Toronto Empathy Questionnaire. A thematic analysis of book club sessions and open-ended comments in the post-intervention survey was conducted. RESULTS:  Participants included 74 responders to the baseline survey and 73 responders to the post-intervention survey. Empathy score change in the book club participants was not statistically significant from those who did not participate in any book club sessions (F(2, 39) = 0.42, p=0.66). Thematic analysis of the book club sessions revealed four themes that highlight how the book club enhanced empathy awareness among trainees and clinicians: 1) a wake-up call, 2) deciding whether to take action, 3) learning and nurturing empathy, and 4) changing the culture. CONCLUSION:  There were no significant changes in empathy scores associated with book club participation. Thematic analysis highlighted barriers toward empathetic patient care, areas for improvement, and voiced intentions to practice with heightened empathy. Book clubs may be a viable venue to nurture a culture of increased self-awareness and motivation to counteract loss of empathy, but just one experience may not be sufficient.

El cirujano de Al-Ándalus. Aproximación a la vida y obra de Abulcasis de la mano de Antonio Cavanillas de Blas / Al-Andalus' surgeon. An approximation to the life and work of Abulcasis by the hand of Antonio Cavanillas de Blas

Actualmente, mucha gente sigue pensando en «ciencias o letras» como dos ramas separadas y completamente distintas a la hora de elegir una carrera o simplemente de hacerse una idea de los intereses de una persona. Sin embargo, cada vez hay más esfuerzos para cambiar este concepto y dar a entender que no son opuestos, sino complementarios. Las letras se nutren de los avances de las ciencias y las ciencias necesitan de las letras para expresarse, avanzar y desarrollarse. Ejemplos claros son los libros que tratan temas médicos o relacionados con la medicina, ya sea desde la óptica del paciente y su entorno o desde la mirada del médico. Estos textos contribuyen a la formación humanística del médico y de los estudiantes de medicina: a cimentar el humanismo médico que debe presidir la relación entre el enfermo y el médico. En este trabajo aportamos una lectura de la relación entre literatura y medicina mediante la narración que Antonio Cavanillas de Blas hace de Abulcasis en su obra El Cirujano de al-Aldalus. (AU)

Nowadays, many people still think of «science and humanities» as two separate branches, completely different when choosing a career or simply when imagining where a person´s focus of interest lies on. Nevertheless, there is an increasing effort to change this point of view and make us realize they are not opposite, but rather complementary. Humanities nurture with science´s advances and science needs humanities in order to express itself, advance and develop. Clear examples of this are the books that talk about medicine and medicine related themes. These texts promote the humanistic training of doctors and medicine students: creating a solid foundation of humanistic medicine, which ought to preside the patient- doctor relationship. In this article, we contribute to present the close relationship between literature and medicine analyzing the description Antonio Cavanillas de Blas gives us of Abulcasis in his work El Cirujano de al-Andalus. (AU)

On Doctors and Their Operas: A Critical (and Lyrical) Analysis of Medicine in Opera.

The goal of this research was to analyze the opera repertoire in terms of contents of physician roles. An additional goal was to pinpoint significant characters and passages that exemplify the changing role and perception of medicine in society over five centuries. A systematic search was performed. Musical characteristics and performing roles, and their determinants, were tabulated and formally analyzed. Of 493 operas listed, 53 (10.7%) were identified as having either a patient and/or doctor as characters. These operas span 239 years, from 1777 to 2016. Beyond unspecified Family Medicine and Generalists, some operas could be attributed to medical specialties, including 3 (5.7%) to Respiratory. Most interestingly, the 34 operas (6.9%) with physician roles are all represented by male characters, distributed by voice register mostly in the grave chords. Overall, the composer that appears with the highest interest in reporting disease is Giuseppe Verdi, with nine operas that include medical doctors. Finally, a trend can be observed regarding the evolving role of doctors, from mostly minor, buffal roles, either with magical or comical components in the 18th century, to a professional/technical physician more recently. Opera depicts a changing perception of the roles of doctors throughout history, with a blatant gender bias that still persists.

A new path for humanistic medicine.

According to recent approaches in the philosophy of medicine, biomedicine should be replaced or complemented by a humanistic medical model. Two humanistic approaches, narrative medicine and the phenomenology of medicine, have grown particularly popular in recent decades. This paper first suggests that these humanistic criticisms of biomedicine are insufficient. A central problem is that both approaches seem to offer a straw man definition of biomedicine. It then argues that the subsequent definition of humanism found in these approaches is problematically reduced to a compassionate or psychological understanding. My main claims are that humanism cannot be sought in the patient-physician relationship alone and that a broad definition of medicine should help to revisit humanism. With this end in view, I defend what I call an outcomes-oriented approach to humanistic medicine, where humanism is set upon the capacity for a health system to produce good health outcomes.

Integrative medicine: Breaking down silos of knowledge and practice an epigenetic approach.

