Deborah Kirklin

A cluster design controlled trial of arts-based observational skills training in primary care

Objective  To investigate whether the observational skills of doctors and nurses can be improved by arts‐based observational skills training.

Living with and dying from cancer: a humanities special study module

We describe a humanities-based, special studies module (SSM) exploring the impact of cancer on the lives of patients, families and professionals. Literature, film, art and drama provide third year medical undergraduates with vicarious experience of all of these perspectives in a format that has proved highly acceptable to students and tutors. The development, delivery, evaluation and evolution of this humanities-based course are described and we highlight some important elements of course organisation that emerged as being integral to its success.

Responding to the implications of the genetics revolution for the education and training of doctors: a medical humanities approach

Background  Rapid advances in the field of genetics continue to present medical educators with significant challenges. Whilst there is undoubtedly a pressing need to educate doctors about genetic disorders, research and therapies, there is a parallel need to provide a context for all of these.

Humanities special studies modules: making better doctors or just happier ones?

“ … the sensitivity of the artist may equal the knowledge of the scientist. Both have the same object, nature, and perhaps in time it will be possible for them to link together in a great and marvellous force which is at present hard to imagine.”1 These are exciting times for medical humanities in the UK, with artists and scientists working hand in hand to help deliver a more humanistic approach to health care.2 The existence of this journal and the wealth of innovative work it reports in this issue bear testimony to the enthusiasm and creativity of those active in the field. Throughout the country educators are taking up the challenge contained in the General Medical Councils (GMC) Tomorrows Doctors 3 and are developing and delivering humanities special study modules (SSMs) to complement the core medical …

The Journal of Medical Ethics and Medical Humanities: offsprings of the London Medical Group

Ted Shotters founding of the London Medical Group (LMG) 50 years ago in 1963 had several far reaching implications for medical ethics, as other papers in this issue indicate. Most significant for the joint authors of this short paper was his founding of the quarterly Journal of Medical Ethics (JME) in 1975, with Alastair Campbell as its first editor-in-chief. In 1980 Raanan Gillon began his 20-year editorship (after which 5-year appointments extendable for up to 2 further years were instituted!). Gillon was succeeded in 2001 by Julian Savulescu, followed by John Harris and Soren Holm in 2004, with Julian Savulescu starting his second and current term in 2011. In 2000 an additional special edition of the JME, Medical Humanities (MH), was published, under the founding joint editorship of Martyn Evans and David Greaves. In 2003 Jane Macnaughton succeeded David Greaves as joint editor. Deborah Kirklin, under whose auspices MH became an independent journal, took over in 2008, and she was succeeded in 2013 by Sue Eckstein. This short paper offers reminiscences and reflections from the two journals’ various editors. From the start the JME was committed to clearly expressed reasoned discussion of ethical issues arising from or related to medical practice and research. In particular, both Edward Shotter and Alastair Campbell, each a cleric (one Anglican, the other Presbyterian), were at pains to make clear that the JME was not a religious journal and that it had no sort of partisan axe to grind. Campbells appointment as founding editor was something of a surprise, as the original intention had been to appoint a medical doctor, who (‘up to the elbows in blood’) could be expected to know medical practice from the inside. However, in 1972 Campbell, a Joint Secretary of the Edinburgh Medical Group, had published Moral dilemmas in medicine . …

Ancient answers to modern maladies: the art of actively seeking out the patient’s voice

Sometimes, perhaps more often than most of us like to admit, it can feel like we’re just pawns in some giant chess game. Too small and insignificant to influence the players, we worry instead about how the game will end, cherishing those moments when, just occasionally, for a moment or two, we seem to be in control of what’s happening around us. For the ancient Greeks the players of this all too often cruel game were the gods, a group of individuals whose petulance, power and pride demanded attention and respect. And no matter how hard some might try to thwart the gods, few doubted that fate would out in the end with the only choice available to mere mortals being about how one lived, not how, when or why one died. Watching the events of the last nine months unfold, as natural and manmade disasters have wreaked havoc around the world, as individuals and their leaders have sought to give a voice to the feelings of powerlessness that these events have engendered, and as fears of social unrest have raised haunting spectres from the past, the echoes of Greek tragedy haven’t seemed that far away. And as more and more people around the world are forced to learn to adapt to these changed circumstances the human need to understand what it all means can be overwhelming. The search for meaning and the drive to create meaning where none appears to exist is perhaps central to what it means to be human. And it is in our one to one encounters with each other, with the world around us, and with our own sense of self that this search for meaning begins. For patients, families and doctors the challenges and uncertainties that accompany serious illness can provide an unwelcome impetus …

