Medical Humanities in Education: Definition, History, Benefits, Challenges, Debates and Experiences of Medical Schools around the World


Amal A. Abdul-Rasheed El-Moamly, M.D., Ph.D.
Suez Canal University Round Road, Ismailia, Egypt

Series: Education in a Competitive and Globalizing World
BISAC: EDU015000

Medical humanities (MH) teaching is considered an important requirement in medical education curricula, as it is concerned with the human side of medicine. The introduction of MH in medical curricula and training programs aims mainly to produce doctors with professional attitudes, respect for the dignity and humanity of their patients, and concern for the patient as a human being rather than merely a disease to treat. To achieve this holistic view of medicine, MH has been increasingly introduced in medical curricula around the world as an interdisciplinary field of education that acknowledges the theoretical, critical and practical insights from across the social sciences, literature, history, philosophy, religion and arts. The aim here is to explore the meanings attached to health, illness, life and death, and to propose a psychosocial–biological approach to health care.

Since its advent in medical curricula, MH has given rise to many debates. What, why, when, who, and how are controversial questions raised by many experts in the field. This book puts MH under the microscope. It presents an overview of the definition and history of MH, explores the international scene, and evaluates the extent and various forms of MH programs throughout the world. It also discusses the learning theories which support the philosophy of teaching MH, summarizes the debates surrounding MH, pros and cons of MH in medical curricula, challenges to implementation, and priorities for the future. Also explored here is research evidence on the impact of MH in the medical education field and students’ learning outcomes, program evaluation and student assessment methods, factors that contribute to the success or failure of MH education, and further research needs. It is hoped that this book will serve as a guide to medical educators and decision makers at world educational institutions who wish to achieve the benefits of introducing MH in their medical curricula.

Table of Contents

Table of Contents


Chapter 1. Abstract

Chapter 2. Introduction

Chapter 3. Definition of Medical Humanities

Chapter 4. History of Humanities in Medical Curricula

Chapter 5. Debatable Issues on Medical Humanities

Chapter 6. How Exactly Can Medical Humanities Produce Its Beneficial Educational Outcomes?

Chapter 7. Summary of the Advantages of Teaching Medical Humanities

Chapter 8. What Obstacles Are There to Incorporating Humanities in Medical Curricula?

Chapter 9. Other Controversial Issues on Medical Humanities

Chapter 10. Research Evidence of the Impact of Humanities on Medical Education and Learning Outcomes

Chapter 11. What Experiences in Medical Humanities Have Been Implemented in Medical Schools around the World?

