ED 107 541 SO 007 935 TITLE Institute on Human Values in ...

1 DOCUMENT RESUMEED 107 541SO 007 935 TITLEI nstitute on Human Values in Medicine. Human ValuesTeaching Programs for Health for Health and Human Values , Philadelphia, AGENCYN ational Endowment for the Humanities (NFAH),Hashington, DATEApr 74 NOTE202p.; For related documents, see SO 007 920, 921,922, and 934; Not available in hardcopy, Out ofPrintEDRS PRICEMF-$ HC Not Available from EDRS. PLUS POSTAGEDESCRIPTORSC urriculum Development; Ethical Values ; Health;Higher education ; Humanistic education ; Humanities;Humanization; *Interdisciplinary Approach; *MedicalEducation; *Uedicine; *Program Descriptions; *ValuesABSTRACTThis document contains descriptions of 19 teachingprograms which share the common goal of emphasizing Human Values asan important area of education in the-health professions. Thislisting is the result and expansion of the Institute on Health andHuman Values Conference. Three broad areas are outlined which the 19schools emphasize in their programs: paramedical education ; medicalethics; and social science and humanities relationships.

2 The listingsare alphabetical by state, and most include a rationale for a valuesorientationgoals and objectives, resources, and coursedescriptions-. Problems of some of the courses are also listed.(Author/JR).,1,.; ,/}fk11,F >p,..,1itInstituteonHumanValues inMedicineHUMAN Values TEACHING PROGRAMSFOR HEALTH PROFESSIONALSA pril, 1974 Society for Health and Human ValuesChairman of the InstituteEdmund D. Pellegrino, President for Health AffairsChancellor of the Medical UnitsUniversity of Tennessee, MemphisProject Director and EditorLorraine L. Hunt, ,Sponsor and AdministratorSociety for Health and Human Values723 Witherspoon BuildingPhiladelphia, Pennsylvania 19107 Ronald W. McNeur, , Executive DirectorFunded by the National Endowmentfor the HumanitiesGrant NO. EH 7278-73-104;00003,4,00-011,4 Copyright (C) by Society for Health and Human rights publication or parts thereof may not be reproduced inany form without permission from the Society for Health and HumanValues, 723 Witherspoon Building, Philadelphia, Pennsylvania, 1972 the Institute on Human Values in Medicine issued the Pro-ceedings of the Second Session, a report of the Institute 's conferenceheld at Williamsburg, Virginia, in April, of that tothat report were descriptions of Human Values teaching programsthencurrent in eleven medical copies of the Proceedings circulated, it became clear thatthese program descriptions provided significant practical assistanceto individuals who were working on the development of similar programsat their institutions, and wished to review the experience ofothersto facilitate their own the past two years, numerous changes have occurredwithinthe eleven programs originally reported.

3 Moreover,additional humanvalues teaching programs have emerged at eight other orderto make this new information available, the Institute on HumanValuesin Medicine commissioned appropriate persons involved withthese nine-teen programs to prepare new or revised publication is the result of their effort, for whichI wouldlike to record my personal generous sharing of experience,perspective, and practical information that characterizesthese reportscharacterizes their authors also, as I have come to know inthe courseof working with them to produce this cooperation hasbeen outstanding from start to finish of this project,and I am verygrateful to each of L. Hunt; Director and EditorInstitute on Human Values in Medicine00005 TABLE OF CONTENTSF orewordIntroductionCaliforniaUniversity of California-DavisJoe P. Tupin, of California-Los AngelesBernard Towers, , of California-San FranciscoMidhael Garland, UniversityF. C. Redlich, and David C.

