Data_Sheet_1_Medical Humanities Education and Its Influence on Students' Outcomes in Taiwan: A Systematic Review.docx

BackgroundMedical 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.
MethodsWe 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.
Results17 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.
ConclusionFindings 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.
Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO, identifier: CRD42019123967.

背景 医学教育一直强调将医学人文培训纳入课程体系的重要性，以助力医学生与护理学生的未来临床执业，该项工作多年来也位列台湾地区医疗卫生教育研究的国家级资助优先方向清单之中。然而，此项推动举措在多大程度上促成了医学人文培训的落地、其纳入课程体系的核心理据为何，以及该项培训的实际应用成效仍在很大程度上尚未明确。本研究旨在针对台湾地区的医学人文培训项目，围绕上述问题展开探讨。
方法 本研究实施了一项系统综述。纳入标准为2000年至2019年间，以英语或汉语发表、报告台湾地区医疗卫生教育场景中医学人文课程教学成效的相关研究。本研究遵循系统综述与元分析优先报告条目（Preferred Reporting Items for Systematic Reviews and Meta-Analyses, PRISMA）指南，在PubMed、Embase、ERIC、PsycInfo、Web of Science五大电子数据库中开展了文献检索。本研究采用最佳证据医学教育（Best Evidence Medical Education, BEME）全球量表与柯克帕特里克评估层级（Kirkpatrick Levels）来评估证据强度。
结果 本研究从初步检索获得的134篇文献中，最终筛选纳入17篇。相较于基于认识论视角与批判性视角的研究路径，将医学人文教育纳入课程体系的内在理据与工具性理据更为普遍。研究发现，参与医学人文培训可带来多项积极影响，包括改善参与者的态度、知识储备与专业技能水平。但针对学生行为改变、或其与同事及患者的持续互动这类具有明确效应的最高层级证据，目前仍较为匮乏。
结论 研究结果表明，尽管医学人文教育在台湾地区已得到广泛实施，但目前尚未就其纳入课程的核心理据，以及如何将西方医学人文教育本土化适配至亚洲地区形成明确共识。未来仍需开展相关研究，探索医学人文教育对医学生与护理学生的长期影响，以及其对患者临床照护的实际作用。
系统综述注册信息 注册平台：https://www.crd.york.ac.uk/PROSPERO，注册编号：CRD42019123967。