Medical Humanities Education: What to Teach, How to Assess

Learning content and assessment in medical humanities

Medical humanities education develops the ability to understand patients’ lives, suffering, and social relationships alongside the knowledge needed to explain diseases. Literature and the arts, patient narratives, and writing about clinical experiences provide opportunities for students to reflect on their own observations and judgments. Educational aims include empathy and communication, ethical judgment, tolerance of ambiguity, and professional identity formation.

Arts education for reading patient vulnerability

An editorial on the value of arts education examines conflicts between medical professionals and patients, and between medicine and society. It focuses on differences in how narratives are interpreted to understand others’ experiences and suffering (An, 2026). The editorial describes clinical practice as an approach to the patient’s bedside. The bedside is a time and place in which individuals lose control in the face of disease and death and reveal themselves to others. The ability to recognize patient vulnerability and respond with care is an important educational aim of arts education. The editorial examines the three manuscripts in the special issue from historical, philosophical, and practical perspectives. Among them, a narrative literature review situates its discussion within the expansion of Korean medical humanities education following the 2000 separation of drug prescribing and dispensing. This expansion aimed to foster professionalism, social accountability, and communication skills. The literature review cited in the editorial selected 44 papers from six domestic and international databases, and the reported educational outcomes mostly corresponded to Kirkpatrick level 2. Research focused on narrative medicine and reflective writing, with self-report surveys and essays serving as the main sources of outcome data. The literature review proposed establishing arts-based learning as a core component of the integrated six-year curriculum.

The philosophical discussion considers whether students may learn ‘fake empathy’ tailored to assessments when empathy is treated as a standardized communication skill and an assessment task. Phronesis, or practical wisdom, provides a rationale for arts education by enabling students to interpret patients’ silence and hesitation in specific situations. One medical student’s experience was recorded in an intensive care unit parallel chart. The student checked the pupillary and Babinski reflexes of an unconscious patient. The student felt a sense of accomplishment at seeing previously learned knowledge manifested in a body and tried to demonstrate the findings to peers. On lifting the patient’s eyelids, the student perceived sadness in the patient’s gaze. The student interpreted it as saying “stop” and reflected on this behavior. During rounds the next day, the student experienced suffering and a sense of responsibility instead of the pleasure of reporting findings. The editorial connects this change to defamiliarization and the alienation effect (verfremdung) in art. It acknowledges the difficulty of fully explaining how the student came to read the gaze in that way.

Presented as a practical example, the ‘Medicine, Society, Culture and Arts’ course at Yonsei University Wonju College of Medicine served first-year pre-medical students. It offered three sequential modules: ‘Medical Identity and Philosophy’, ‘Arts-Based Education Through Media and Field’, and ‘Career Exploration and Future Planning’. A performance by the Wonju Philharmonic Orchestra is described as an opportunity to practice non-verbal listening. Observing the space and artworks at Museum SAN offers practice in visual literacy and tolerance of ambiguity. The faculty and administrative team rescheduled the regular class to 7 PM to coincide with the external performance and secured funding. Initial student reactions were addressed by presenting scientific evidence on medical observational skills and empathy at the beginning of the semester. The editorial interprets the experience of drawing on the university’s founding spirit and local cultural resources as an emotional resource that fosters community bonds and social accountability. The instructor becomes a ‘companion in interpretation’ who asks what the student saw and heard and treats discomfort and suffering as starting points for reflection.

Understanding human beings through patient narratives and illness narratives

A book review of Connected Suffering links understanding and respect for human beings to medical care and physician training (Han, 2024). The book recounts the stories of patients encountered by an internal medicine specialist during three years of service as a public health doctor at a free clinic for foreign workers in Garibong-dong, Seoul. The review explores the significance of describing patients’ diseases and pain through both the experiences of the young doctor at the time and the reflective perspective of the experienced doctor today. Patient narratives provide material for anthropological and philosophical reflection on the lives of people experiencing suffering.

The review connects childhood experiences in Guro-dong and life as an immigrant in the United States to the patient narratives in the book. It describes both being perceived as a US university professor in Korea and living as an immigrant in the United States. This illustrates how the same person experiences different relationships and treatment depending on the social environment. Memories of doctors who either understood personal illness narratives or did not try to understand them show how medical care is experienced by the person receiving treatment.