Chapter 12. Conclusion

Chapter 13. Search Strategy

Chapter 14. Acknowledgements

Chapter 15. References



[1] Shah, N; Aly, SM. Teaching of medical humanities in medical universities of Pakistan.  J Pak Med Assoc ., 2015, 65 (4), 414-7. [2] Doukas, DJ; McCullough, LB; Wear, S. Reforming Medical Education in Ethics and Humanities by Finding Common Ground With Abraham Flexner.  Acad Med , 2010, 85, 318-23. [3] Penn State University, Students, Humanities, Curriculum. Accessed 12 October 2016 at: [4] Frank, JR. (Ed). The CanMEDS 2005 physician competency framework.  Better standards. Better physicians. Better care.  Ottawa: The Royal College of Physicians and Surgeons of Canada, 2005. [5] Hooker, C. The medical humanities-a brief introduction. Aust Fam Physicians , 2008, 37, 369-70.<br>[6] Fieschi, L; Matarese, M; Vellone, E; Alvaro, R; De Marinis, MG. Medical humanities in healthcare education in Italy: a literature review.   Ann Ist Super Sanita. , 2013, 49(1), 56-64. DOI: 10.4415/ ANN_13_01_10. [7] Evans, M. Reflection on the humanities in medical education. Med Educ , 2002, 36(6), 508-13. <br>[8] Evans, H. Medical humanities: stranger at the gate or long. lost friend?  Med Health Care Philos , 2007, 10, 363-72. DOI: 10.1007/ s11019-007-9079-x. [9] Brody, HJ Defining the medical humanities: Three conceptions and three narratives.  J Med Humanit , 2011, 32, 1-7. DOI: 10.1007/s10912-009-9094-4.  [10] Berger, J; Mohr, J.  A fortunate man. The story of a country doctor . London: Allen Lane, 1968.<br>[11] Evans, M; Arnott, R; Bolton, G; et al. The medical humanities as a field of enquiry. Statement from the Association for Medical Humanities.  J Med Ethics , 2001, 27, 104-105.<br>[12] Kirklin, D. The Centre for Medical Humanities, Royal Free and University College Medical School, London, England.  Acad Med , 2003, 78, 1048-53. [13] Bates, DG. Humanism in undergraduate medical education. Can Med Assoc J</i></b></u>, 1971, 105, 258.<br>[14] Batistatou, A; Doulis, EA; Tiniakos, D; Anogiannaki, A; Charalabopoulos, K. The introduction of medical humanities in the undergraduate curriculum of Greek medical schools: Challenge and necessity.  Hippokratia , 2010, 14, 241-3. [15] Hurwitz, B; Dakin, P. Welcome developments in UK medical humanities.  J R Soc Med , 2009, 102, 84-5. [16]  Medical Humanities -Drew University. Accessed 16 September 2016 at:…/ New_Med_Hum_Course_ List_ 2014-2015.p. [17] Gordon, J. Medical humanities: to cure sometimes, to relieve often, to comfort always. MJA , 2005, 182, 5–8.<br>[18] IC McManus. Humanity and the medical humanities.  Lancet , 1995, 346, 1143-45. <br>[19] Perry, M; Maffulli, N; Willson, S; Morrissey, D. The effectiveness of arts-based interventions in medical education: a literature review. Med Educ</i></b></u>, 2011, 45, 142-8. DOI: 10.1111/j.1365-2923. 2010.03848.x.  [20] Ousager, J; Johannessen, H. Humanities in undergraduate medical education. A literature review.  Acad Med , 2010, 85, 988-98. DOI: 10.1097/ACM.0b013e3181dd226b.  [21] Binetti, P; De Marinis, MG. La prospettiva pedagogica nella Facoltà di Medicina. Roma:  SEU , 2002. <br>[22] Sommerville, M. The search for ethics in a secular society. In: Sommerville Margaret., editor. Ethics of Science and Technology: Explorations of the frontiers of science and ethics. Paris:  UNESCO , 2006, pp. 17–40.<br>[23] Marshall, PA. Anthropology and Bioethics.  