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Acad Med. 2019 Apr 2. doi: 10.1097/ACM.0000000000002732. [Epub ahead of print]

A Lexicon of Concepts of Humanistic Medicine: Exploring Different Meanings of Caring and Compassion at One Organization.

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E. Stergiopoulos is a fourth-year medical student, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. R.H. Ellaway is professor, Department of Community Health Sciences, and director, Office of Health & Medical Education Scholarship, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; ORCID: N. Nahiddi is a resident, Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Qu├ębec, Canada. M.A. Martimianakis is associate professor and director, Medical Education Scholarship, Department of Paediatrics, and scientist and associate director International and Partnerships, The Wilson Centre, Faculty of Medicine University of Toronto, Toronto, Ontario, Canada; ORCID:



There has been scant scholarly attention paid to characterizing how the numerous definitions of terms associated with compassion and humanism have been mobilized or what the organizational implications of pursuing different constructs might be. This study explored the uses and implications of the terminology associated with humanistic medicine in the work of the Associated Medical Services (AMS) Phoenix Project.


This study involved two phases (2014-2015). In the first, different methodologies were explored; this involved two pilot group workshops with AMS Phoenix Project participants and stakeholders that explored ways of parsing and interpreting core concepts used in the project. The authors then assembled an archive of texts associated with the project, comprising the project website and blog posts, conference proceedings, and fellowship and grant applications. Informed by critical discourse analysis, the authors identified, described, and analyzed core terms related to the project's mission and explored the type of health care practices and reforms implied by their use.


Two recurring core terms, care/caring and compassion, and eight clusters of terms related to these core terms were identified in the archive. Caring and compassion as terms were articulated in various psychological, sociological, and political configurations. This polysemy reflected a diverse array of health care reform agendas.


Understanding how different interpretations of caring and compassion cluster around core topics and concerns of humanistic medicine offers scholars an entry point for comparing and appraising the quality and direction of reform agendas, including multilevel strategies that involve systems-level changes.

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