Editorial: Medical students and arts and humanities research—fostering creativity, inquisitiveness, and lateral thinking

In the first issue of this journal, Education and Debate asked whether medical humanities would help make better doctors or just happier ones.1 That question begs a number of others, among them: what is a good doctor, what attributes might such a doctor possess, and are there different kinds of good doctors that medical educators should be helping to graduate? Appropriately, the focus of much of the published data on arts and humanities based medical education is on equipping doctors with the skills, knowledge, and attitudes necessary for clinical practice. The emphasis, either explicitly or implicitly, is on the doctor/patient interaction, and on the role of medical humanities in enhancing the quality of that interaction. The ability to appreciate the perspective of all those affected by illness, to reflect on one’s own practice, and to contextualise the lived experience of illness, socially, culturally, and historically are among the objectives ascribed to medical humanities teaching. By contrast, the Education and Debate paper in this issue describes a medical humanities …

Metaphors for medicine: revealing reflections or just popular parodies?

“‘ . . .before you get spoilt by it all. Before you become a fully qualified doctor, just give me a helping hand as a human being.’ (Kostoglotov: cancer patient)”1 Are human beings irreversibly “spoilt” by medical training or merely disengaged from “normal” human interaction? If what is desired is a doctor who reaches out as a human being to his or her patients then it is important for educators to know why that sometimes fails to happen. Is the end product of medical training (sometimes) incapable of stretching out its hand or instead just disinclined to do so? If the latter, then presumably we should focus our energies on motivating practitioners to reach out by, for example, inspiring empathy. If, however, medical …

Questioning the habitual and taken-for-granted

In the fifth of a series of papers, Alan Bleakley and Rob Marshall1 “use thinking with Homer as a medium and metaphor for questioning the habitual and the taken-for-granted in contemporary [medical] practice”. The importance of being prepared to challenge the status quo has been brought into sharp and painful relief by the on-going scandals about the care, or rather lack thereof, provided to some National Health Service (NHS) patients, most notably in The Mid-Staffordshire NHS Foundation Trust. The status quo in Mid-Staffordshire was one of poor care, high mortality rates and widespread patient concern, compounded by managerial and clinical inaction. Appalling care had, quite literally, become habitual and taken-for-granted. As the inquiry report makes clear, there were many warning signs, but because of “an engrained culture of tolerance of poor standards, a focus on finance and targets, denial of concerns, and an isolation from practice elsewhere”, as well as professional disengagement whereby “clinicians did not pursue management with any vigour with concerns they may have had”, nothing was done to improve the situation.2 With hindsight, it seems all too obvious what should have …

The isolation, loneliness and helplessness of being homeless

One of the hotly debated questions, at the journals recent editorial board meeting, was how to communicate, to our readers, the clinical relevance of the papers we publish. It is an interesting question, and one moreover that begs several others, not least amongst them being whether it is appropriate to expect a medical humanities scholarship to be directly, or indirectly relevant to patient care and clinical practice. Laying that old bugbear to one side, I would like to argue that one of the strengths of medical humanities is its ability to shine a light into some of the darker, and more neglected corners of medicine and social care, and thereby revealing what can be uncomfortable truths. Take, for example, the cover image for this issue, featuring Homeless 1 , by medical student Rory Hutchinson, one of the winners of the inaugural MDU Mark Brennan Prize (Visual Arts category). Rorys work was ‘inspired by the treatment of homeless patients within the medical system’, and aims to ‘raise awareness …