Med Anthropol Q. , 1992, 6, 49–73.<br>[24] von Engelhardt, D. Teaching History of Medicine in the Perspective of “Medical Humanities” Croat Med J ., 1999, 40, 1–7.<br>[25] Adel-Halim, R; AlKattan, K. Introducing medical humanities in the medical curriculum in Saudi Arabia: A pedagogical experiment.  Urol Ann , 2012, 4 (2), 73-79 doi:10.4103/0974-7796.95549.<br>[26] Kuper, A. Literature and medicine: A problem of assessment.  Acad Med , 2006, 81, 128-37. <br>[27] Darbishire, P. Understanding caring through arts and humanities: a medical/nursing humanities approach to promoting alternative experiences of thinking and learning.  J AdvNurs , 1994, 19, 856-63. DOI: 10.1111/j.1365-2648.1994.tb01161.x.<br>[28] Wainwright, SP; Williams, C. Culture and ageing: reflections on the arts and nursing.  J AdvNurs , 52(5), 518-25. DOI: 10.1111/ j.1365-2648.2005.03620.x.<br>[29] Dellasega, C; Milone-Nuzzo, P; Curci, KM; Ballare, JO; Kirch, DG. The humanities interface of nursing and Medicine. J Prof Nurs , 2007, 23, 3, 174-9. DOI: 10.1016/j.profnurs.2007.01.006.<br>[30] Ogur, B; Hirsh, D. Learning through longitudinal patient care – Narratives from the Harvard Medical School – Cambridge Integrated Clerkship. </i></b></u><i>Acad Med</i></b></u>., 2009, 84, 844–850.<br>[31] Shapiro, J; Rucker, L. Can poetry make better doctors? Teaching the humanities and arts to medical students and residents at the University of California, Irvine, College of Medicine. </i></b></u><i>Acad Med</i></b></u>., 2003, 78, 953–957.<br>[32] Murray, J. Development of a medical humanities program at Dalhousie University Faculty of Medicine: Nova Scotia: Canada: 1992–2003. </i></b></u><i>Acad Med ., 2003, 78, 1020 –1023.<br>[33] Common Program Requirements.  Accreditation Council for Graduate Medical Education</i></b></u>, July 1, 2011. Accessed 15 June 2016 at: http:/: dh_duty hoursCommonPR07012007.pdf.<br>[34] Evans, M; Finlay, IG. London: BMJ Books, 2001. </i></b></u><i>Medical Humanities , pp. 1–3.<br>[35] Macnaughton, J. The humanities in medical education: context, outcomes and structures. Medi Humanit ., 2000, 26, 23–30.<br>[36] Grant, VJ. Making room for medical humanities. Med Humanit , 2002, 28, 45–8.<br>[37] Saunders, C; Mack, M; Woods, A.  Imaginative Worlds: Medical Humanities and ‘the uses of literature’. Inventions of the Text Seminar Series 2010-2011: The Uses of Literature . Accessed 15 January 2016 at: http://medicalhumanities. 01/17/imaginative-worlds-medical-humanities-and-’the-uses-ofliterature.<br>[38] Brody, H. Defining the Medical Humanities: Three Conceptions and Three Narratives.  J Med Humanit . Accessed 15 February at: <br>[39] Banaszek, A. Medical humanities courses becoming prerequisites in many medical schools. CMAJ</i></b></u>., 2011, 183, E.441–2.<br>[40] Cattorini, P. A qualcunopiaceumano. Narrazione, etica e medicina: il caso del cinema. In: Gentile AE, Luzi I, Razeto S, Taruscio D (Eds). Convegno Medicina narrativa e malattierare. IstitutoSuperiore di Sanità. Roma 26 giugno 2009. Atti. Roma: IstitutoSuperiore di Sanità, 2009. (Rapporti ISTISAN, 09/50). p. 69-85. <br>[41] Parizzi, F. La medicina narrativa. </i></b></u><i>L’arco di Giano , 2009, 61, 165-73.<br>[42] Vettore, L. Luciedombre de i nuovi curricula della facoltà di medicina. L’arco di Giano , 2009, 61, 203-20. <br>[43] Torsoli, A. A course of humanities as part of the undergraduate medical curriculum at two Rome Universities. Medic , 1998, 6, 70-1. <br>[44] Bert, G. Punti di vista, aspetti pragmatici della narrazione.  