Teaching the Art of Medicine: A Changing Portrait in Today’s Medical Schools Aaron Lambert, Todd Gress, Marie Veitia Office of Student Affairs & Department.

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Teaching the Art of Medicine: A Changing Portrait in Today’s Medical Schools Aaron Lambert, Todd Gress, Marie Veitia Office of Student Affairs & Department of Internal Medicine Joan C. Edwards School of Medicine, Huntington, WV Introduction  No one to date has ever asked the question “Can the ‘art of medicine’ be taught?” in a scientific study  The art of medicine is slowly being eliminated from medical curriculum – why?  More time for basic science education  Disillusionment in ability to teach intangibles  Disagreement of importance of intangibles in education and patient care  Students who lack education in professionalism and are reprimanded in medical school are 3-8x more likely to be sanctioned in practice 2.  The foundations of the science and the manner in which they are utilized in patient care are, in fact, two parts of one body, not separate conflicting entities  This study poses three main questions: 1.Can the art of medicine be taught? 2.Is the art of medicine important in undergraduate medical education? 3.If so, what is the most effective method of teaching the art of medicine? Methods  The “art of medicine” was defined as “the way in which knowledge is related to advice and treatment. 1 ”  Surveys were created with 13 total questions: 8 questions on a 5-point Likert scale 4 multiple-choice questions 1 short-answer question all surveys were anonymous  Distribution involved two parts: Distributed to all faculty attending physicians, fellows, and residents of MUSOM Distributed to all MS-I students with 3 omitted questions regarding application of art in practice Surveys were returned via campus mail  Surveys were analyzed by: age, gender, medical school attended, field of specialty, and years in practice Study Group Characteristics  Total Surveyed – 278  Response Rate 78.4% (218 surveys returned)  Mean Age – 33.6 yrs, SD – 11.7 yrs  Gender – 86 females (41.1%), 123 males (58.9%)  Status – 58 attendings, 12 fellows, 73 residents, 75 students  84.5% US Graduates vs. 15.5% International Medical Graduates  Years in Practice – 0 yrs: yrs: yrs: yrs: 20 >20 yrs: 50 “Is/Does the art of medicine…” “Regarding the art of medicine, I…” Percent Agree the Art of Medicine Can Be Taught, by Years in Practice Implications  With 81% believing it can be taught and the belief increasing with increasing years of practice, perhaps the more experienced have a better grasp of what the art is, and therefore a better idea of how to teach it.  If 92% believe it is critical and 90% think it is as important as basic science, these results go against the popular trend of today’s evidence-based curriculum. Perhaps we need to rethink our curriculum – are a few more facts worth not being taught how to use them?  The majority opinion on how to teach it seems to be role- modeling and reviewing experiences of doctors. Are we holding our preceptors accountable for their actions?  “…most of us would rather be treated by a doctor who is not only an expert on disease, but also has a feel for people. 3 ” Abstract Objective: The purpose of the present study was to assess attitudes toward the value of the “art of medicine” in medical education, beliefs regarding whether it can be taught and, if so, the methods of teaching that would be most effective. Method: As described by the British Medical Journal (2006), the “art of medicine” is defined in the present study as “the way in which knowledge is related to advice and treatment. 1 ” Data was gathered via 278 anonymous surveys distributed to all Marshall-affiliated physicians, fellows, residents, and entering first-year medical students using a 5-point Likert Scale. Surveys were then analyzed by demographics including age, gender, medical school attended, and field of specialty. Results: Out of 278 surveys, 218 were returned resulting in a 78% response rate. Ninety percent of respondents believe that the art of medicine is as important to medical practice as the basic sciences and ninety-two percent believe it to be a critical component of medical education. Eighty-one percent believe that the art of medicine can be taught, and seventy-six percent would support finding more time in the curriculum for teaching the art of medicine. Out of options given, most respondents seemed to favor role-modeling by preceptors (68%), reviewing experiences of physicians (59%), and small-group discussions (56%) as the most effective methods of teaching the art of medicine. Discussion: The faculty, residents, and first-year students of Marshall University School of Medicine clearly support teaching the art of medicine and believe it can, in fact, be taught and is not just something inherent to certain individuals. Several methods of teaching were identified as important by those surveyed, and action must be taken to ensure the art of medicine is not lost in the shuffle or removed from the undergraduate medical curriculum. Limitations: 1. Single-institution study 2. Small sample size 3. Self-made questionnaire References: 1. Cook Harold J. What stays constant at the heart of medicine. BMJ 2006;333: Pelofsky S. The voice of art and the art of medicine. J Neurosurgery 2002;97: Macgregor Roy. The art of medicine:striving for a more holistic view of our patients. The Lancet 2001;358: