The formation and performance of medical humanities by interns in a clinical setting

Objectives: There were two aims of this study: first, we attempted to identify the medical humanities performed by interns in the clinical ward; second, we wanted to explore the ways that interns learn medical humanities. Materials and Methods: This research was carried out in a general internal medicine model unit of a medical center in southern Taiwan. Researchers conducted field work by participant observation in the ward for 9 months from December 2008 to May 2009, and from November 2009 to January 2010. Eight interns were enrolled in this study. Humanistic behaviors performed by the interns who were investigated during the course of their medical activities were recorded in field records. After participant observation, five interns were interviewed to collect information on their learning processes related to medical humanities. The field records and interview transcriptions were coded according to categories of medical professionalism defined in this study. Results: Four major characteristics of medical humanities were observed from the field work: primacy of patient welfare, patient autonomy, social justice, and sincerity. The most common humanistic practices performed by the interns included converting medical knowledge into lay language when communicating with the patient's family, closing the bedside curtain for privacy and arranging social worker consultations to help patients. Three learning models were also identified that were associated with the performance of humanistic practices observed in the field. Interns may learn medical humanities through learning by doing, a teaching-learning model, informal peer learning, or a combination of these. Conclusion: This study confirmed that sincerity is a characteristic of medical professionalism and medical humanities. Participant observation can be used as an ideal tool for identifying humanistic medical practices in daily clinical settings, and an interview can become a supplemental method to validate what has been observed.