Medicina Narrativa , 2011, 1, 27-36.<br>[45] Walsh, K. The humanities in medical education – what is the future?  Ann Inst Super Sanità , 2013, 49 (2).<br>[46] Editorial. The arts as aids to learning.</i></b></u><i> J Royal Coll Gen Pract , 1976, 26, 555-9.<br>[47] Cooper, RA; Tauber, AI. New physicians for a New Century. Acad Med , 2005, 80, 1086-8.<br>[48] Coulehan, J.  What is medical humanities and why? Comment, Medical Ethics on Stage, Literature, Arts and Medicine Blog</i></b></u>. Accessed 25 May 2016 at: blog/ ?p=100.<br>[49] British Medical Association Medical Education Subcommittee. </i></b></u><i>Role of the patient in medical education.</i></b></u> Accessed March 2016 at<br>[50] General Medical Council. (2009). Tomorrow’s Doctors 2009: </i></b></u><i>a draft for consultation</i></b></u>. 15 December 2008 to 27 March 2009.<br>[51] Accreditation Council for Graduate Medical Education, (1999). </i></b></u><i>ACGM</i></b></u>E Outcome project. Available at: [ Outcome/comp2.asp].<br>[52] Royal College of Physicians and Surgeons of Canada. Extract from the CanMEDS2000 Project Societal Needs Working Group Report. </i></b></u><i>Med Teach</i></b></u>, 2000, 22, 549–54.<br>[53] Association of American Medical Colleges. Report 1. Learning Objectives for Medical Student Education, Guidelines for Medical Schools. Medical School Objective Project. Washington, DC: AAMC 1998.<br>[54] Muntoni, F. (2009). Medical education and professionalism. </i></b></u><i>The Lancet</i></b></u>, 2009, 373 (9668), 980. <br>[55] Macnaughton, J. The humanities in medical education: context, outcomes and structures.  Med Humanities</i></b></u>, 2000, 26, 23-30.<br>[56] Shapiro, J; Coulehan, J; Wear, D; Montello, M. Medical Humanities and Their Discontents: Definitions, Critiques, and Implications. </i></b></u><i>Acad Med</i></b></u>, 2009, 84, 192-8.<br>[57] Shaikh, A; Humayun, N. Medical Ethics in Undergraduate Medical Education in Pakistan: Towards a Curricular Change. </i></b></u><i>In Contemporary issues in Bioethics</i></b></u>. Accessed 20 Oct 2016 at: 31748.pdf.<br>[58] Federspil, G. Le Humanities e il ragionamento clinico. </i></b></u><i>Medic</i></b></u>, 2004, 12, 27-36.<br>[59] Antiseri, D. Conosciamo solo tramite la Scienza? A che cosa servono l’Arte e la Letteratura. </i></b></u><i>Medic</i></b></u>, 1996, 4, 109-14.<br>[60] Galli, G. Ilrapporto medicina – scienzeumane in un’ottica multidisciplinare. </i></b></u><i>Medic , 2001, 10, 45-9.<br>[61] Binetti, P. Modi e modelli dell aformazione medica. </i></b></u><i>Medic</i></b></u>, 2004, 12, 18-25.<br>[62] Virzì, A; Bianchini, O; Dipasquale, S; Genovese, M; Previti, G; Signorelli, MS. Medicina narrativa: Cos’è? </i></b></u><i>Medicina Narrativa</i></b></u>, 2011, 1, 9-13.<br>[63] Cagli, V. Letteratura, arti e medicina narrativa. </i></b></u><i>Tutor</i></b></u>, 2004, 4, 19-25.<br>[64] Friedman, LD. The precarious position of the medical humanities in the medical school curriculum. </i></b></u><i>Acad Med</i></b></u>, 2002, 77, 320-2.<br>[65] Jakob, O; Helle, J. Humanities in Undergraduate Medical Education: A Literature Review. </i></b></u><i>Acad Med</i></b></u>, 2010, 85, 988-98.<br>[66] Welch, TJ. Harrison, SL. Teaching medicine through the study of literature: Implementing a fourth-year distance learning elective. </i></b></u><i>Academic Medicine</i></b></u>, 2016, 91(3), 360-4. DOI: 10.1097/ACM. 0000000000001030.