Medical Humanities and their Place in the Curriculum: Opinions of Cobem/2017 Participants

Abstract: There is a growing perception that medical training with an exclusive focus on biological disciplines is insufficient for the understanding of the complexity and individuality of human illness. We start from the assumption that medical humanities make an important contribution to medical education, through references to expanded understanding of the health-disease process and to the organization of health care, that is, directed at humanization. This work sought to assess the perceptions of a group of students, teachers and coordinators of a medical course on the integration of the disciplines of medical humanities in the curricula of medical courses. The descriptive, quantitative and cross-sectional research consisted of the application of a structured questionnaire to a group of participants of the 55th Brazilian Congress of Medical Education (COBEM, Porto Alegre, RS, October/2017), considered to be a convenience sample. The event participants were approached during the intervals of the conferences and invited to answer a questionnaire that sought opinions on the insertion and the integration of the disciplines of the human sciences into the curricula of the medical courses. The questionnaire also contained the sample’s characterization of the region of origin, the legal scope of the institution (private, public or confessional) and the role of the respondent (teacher, student or coordinator). A total of 234 (two hundred and thirty-four) individuals answered the questionnaires, which were submitted to descriptive statistical analysis. The analysis showed that the medical humanities are perceived as important for the medical formation, but there is no consensus about their being crucial for the acquisition of humanistic skills. There are interdisciplinary curricular experiences; however, not all of them perceive the subjects of humanities at different times in the medical curriculum or articulated with other disciplines. While interdisciplinary experiences are perceived more easily, the cross-sectional articulation of humanistic topics appears to a lesser degree. According to the answers, the disciplines remain concentrated only in the initial periods; however, the perception of sufficiency discloses quite divided opinions. There is also a slight difference in opinion about the articulation of the humanities in the basic and advanced cycles. The lower perception of integration of the humanities appears in practices that integrate teaching-service-community.

摘要：当前学界逐渐形成共识，仅聚焦生物学科的医学培训，难以让从业者充分理解人类疾病的复杂性与个体差异性。本研究基于如下假设：医学人文学科可通过拓展对健康-疾病过程的认知、优化医疗照护的组织模式（即旨在实现医疗人性化），为医学教育提供重要支撑。本研究旨在评估某医学课程的学生、教师及课程协调员群体，对医学人文学科融入医学课程体系的认知情况。

本项描述性定量横断面研究，采用便利抽样法，以2017年10月于巴西阿雷格里港举办的第55届巴西医学教育大会（COBEM）参会者为研究对象，通过结构化问卷开展调研。研究人员在会议间歇期间向参会者发放问卷，征询其关于人文学科嵌入与融入医学课程体系的相关意见。问卷内容还涵盖样本的来源地区、所属院校的办学属性（私立、公立或教会院校）以及受访者的身份（教师、学生或课程协调员）。

最终共有234名（二百三十四名）参与者完成问卷，研究采用描述性统计方法对回收数据进行分析。分析结果显示，尽管多数受访者认为医学人文学科对医学人才培养具有重要意义，但对于其是否为获取人文关怀技能的关键要素，尚未达成广泛共识。当前医学课程已存在跨学科教学实践，但并非所有参与者都认可人文学科在医学课程不同阶段或与其他学科联动的教学模式。相较于跨学科教学实践，人文主题的横向课程融合在现有体系中体现得相对较少。调研结果表明，医学人文学科仍仅集中设置于医学课程的初期阶段，而关于课程设置充足性的看法则存在显著分歧。此外，参与者对于基础与进阶学习阶段的人文学科融合模式也存在轻微的认知差异。在教学-服务-社区联动的实践中，医学人文学科的融合认知度相对更低。