Step-by-step curriculum connecting clinical experience and reflection

A study of the Doctoring and Medical Humanities (DMH) curriculum examined how the educational aim of connecting medical practice with humanistic reflection was translated into curriculum design, implementation, and assessment (Lee & An, 2020). At the time of the study, all 40 medical schools in Korea offered medical humanities curricula. Operational challenges included students’ perceptions of these courses as electives, teaching burdens related to instructors’ disciplinary backgrounds, and limited instructional time. Yonsei University College of Medicine formalized ‘Medicine and Society’ through the Curriculum Development Project 2004 (CDP2004). It developed DMH following CDP2013, which promoted the introduction of outcome-based education and absolute grading. To analyze the curriculum reform retrospectively, the research team developed five review questions based on the six steps of Kern’s Curriculum Development Model, which had guided the reorganization. Review materials included the CDP2013 report, committee meeting minutes, workshop materials, curriculum catalogs, syllabi, student handbooks, and assessment rubrics. End-of-course evaluations and graduation surveys from the 2018, 2019, and 2020 graduates who completed the entire reorganized curriculum were also analyzed using means, standard deviations, and Cohen’s d. The needs analysis for the reform took place over one year beginning in June 2011. It drew on student and course evaluations (2006–2011), curriculum committee evaluations (2009–2010), and Introduction to Clinical Medicine surveys (2009–2010). It identified areas for improvement related to content overlap, connections between courses, class participation, and assessment criteria.

DMH was designed as a three-step spiral comprising doctoring basic, practicum, and integrated phases. In the first-year basic phase, students learned principles and concepts of medical communication, medical ethics and law, and medical leadership, and engaged in reflective writing. The leadership component allowed students to choose an area of interest from three sub-tracks. In the second-year practicum, students learned basic physical examination skills and normal findings through encounters with standardized patients. They then conducted examinations and interviews at community clinics and reflected on communication, ethics, law, and social issues. Assessment combined written examinations, assessments of basic clinical skills, evaluations by clinical attendings and standardized patients, and practicum reports. The third- and fourth-year integrated phase used case-based small group discussions, scenario writing, role-playing, and presentations. Topic reviews and grand rounds covered patient safety, precision medicine, big data, AI, palliative care, social accountability, and career development. Innovation projects involved identifying areas for improvement in medical settings and proposing solutions. A standing Medical Humanities and Social Sciences Committee took over the work of a temporary project group and an outcome-based task force team. Course directors and subject directors were responsible for implementation. Small group tutors received an orientation in advance and videos modeling instructional guidance. One administrative staff member supported the committee, classes, assignment grading, and data organization.

The proportion of assessment allocated to tasks increased from 17% to 57% in the first-year basic phase, and from 30% to 61% in the third-year integrated phase. Satisfaction among the 2020 graduates, measured on a 5-point scale, was 3.29±0.91 for the basic phase, 4.11±0.70 for the practicum, 3.84±0.98 for the third-year integrated phase, and 3.58±0.94 for the fourth-year course. Cohen’s d for practicum satisfaction compared with the basic phase was 0.43 in 2018, 0.50 in 2019, and 1.01 in 2020. The proportion citing diverse experiences and knowledge as strengths in open-ended responses was 54.2% [26/48] for the first year and 39.0% [41/105] for the third year. Interaction and small group discussions were also identified as strengths in the third year (36.1%). The study proposed refining questions and assessment guidelines and securing the participation of clinical attendings to help connect clinical experiences with reflection. It also proposed adjustments to assignment workloads and feedback methods. Proposed follow-up work included systematic research on accumulated reflective work and the development of indicators of competency attainment.

Reading notes

In DMH, the proportion reporting assignments as a burden was 30.0% [12/40] in the first year and 77.3% [17/22] in the third year. These figures require consideration of which students answered each open-ended question. Because these results are based on satisfaction and open-ended responses, interpreting them requires distinguishing reactions to classes at successive stages from changes in medical humanities competencies. Research on learning transfer in medical education can examine how interpretations expressed in reflective writing are subsequently drawn on in patient interviews and clinical judgments.

References

An, Shinki. (2026). At the bedside facing vulnerability: The proper place of culture and arts in medical education. Korean Medical Education Review, 28(2), 89–91. https://doi.org/10.17496/kmer.26.025

Lee, I. R., An, S. (2020). A critical review of medical humanities education curriculum development based on Kern’s curriculum development model. Korean Medical Education Review, 22(3), 173–188. https://doi.org/10.17496/kmer.2020.22.3.173

한희영. (2024). 연결된 고통. 의학교육논단, 26(1), 77–78. https://doi.org/10.17496/kmer.24.004