<br>[67] Walling, A; Merando, A. The fourth year of medical education: A literature review. </i></b></u><i>Acad Med</i></b></u>., 2010, 85, 1698–1704. <br>[68] Cosgrove, EM; Ryan, MJ; Wenrich, MD. Empowering fourth-year medical students: The value of the senior year. </i></b></u><i>Acad Med</i></b></u>., 2014, 89, 533–535.<br>[69] Shapiro, J; Duke, A; Boker, J; Ahearn, CS. Just a spoonful of humanities makes the medicine go down: Introducing literature into a family medicine clerkship. </i></b></u><i>Med Educ</i></b></u>., 2005, 39, 605–612.<br>[70] Jones, AH. Why teach literature and medicine? Answers from three decades.</i></b></u><i> J Med Humanit.</i></b></u>, 2013, 34, 415–428.<br>[71] Arntfield, SL; Slesar, K; Dickson, J; Charon, R. Narrative medicine as a means of training medical students toward residency competencies. </i></b></u><i>Patient Educ Couns.</i></b></u>, 2013, 91, 280–286.<br>[72] Jones, AH; Carson, RA. Medical Humanities at the University of Texas Medical Branch at Galveston. </i></b></u><i>Acad Med</i></b></u>, 2003, 78, 1006-9.<br>[73] Gupta, R; Singh, S; Kotru, M. Reaching people through medical humanities: An iniative. </i></b></u><i>J Educ Eval Health Prof</i></b></u>, 2011, 8, 5.<br>[74] Stern, DT; Jordan, JC; Bruder, A; Packer, B; Sole, A. </i></b></u><i>Teaching humanism Perspect Bio Me</i></b></u>, 200, 51(4), 495-507.<br>[75] Schwartz, W; Abramson, JS; Woinowich, I; Accordino, R; Ronan, J; Rifkin, MR. Evaluating the impact of the humanities in medical education. </i></b></u><i>Mt Sinai J Med</i></b></u>, 2009, 76(4), 372-80. DOI: 10.1002/ msj.20126.<br>[76] Hooker, C; Noonan, E. Medical humanities as expressive of Western culture. </i></b></u><i>Med Humanit</i></b></u>., 2011, 37, 79–84.<br>[77] El-Moamly, A. In: </i></b></u><i>Medical Education in the New Millennium</i></b></u>. 1</i></b></u>st</i></b></u> ed. Nova Science Publishers New York, USA. 2010. <br>[78] Gaufberg, E. Batalden. </i></b></u><i>The third thing in medical education The Clinical Teacher</i></b></u>, 2007, 4, 78–81.<br>[79] Lyss-Lerman, P; Teherani, A; Aagaard, E; Loeser, H; Cooke, M; Harper, GM. What training is needed in the fourth year of medical school? Views of residency program directors. </i></b></u><i>Acad Med</i></b></u>., 2009, 84, 823–829. <br>[80] Silk, H; Shields, S. Teaching Humanities in Medicine: The University of Massachusetts Family Medicine Residency Program Experience. </i></b></u><i>Journal of Learning Through the Arts.</i></b></u>, 2012, 8 (1).<br>[81] </i></b></u><i>Teaching medical humanities at Rochester Medical School</i></b></u>. Accessed April 2016 at: MediaLibraries/URMCMedia/medical-humanities/documents/ 1516-Y1-Med-Hum-seminar-descriptions-1015.pdf.</i></b></u><u><br></i></b></u>[82] Peters, AS; Greenberger-Rosovsky, R; Crowder, C; Block, SD; Moore, GT. Long-term outcomes of the New Pathway Program at Harvard Medical School: A randomized controlled trial.  Acad Med. , 2000, 75, 470–479.<br>[83] DiLalla, LF; Hull, SK; Dorsey, JK. Effect of gender, age, and relevant course work on attitudes toward empathy, patient spirituality, and physician wellness. Teach Learn Med ., 2004, 16, 165–170.<br>[84] Wang, WD; Lue, BH. National Taiwan University College of Medicine, The Design of Medical Humanities Courses for Clerkships.  Acad Med ., 2003, 78 (10), 1073-1074.<br>[85] Shankar, PR. A voluntary medical humanities module in a medical college in Western Nepal: participant feedback.  Teach Learn Med ., 2009, 21(3), 248-53. doi: 10.1080/ 104013309030 20605.<br>[86] Fatovic-Ferencic, S. The History of Medicine Teaching Program in Croatia.  Acad Med ., 2003, 78(10), 1028-1030.<br>[87] Batistatou, A; Doulis, EA; Tiniakos, D; Anoqiannaki, A; Charalabopoulos, K. The introduction of medical humanities in the undergraduate curriculum of Greek medical schools: challenge and necessity.  Hippokratia ., 2010, 14(4), 241–243.<br>[88] Rodriguez delPozo, PR; Fins, JJ. The Globalization of Education in Medical Ethics and Humanities: Evolving Pedagogy at Weill Cornell Medical College in Qatar. Acad Med ., 2005, 80(2), 135-140.<br>[89] Moodley, K. Teaching medical ethics to undergraduate students in post-apartheid South Africa 2003-2006.   J Med Ethics. , 2007, 33(11), 673-677.<br>[90] Oguz, NY. The narrative approach in teaching medical ethics: The Turkish experience.  Med Law ., 2000, 19 (3), 421-431.<br>[91] Li, J; Qi, F; Guo, S; Peng, P; Zhang, M. Absence of humanities in China’s medical education system.  Lancet ., 2012, 18 (380), 648. doi: 10.1016/S0140-6736(12)61368-3.<br>[92] Tokuda, Y; Hinohara, S; Fukui, T. Introducing a New Medical School System into Japan. </i></b></u><i>Ann Acad Med  Singapore, 2008, 37, 800-802.<br>[93] Sheard, S. Developing history of medicine in the University of Liverpool medical curriculum 1995-2005. Med Educ. , 20066, 40 (10), 1045- 1052.<br>[94] Collier, R. Medical education needs overhaul to train more user-friendly physicians, AFMC says. <i>CMAJ ., 2010, 182 (4), E201-E203. doi:10.1503/cmaj.109-3174.<br>[95] Future of Medical Education in Canada (FMEC): A Collective Vision for MD Education Report. Accessed at: fmec/pdf/collective_vision.pdf.<br>[96] Banaszek, A. Medical humanities courses becoming prerequisities in many medical schools.  CMAJ ., 2011, 183 (8), E441-E442.<br>[97] Magwood, B; Casiro, O; Hennen, B. The medical humanities program at the University of Manitoba, Winnipeg, Manitoba, Canada. Acad Med ., 2003, 78 (10), 1015-1019.<br>[98] Shapiro, J; Rucker, J. Training the clinical eye and mind: Using the arts to develop medical students’ observational and pattern recognition skills.  Med Educ. , 2006, 40, 263-268.<br>[99] Cann, W. A testing for ethical standards.  BMJ >., 2005, 330, 1510.<br>[100] Podolsky, SH; greene, JA. Are the Medical Humanities for Sale? Lessons from a Historical Debate. J Med Humanit , (2016) 37, 355. doi:10.1007/s10912-014-9301-9.<br>[101] Kiessling, C; Muller, T; Becker-Witt, C; Bedenau, J; Prinz, V; Schleiermacher, S. A Medical Humanities Special Study Module on Principles of Medical Theory and Practice at the Charite, Humboldt University, Berlin, Germany.  Acad Med ., 2003, 78 (10), 1031-1035.<br>[102] Frich, J; Fugelli, P. Medicine and the Arts in the Undergraduate Medical Curriculum at the University of Oslo Faculty of Medicine, Oslo, Norway. Acad Med ., 2003, 78 (10), 1036-1038.<br>[103] Louis-Courvoisier, M. Medical Humanities: A New Undergraduate Teaching Program at the University of Geneva School of Medicine, Switzerland. Acad Med. , 2003, 78 (10), 1043-1047.

Publish with Nova Science Publishers

We publish over 800 titles annually by leading researchers from around the world. Submit a Book Proposal Now!