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Acad Med. 2015 Nov;90(11):1462-5. doi: 10.1097/ACM.0000000000000743.

Bringing home the health humanities: narrative humility, structural competency, and engaged pedagogy.

Author information

1
R.K. Tsevat is a medical student, Columbia University College of Physicians and Surgeons, New York, New York. A.A. Sinha is a recent graduate, Master's Program in Narrative Medicine, Columbia University, New York, New York. K.J. Gutierrez is a recent graduate, Master's Program in Narrative Medicine, Columbia University, New York, New York. S. DasGupta is a faculty member, Master's Program in Narrative Medicine, Columbia University, New York, New York.

Abstract

As health humanities programs grow and thrive across the country, encouraging medical students to read, write, and become more reflective about their professional roles, educators must bring a sense of self-reflexivity to the discipline itself. In the health humanities, novels, patient histories, and pieces of reflective writing are often treated as architectural spaces or "homes" that one can enter and examine. Yet, narrative-based learning in health care settings does not always allow its participants to feel "at home"; when not taught with a critical attention to power and pedagogy, the health humanities can be unsettling and even dangerous. Educators can mitigate these risks by considering not only what they teach but also how they teach it.In this essay, the authors present three pedagogical pillars that educators can use to invite learners to engage more fully, develop critical awareness of medical narratives, and feel "at home" in the health humanities. These pedagogical pillars are narrative humility (an awareness of one's prejudices, expectations, and frames of listening), structural competency (attention to sources of power and privilege), and engaged pedagogy (the protection of students' security and well-being). Incorporating these concepts into pedagogical practices can create safe and productive classroom spaces for all, including those most vulnerable and at risk of being "unhomed" by conventional hierarchies and oppressive social structures. This model then can be translated through a parallel process from classroom to clinic, such that empowered, engaged, and cared-for learners become empowering, engaging, and caring clinicians.

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PMID:
25945967
DOI:
10.1097/ACM.0000000000000743
[Indexed for MEDLINE]

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