Recent professionalism initiatives throughout the medical community and the revised ACGME competencies (1999) envision the goals of medical education and practice in the humanistic terms described in earlier in this series. This emphasis has intensified curricular changes in many medical institutions. Thomas Jefferson University’s response has included a more integrated approach to teaching the sciences and clinical skills and to incorporating material and pedagogy from the world of liberal arts throughout the curriculum.

A periodic instructor/presenter in each of the programs cited earlier, I have been a Visiting Scholar/Faculty in Medical Humanities at Thomas Jefferson University since 2000. Sponsorship has been provided by several sources: a Visiting Scholar’s Grant from the Pennsylvania Humanities Council and support from the Center for Palliative Care (2000-2001); the John Templeton Curricular Development Grant in Medicine and Spirituality, the Department of Family Medicine, and the Deans’ Office (2002-present).

Regular, if part-time, participation of a humanities faculty member in Jefferson’s teaching and research community has contributed to several exciting innovations:

• First and Second Year Orientation now include presentations and workshops on empathy, altruism, the nature of suffering, and patients’ views of the physician’s role.
  
  
• Many of the humanities components formerly relegated to electives have been included in the lectures for the first year Medical Practice for the 21st Century. The course syllabus has a guide to the medical humanities anthology On Doctoring edited by Reynolds and Stone and distributed to first year medical students throughout the USA for the past five years, courtesy of the Robert Wood Johnson Foundation. Requirements for the course include students’ personal versions of the Hippocratic Oath, role playing exercises for gathering and giving information, problem-based learning, and brief reflective essays on their office visits and on the impact of their own spirituality.
  
  
• Newly incarnated as Human Form and Development, the course on gross anatomy begins with two presentations on spirituality and the body using poetry and other readings, and has a small-thus far- web portfolio of images of the body in art. These reproductions provide the screen background for lectures on dissection. Indeed, the new course title itself embodies the link between art and medicine. Students also are invited to submit a written response to their anatomy experience. The course concludes with a memorial for the cadavers in the Jefferson anatomy lab.
  
  
• Student completion of the Hojat Empathy Scale developed at Jefferson.

Although the current curriculum has no medical humanities courses per se, the integrated approach insures that all first and second year students participate in the activities described above.

Implementing the terms of the Templeton Grant, in place until 2005, the goals for medical humanities at Jefferson have four features:

1. Introducing more occasions and materials for self reflection at pivotal moments throughout the undergraduate and graduate curriculum and in faculty development programs
2. Improving student communication skills
3. Analyzing the themes which emerge in the narratives the “Templeton team” already has collected and those to be developed
4. Creating assessment tools for evaluating the short and long term impact of these curricular initiatives

A humanistic medical education can lose its potency quickly if not reinforced and modeled, and systematic research has much to reveal about how self-reflection, literature and the arts can exercise the empathy and mindfulness conducive to healing.

Future columns will describe the progress of these objectives and will offer examples of texts, films, and teaching strategies that can be adapted to the needs of many courses and departments.

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