4 Duncombe, of ColumbiaHoward University18121728 Doris Adler, Ph, of Florida36 Sam A. Banks, College of Georgia43 Russell R. Moores, of KansasRobert P. Hudson, , Hopkins UniversityDennis G. Carlson, and Geri berg , of MarylandGerard J. Hunt, YorkTABLE OF CONTENTS(Continued)State University of New York-Stony BrookDaniel Fox, CarolinaDuke UniversityMarjorie A. Boeck, of North Carolina-Chapel HillMerrel L. Flair, State University (Hershey Medical Center)E. A. Vastyan, , University of South Carolina129 Albert H. Keller, Jr., , Medical College140 Walter G. Vesper, of Tennessee Medical Units145 David C. Thomaama, of Texas Medical Branch-Galveston157 Chester R. Burns, , College of VirginiaGlenn R. Pratt, nineteen teaching programs described in the following pagesshare the common goal of emphasizing Human Values as an important areaof education in the health have numerous other simi-larities, but many differences as well because over time, each institu-tion has developed a particular approach that best meets its own programs presented here are offered not as models to be copied,but as samples of experience that can be studied and reflected of the variety of style and organization represented, within thiscollection, it may be helpful to indicate briefly certain relationshipsof program emphasis and institutional milieu:*Design for students in paramedical education :Medical College of GeorgiaHoward UniversityJohns Hopkins UniversitySOY-Stony BrookUniversity of Tennessee Medical UnitsUniversity of Texas Medical BranchMedical College of VirginiaEmphasis on medical ethics.

5 University of California-San FranciscoMeharry Medical CollegeClose relation of the social sciences and humanities:University of FloridaMedical College of GeorgiaUniversity of KansasUniversity of MarylandSOY-Stony BrookMedical University of South CarolinaThe table of contents lists schools alphabetically by state, andindicates tl-e page numbers of each comments above areover-simplified labels that are intended to serve only an index function;they should not be considered adequate descriptions of the full link with medical students' initial contacts withpatients, history-taking, early core curriculum courses, of California-DavisUniversity of California-Los AngelesUniversity of KansasDuke UniversityUniversity of North Carolina-Chapel HillUniversity of Texas Medical BranchEmphasis on ward experiences, clerkships, and/or residency:University of FloridaMedical University of South CarolinaMedical College of VirginiaEvolvement from an initial medical school chaplaincy:Medical College of VirginiaYale UniversityResponse to geographical separation from parent university:Medical College of GeorgiaPennsylvania, State University (Hershey Medical Center)University of Texas Medical BranchUtilization of resources of parent university:Duke UniversityUniversity of FloridaSUNY-Stony BrookUniversity of North Carolina-Chapel HillYale UniversityEarly-stage planning efforts.

6 University of MarylandUniversity of North Carolina-Chapel HillUniversity of Tennessee Medical. Unitsiite06009 UNIVERSITY OF CALIFORNIA AT DAVISS chool of MedicinePrepared byJoe P. Tupin,Department of Course:"Behavioral and Environmental Biology"Administrative StructureThis required course extends over three quarters (60 contact hours)during the first year and is taught .by a multi-disciplinary committeefrom the departments of behavioral biology, psychiatry, pediatrics,pharmacology, and community health; the ChairmaiiShip itis scheduled it competes with the Molecular and Cellular Biology Coursein the first quarter and Organ Systems Biology Course (combination ofgross anatomy and physiology) in the second and third is funded from the School of Medicine budget, as are all otherrequired began with the first class at Davis 6 years course committee is responsible administrative committee for execution, budget, faculty committee for implementation of faculty educationalpolicy, , content, quality of instruction, and continuing impetus for the course is the the first two years, the curriculum is divided into a requiredsegment ("core" 20 hour/week) and an elective studentsare not required to take any electives, but may also use the remainderof the day for studying, recreation or rationale of the course is to introduce basic (normal)

