IMHU-4060 - Medical Humanities in Literature: Physician Stories

IMHU-4060 - Medical Humanities in Literature: Physician Stories

Elective Title: Medical Humanities in Literature: Physician Stories
Course Number: IMHU-4060
Elective Type: career Duration/Weeks: 4 Max Enrollment: 5
Prerequisites: Successful completion of Year 2
Additional Requirements: C-form required
Responsible Faculty Director: Anne Hudson Jones, PhD Periods Offered: 5, 6, 7, 9, 10, 12, 13 excluding holiday period 8 
Coordinator: Other Faculty: Other faculty in Medical Humanities
Location to Report on First Day:
Online via Skype or teleconferencing

The goal of this course will be to explore topics of current importance in clinical and social medicine which include chronic illness & suffering, public health, cultural competency, & death & mortality. The medical humanities offer a wide variety of windows into the experiences of physicians and patients. Both fiction and non-fiction provide opportunities to engage with topics that are uncomfortable or difficult is a safe space. Drawing on the experiences of other physicians can provide valuable lessons about social problems, flawed thinking, medical errors, and misunderstandings. These well-written works offer medical students opportunities to explore their own values and what they can do to better serve patients, especially in challenging situations.

Students must demonstrate orally and in writing skills in analyzing the works of literature assigned and how they contribute to understanding narrative and the moral development of the physician.

Description of course activities
Students will read 6 book-length works by and or about physicians, analyze the works in terms of style, perspective, characterization, symbolism, metaphor, and ethical and social implications. Students will meet with the faculty member(s) once each week via Skype or teleconferencing for 2 hours to discuss the materials and analyses. Students will produce a 1-2 page summary of each work and analysis.
A final 10-15 page, double-spaced critical analysis essay covering one or more of the assigned readings will be due by 5:00 p.m. on the final Friday of the period.

Type of students who would benefit from the course
Any medical student interested in physician stories and the medical humanities will find this course valuable.

Weekly Schedule
  Clinical Activities (estimated schedule)  
Day of Week   AM   PM
Monday 8:00-12:00pm Self Study 1:00-5:00 Self Study
Tuesday 8:00-12:00pm Self Study 1:00-5:00 Self Study
Wednesday 10:00am-12:00pm meet with physician 1:00-5:00 Self Study
Thursday 8:00-12:00pm Self Study 1:00-5:00 Self Study
Friday 8:00-12:00pm Self Study 1:00-5:00 Self Study

 Average number of patients seen per week: N/A didactive elective- no clinical component)
 Call Schedule: N/A

Research Activities (estimated schedule)
Activity Hours per Week
Faculty Contact-Time 5
Self-Directed Study 20
Data-Collection/Analysis 15

Method of Student Evaluation
1.  Clinical Observation
  A. Where are students observed on this elective?
    Inpatient Service   Ambulatory   Surgery   Standardized patients
Patients simulators   Other
  B. Frequency - How often are students observed clinically?
  C. Format - What method(s) are used to document the student's clinical performance?
    Daily oral feedback   End of period oral feedback   Written feedback

2.  Oral Presentation
  A. Audience - To whom does the student present?
    Instrutor and one other
  B. Frequency / Duration of Presentation(s)?
  C. Format - What guidelines are set for the student's presentation?
    and discuss the impact on the physician's professional development.
  D. Assessment - Who assesses the student's presentation performance?
    Self-assessment   Peer assessment   Faculty assessment
  E. Method of content selection
    Current cases  Student-selected topic   Assigned topic

3.  Written Assignment (H&P's, notes, papers, abstracts, etc.)
  A. Frequency of written assignment(s)?
    weekly plus a final
  B. Format - What guidelines are set for the student's written work?
    The 1-2 page summaries are informal essays that are part of ordinary participation. The final paper will be 10-15 pages, double-spaced with standard margins and no larger than 12pt font. This is a formal essay that will include full citations.
  C. Length of written assignment(s)?
    Abstract   Annotated bibliography   1 - 2 page paper   3+ page paper
  D. Are recent references required?   No    If yes, how are they selected?
    References are required. The readings will serve as the key sources. However, students may cite from peer-reviewed journals.
  E. Method of content selection - e.g. student-selected, relate to cases, etc.?
    practice of medicine, the experience of medical training, or being a patient.
  F. Audience - Who assesses the student's written performance?
    Peer Assessment     Faculty Assessment     Other

4.  Examination
    Oral   Written multiple choice   Written essay / short answer   OSCE

5.  Extra Course Activities
  What expectations do you have for the student to demonstrate participation in the elective (e.g. small group activities, seminars, thoughtful questions, providing resources, journal club, resident lecture attendance)?

6.  Additional Costs
  Please list any additional costs and/or purchases (books, materials, movies to watch, etc.) that are required for this course. Include an estimated total cost. If there are no additional costs, please enter "None".

7.  Other Modes of Evaluation
  Please explain below.

8.  If this course is an Acting Internship, please complete the following:
  A. Objectives for the AI should relate directly to the Entrustable Professional Activities (EPAs). Each AI should describe how the four key Year-4 EPAs that our school has identified as being Year-4 skills are assessed. The Year-4 objectives are:
1. Entering and discussing orders/prescriptions.
2. Give or receive patient handover to transition care responsibility.
3. Recognizing a patient requiring urgent or emergent care and initiating management.
4. Obtaining informed consent for tests and procedures.
Specify how the student will be given formative feedback on their clinical skills.

Year-4 students should demonstrate mastery of EPAs they developed in the clerkship year, including recommending and interpreting common diagnostic and screening tests, and performing general procedures of a physician. They should be able to demonstrate masterfully and independently skills they mastered in Years 2-3, including efficiently performing comprehensive admission-notes and succinct daily progress notes and perform accurate, concise, and hypothesis-driven clinical presentations, form clinical questions and retrieve evidence to advance patient care. They should be able to demonstrate basic understanding of and beginning mastery of collaborate as a member of the interprofessional team and identify system failures and contribute to a culture of safety improvement.

List advanced clinical skills that a student will be assured an opportunity to practice.

How specifically will this AI build on developing skills from the clerkship year to prepare students for internship?

What opportunities will typically be available to all students who take this AI (procedures, required presentations, etc.)? What opportunities may be available based on patient load/presentation or student initiative (ie. Writing a case report)?

An AI should have expectation of a minimum of 32 hours per week of clinical responsibilities. Duty hours should be capped at ACGME limits for an intern, thus up to 24 hours followed by 4 hours of activities related to patient safety, education, and handoff. Students cannot work more than 80 hours per week averaged over 4 weeks. They can only have 1 day off in a 7-day work week with 8 hours off between shifts.

Clinical responsibilities will vary depending on specialty, but how is the student functioning with work commensurate to a PGY1 with an appropriate level of training?

How is the student demonstrating drawing clinical conclusions and/or developing a management plan and documentation as an intern would do?

How and by whom will midpoint feedback be provided to the student? How will you remediate deficiencies identified at midpoint?

Acting Internship students often seek letters of recommendation following their experience. How many different Faculty will work directly with the student and have knowledge of the student's abilities to detail in a written evaluation? Describe the degree of supervision and interaction with faculty vs. residents or other providers and how feedback will be obtained if more direct work is with residents or other providers.