The future of medicine is discussed in the context of epigenetic influences during the entire life course and the lived experiences of each person, avoiding as much as possible the "medicalization" of the individual and taking a more humanistic view. The reciprocal communication between brain and body via the neuroendocrine, autonomic, metabolic and immune systems and the plasticity of brain architecture provide the basis for devising better "top down" interventions that engage the whole person in working towards his or her welfare. The life course perspective emphasizes the importance of intervening early in life to prevent adverse early life experiences, including the effects of poverty, that can have lifelong consequences, referred to as "biological embedding". In the spirit of integrative, humanistic medicine, treatments that "open windows of plasticity" allow targeted behavioral interventions to redirect brain and body functions and behavior in healthier directions. Policies of government and the private sector, particularly at the local, community level, can create a supporting environment for such interventions. See "Common Ground for Health: Personalized, Precision and Social Medicine McEwen & Getz - https://www.youtube.com/watch?v=IRy_uUWyrEw.

Introduction to the Four Principles of Biomedical Ethics in Confucius / 中国医学伦理学

It is not only the problem of the real life,but also the challenge of the biomedical ethics for how to get the balance and compromise between the principlism and situationism.The fairness in Confucian is constructed on the basis of the external nature,and also is a standard and content-full ethical principle,which is different from the political one in the western culture.The Confucian basis is the principlism but does not refuse the situationism.In the four principles of Confucian,both fairness and respect for autonomy belong to the principlism,while the other two of knowing where to stop and no harm or the principle of benefit of utilitarianism are the basis of the situationism.The principle of knowing where to stop is the internal core spirit of the Confucian moral virtue and ethical principles,but fairness is the first principle of its all external principles.

Research on the Evaluation Index System of Clinical Physicians' Humanistic Medicine Practice Ability / 中国医学伦理学

Through expounding the connotation of clinical physicians'humanistic medicine practice ability,this paper pointed out that building the evaluation index system should abide by the four principles of systematicness,scientificity,guidance and feasibility.Constructing the evaluation index system of clinical physicians' humanistic medicine practice ability included 4 first-level indicators,13 second-level indicators and 47 third-level indicators,which is beneficial to promoting the physicians' humanistic medicine practice ability and is conducive to improve the human resource evaluation and management of hospitals.

Clinical scenery drama in doctor-patient communication training and evaluation / 基础医学与临床

Humanistic doctor-patient communication is an essential capability for medical workers and is as impor -tant as medical technology .Its education has been getting more and more attention in recent years .However , the training and evaluation of humanistic doctor-patient communication as a practical other than theoretical capability has been difficult .A new method , clinical scenery drama , based on psychodrama and role theory , is developed by Dept.of Psychological Medicine , Peking Union Medical College Hospital from recent 10 years of medical doctor and student training .In clinical scenery drama , medical students are thrown to different roles to empathize with their feelings and conflicts , try to resolve clinical dilemma with humanistic communication technique besides medi-cal technology .Then the sharing and comments from teachers and observers help students to understand the situa -tion from other perspectives and think about other possible solutions .

Medical Integration from the Perspective of Humanistic Medicine:The Inevitability and the Leading Role of Holistic Integrated Medicine / 中国医学伦理学

Humanistic medicine is the contemporary essential characteristics of medicine,which is different from the ancient and modern medicine.The basic modality of humanistic medicine is integration,and the implementation of bio-psycho-social medical model is the basic content of humanistic medicine integration.Holistic integrated medicine is a clear understanding of the comprehensive modality of humanistic medicine,and leads and promotes the integration of humanistic medicine.The continuous improvement of the theoretical framework of holistic integrated medicine and its implementation in practice will promote the development of health care.

Rethinking on Medicine and Humanistic Integration / 中国医学伦理学

"Medicine" and "Medical Science" are two different concepts.In the strict sense,"the integration of medicine and humanity" should be interpreted as "the integration of medical science and humanistic medicine".It is a return to the true medicine,of which goal is to better service for patients' physical and psychological health and promote their quality of life.In the view of teaching,the main path of integration includes the integration of ideas,curriculum,teachers,methods,and assessment.

Discussion on Excessive Medical Treatment Countermeasures in the Perspective of Humanistic Medicine / 中国医学伦理学

Based on the analysis of definition and the causes of excessive medical treatment, this paper discus-ses the harm of excessive medical treatment concretely, including increased health care costs, the waste of medical resources, worsening doctor-patient conflicts that influence the development of holistic medicine. And in the per-spective of ethics, professional spirit and the humanistic quality, it puts forward the prevention and countermeasures to solve the problem of excessive medical treatment.

Getting personal: can systems medicine integrate scientific and humanistic conceptions of the patient?