7 Bio-logical, psychological, and socio-cultural aspects of behavior as re-lated to health practitioners, patients, and the health care course committee also introduces material relevant to social valuesystems, cultural perspectives, and ethics in health humandevelopmental model is followed, supplemented by presentation ofgeneral socio-psychological topics, , healing, medical control implications of cultural biases and medical de-cisions are and ObjectivesThe principal goal of the course is to provide the freshman medicalstudets with the opportunity to view the inter-relationship of social,cultural, psychological, and biological factors in normal individual andgroup the course the emphasis is on the holisticview of man and his relationship to the social medical practice are and similarities amongcultural and socio-economic groups are emphasized and related to valuesystems, attitudes toward health, is given the roleplayed by personal and cultural value systems as brought to the medicalsetting by the physician (medical student), the patient, and clinical examples are used where and ContentDuring the first two quarters, the course is structured around thedeveloping person, the Human life cycle from conception through death,including the phases of gestation, infancy, childhood, adolescence,youth, adulthood, and old consideration is given to the"common life crises," emphasis is on the maturational process common toage groups, rather than "fixed" developmental norms or of various cultural groups are areas (as well as the general social,--diiitiiika biological,and psychological factors) are integrated into the appropriate develop-mental stages--for example.

8 "Drug Use and Abuse" is covered in thesection on adolescence and third quarter facused on largersocial , impact of focus is on the medical care situation and Human growth anddevelopment, Great emphasis is placed on how these factors influencethe physician's attitudes, decisions, and the patient's access to is an ethical question dealt with in depth or as a pure problem,nor do we commonly focus on the "traditional questions" of , informed consent, therapeutic abortion, of Concern and introduce basic concepts of personal growth as a functionof the social, cultural, and biological bring the student's awareness to bear on his own valuesystem and how it affects him in his relationship to thepatient, medical practice, and the institutions of introduce value systems as a differential expression ofcultural and socio-economic factors.(We are not specificallyconcerned with an elaborate exposition of the various positionsrelated to ethical issues as much as we are concerned with thestudent's awareness of the existence of ethical issues 22r sein his day-to-day activity and specifically, the value systemswhich may bear on his decisions, attitudes, and goals.)

9 Consideration is given to ethics of specific this regard there is in this course (and others) brief dis-cussion of questions of therapeutic abortion, transplantation,informed consent, death, and are not concerned withsupplying a final answer to these difficult questions, butrather in sensitizing the student to ethical issues in day-to-day emerging problem that I suspect will increasingly occupyour attention in this regard is the potential role of themedical profession as an agent for transmission of Values ,Educational Methods and ResourcesWe use audiovisual presentatiops, 'reading assignments, lectures,small-group discussions, and field an operational pointof view, these center around clinical problems so that the student willfeel that the discussion is "medically relevant."Frequent clinical examples are used to illustrate the ethicaldilemmas as well as the various aspects of normal growth and trips to key institutions such as local prisons, nursinghomes, and ;hospitals have been extremely successful in bringing asense of reality to the resources have varied, depending on who was teachrga particular segment, but videotaped interviews of patients, films',reprints, and field trips2 have been most offeringunusual viewpoints have been are five full-time faculty members on the committee is the faculty with the responsi-bility of design, development, and implementation of the , there are six small group leaders drawn from the facu)ty ingeneral who work with the faculty members are availableon request, as are outside course is allotted 20 hours per quarter for has been no problem -- we have used small-group roomsand large lecture rooms on a scheduled.

10 UCB Extension, 16mm -- one of a three-part series on marriage,birth, and trips to prisons, hospital, and emergency :Faith healer, commune are budgeted for $3,000 per year for a 100 have had good support from the Dean and most of the departmentchairmen and a majority of the faculty, as well as the Committee onEducational support has come primarily from the clinicalfaculty, although it extends to all' departments and time we do not envision any major attack, although as noted belowthis course is always somewhat more vulnerable than core curriculum consists of only 20 contact hours per week,with the remaining time available for , thecompetition !"?.r required-course time is keen among the courses that deal with "hard science" havebeen somewhat doubtful of the merit and the time afforded have been unorganized but consistent attemptsto capture some of this time, or to move this course into anelective competition is derived from two bases:(a) the time pressure described above, and (b) the inherentdistrust of behavioral-social issues and their questionable(as seen by other faculty members) application to the practiceof major obstacle has been the organization of thismaterial so that it will be perceived by the student as rele-vant and student body, like most others aroundthe country, is quite concerned about the "relevancy" of thecurriculum, and also is greatly preoccupied with the socialimplications of medical education and organi-zation of this course has been a/ continuous and nagging Course:" Human .