RATIONALE, AIMS AND OBJECTIVES: The practicing doctor, and most obviously the primary care clinician who encounters the full complexity of patients, faces several fundamental but intrinsically related theoretical and practical challenges - strongly actualized by so-called medically unexplained symptoms (MUS) and multi-morbidity. Systems medicine, which is the emerging application of systems biology to medicine and a merger of molecular biomedicine, systems theory and mathematical modelling, has recently been proposed as a primary care-centered strategy for medicine that promises to meet these challenges. Significantly, it has been proposed to do so in a way that at first glance may seem compatible with humanistic medicine. More specifically, it is promoted as an integrative, holistic, personalized and patient-centered approach. In this article, we ask whether and to what extent systems medicine can provide a comprehensive conceptual account of and approach to the patient and the root causes of health problems that can be reconciled with the concept of the patient as a person, which is an essential theoretical element in humanistic medicine. METHODS: We answer this question through a comparative analysis of the theories of primary care doctor Eric Cassell and systems biologist Denis Noble. RESULTS AND CONCLUSIONS: We argue that, although systems biological concepts, notably Noble's theory of biological relativity and downward causation, are highly relevant for understanding human beings and health problems, they are nevertheless insufficient in fully bridging the gap to humanistic medicine. Systems biologists are currently unable to conceptualize living wholes, and seem unable to account for meaning, value and symbolic interaction, which are central concepts in humanistic medicine, as constraints on human health. Accordingly, systems medicine as currently envisioned cannot be said to be integrative, holistic, personalized or patient-centered in a humanistic medical sense.

Early performance in a humanistic medicine course as a predictor of dental students' later clinical performance.

The purpose of this study was to test the hypothesis that dental students' early ability to demonstrate a humanistic approach with patients is associated with later clinical performance. A first-year humanistic medicine course, Patient Doctor I (PDI), at Harvard School of Dental Medicine combines training in conducting the medical interview with human values, placing a high value on strengthening relationships with patients and emphasizing empowerment, respect, and strong communication skills. Retrospective data were collected in the following domains: PDI course evaluations, admissions information, National Board Dental Examination Parts I and II scores, and Promotions Committee and faculty evaluation scores for hand skills and humanistic and interactive patient-student skills. Planned linear contrasts comparisons were performed for each clinical outcome variable. Tests to support the a priori hypothesis of linear relationships between PDI evaluation ratings and clinical performance, defined as hand skills and humanistic and interactive patient-student skills scores, were significant, both at p=0.03. This study demonstrated the feasibility of measuring dental students' humanistic qualities during the first year. Humanistic qualities (PDI performance) during the first year were found to be associated with clinical performance in the third year of dental school.

A universidade e a formação dos médicos: reflexões humanistas a propósito do pensamento de Ortega y Gasset / The university and the physicians? education: humanistic reflections regarding Ortega y Gasset

A obra ?Missão da Universidade?, que recolhe as conferências que José Ortega y Gasset apresentou aos alunos da Universidade de Madrid em 1920, brinda uma série de considerações de palpitante atualidade e o ponto de partida para a reflexão que os autores elaboram no presente artigo sobre a formação dos médicos. O aluno de medicina dista muito de sair da faculdade completo e pronto para a profissão. Possui conhecimentos detalhados dos variados aspectos da ciência médica, porém lhe falta a capacidade de integrar as informações. E lhe falta um conhecimento vital do destinatário dessa ação médica integrada: do paciente. A pergunta que se impõe é se as faculdades de medicina estão, de fato, formando o profissional adequado para atender as demandas da sociedade. A universidade deve ser a projeção institucional do estudante, conforme o pensamento do filósofo espanhol. A educação universitária tem como objetivo ensinar uma profissão com competência, promover a pesquisa e agregar cultura ? imprescindível para saber se posicionar no mundo ? nos jovens estudantes. Cabe às faculdades de medicina estabelecer as prioridades do que realmente é possível ensinar ao médico durante os anos de formação, as noções imprescindíveis para ser um profissional competente: um desafio de pouco tempo perante um volume crescente de conhecimento, em que não podem ser os pesquisadores ? mas sim os professores, verdadeiros formadores ?, os que devem dirigir esse processo. Um processo que vai muito além de despejar conhecimentos e novidades, implica o desafio da formação integral de um profissional que será um formador de opinião: para tal é imprescindível o compromisso do professor que deve ser um facilitador da reflexão, um motivador no processo de aprendizagem.

Comparison and Enlightenments of Humanity Education in Medical Colleges in China and Foreign Countries / 中华医学教育探索杂志

There is still evident gap between the humanity education of medical college in China and the foreign country's.We can find the heart of the matter and explore ways of solving the problem,by comparing the present condition of the humanity education of medical college in China and the foreign country's.

Introduction to humanistic medicine and medical humanity / 中华医院管理杂志

The authors first give a detailed account of the background against which humanistic medicine came into being and then expound the connotations of humanistic medicine. These include the following aspects. The first one is humanism and the humanistic spirit. The second one is humanistic medicine and the three implications it embodies. The authors argue that humanistic medicine, taken as the science of benevolence, ought to regard the patient as the unity of three aspects, physiological, psychological and social. The third one is medical humanity, viz. medical humanity is indispensable to the advancement from physiological medicine to humanistic medicine. As to what disciplines are involved in medical humanity, no final conclusion has yet been reached on this matter so far.

Humanistic Quality and Medical Ethics of Doctors in Critical Care Medicine / 中国医学伦理学

Doctors in critical care medicine inevitably face certain problems involved in medical ethics,medical law,human-based medicine,communication,team work,physical and mental stress,and professional tiredness.In order to cope with those problems and stresses and promote their accomplishment in medical ethics,it is of great significance for doctors in critical care medicine to assimilate the achievements of medical humanities,and raise their humanistic quality and abilities.