Humanism in global oncology curricula: An emerging priority.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 10505-10505
Author(s):  
Meredith Elana Giuliani ◽  
Maria Athina (Tina) Martimianakis ◽  
Janet Papadakos ◽  
Michaela Broadhurst ◽  
Erik Driessen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Curriculum Design ◽  
Descriptive Statistics ◽  
Healthcare Team ◽  
Biomedical Model ◽  
Shared Decision ◽  
Medical Expert ◽  
Cultural Considerations ◽  
Over Time

10505 Background: Training in humanism provides the skills to achieve shared decision making with patients and their families, to navigate systems level challenges and to function positively within the healthcare team. However, there is potentially a lack of attention to humanistic competencies in global oncology curricula due to the dominance of the biomedical model in curriculum design, the challenge of assessing humanistic competencies and global cultural considerations. The aims of this study were to explore to what extent humanistic competencies are included in global oncology curricula and the nature of the humanistic competencies included. Methods: Sixteen global oncology curricula identified in a prior systematic review were analysed. The curricula were coded using the Gold Foundation’s I.E.C.A.R.E.S (Integrity, Excellence, Collaboration & compassion, Altruism, Respect & Resilience, Empathy and Service) humanistic competency framework and the CanMEDS framework. Descriptive statistics were used to describe the proportion of items attributed to each aspect of the framework. Results: 7733 curricular items were identified in the 16 curricula and 729 (9%) aligned with the I.E.C.A.R.E.S framework. The proportion of humanistic items in individual curricula ranged from 2% to 26%. The proportion of humanistic items has been increasing from the curricula published in 1980-1989 (3%) to the curricula published in 2010-2017 with a mean of 11% (4 to 25%). There was a higher proportion of humanistic competencies in curricula from the European region (9%) than in other regions. Of the humanistic items 35% were under respect, 31% under compassion, 24% under empathy, 5% were under integrity, 2% under excellence, 1% under altruism, and 1% under service. The majority of the humanistic items also aligned with the professional (35%), medical expert (31%) or communicator (26%) CanMEDS domains. Conclusions: The proportion of humanistic competencies has been increasing in global oncology curricula over time however the overall proportion remains low. Humanism is largely represented by competencies of respect, compassion and empathy and there exists a conflation between humanism and professionalism. Future global curricular efforts may benefit from attention to incorporating all aspects of humanistic competencies.

scholarly journals Humanism in global oncology curricula: an emerging priority

2020 ◽  
Vol 27 (1) ◽  
Author(s):  
M. Giuliani ◽  
M.A. Martimianakis ◽  
M. Broadhurst ◽  
J. Papadakos ◽  
R. Fazelad ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Quality Of Care ◽  
Biomedical Model ◽  
Shared Decision ◽  
Medical Expert ◽  
Competency Domains ◽  
Western Perspective ◽  
Over Time

Introduction Training in humanism provides skills important for improving the quality of care received by patients, achieving shared decision-making with patients, and navigating systems-level challenges. However, because of the dominance of the biomedical model, there is potentially a lack of attention to humanistic competencies in global oncology curricula. In the present study, we aimed to explore the incorporation of humanistic competencies into global oncology curricula.Methods This analysis considered 17 global oncology curricula. A curricular item was coded as either humanistic (as defined by the iecares framework) or non-humanistic. If identified as humanistic, the item was coded using an aspect of humanism, such as Altruism, from the iecares framework. All items, humanistic and not, were coded under the canmeds framework using 1 of the 7 canmeds competency domains: Medical Expert, Communicator, Collaborator, Leader, Scholar, Professional, or Health Advocate.Results Of 7792 identified curricular items in 17 curricula, 780 (10%) aligned with the iecares humanism framework. The proportion of humanistic items in individual curricula ranged from 2% to 26%, and the proportion increased from 3% in the oldest curricula to 11% in the most recent curricula. Of the humanistic items, 35% were coded under Respect, 31% under Compassion, 24% under Empathy, 5% under Integrity, 2% under Excellence, 1% under Altruism, and 1% under Service. Within the canmeds domains, the humanistic items aligned mostly with Professional (35%), Medical Expert (31%), or Communicator (25%).Conclusions The proportion of humanistic competencies has been increasing in global oncology curricula over time, but the overall proportion remains low and represents a largely Western perspective on what constitutes humanism in health care. The representation of humanism focuses primarily on the iecares attributes of Respect, Compassion, and Empathy.

scholarly journals Key components of shared decision making models: a systematic review

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e031763 ◽  
Author(s):  
Hanna Bomhof-Roordink ◽  
Fania R Gärtner ◽  
Anne M Stiggelbout ◽  
Arwen H Pieterse
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Healthcare Professional ◽  
Shared Decision Making ◽  
Treatment Options ◽  
Healthcare Setting ◽  
Shared Decision ◽  
Eligibility Criteria ◽  
Choice Awareness ◽  
Over Time

ObjectivesTo (1) provide an up-to-date overview of shared decision making (SDM)-models, (2) give insight in the prominence of components present in SDM-models, (3) describe who is identified as responsible within the components (patient, healthcare professional, both, none), (4) show the occurrence of SDM-components over time, and (5) present an SDM-map to identify SDM-components seen as key, per healthcare setting.DesignSystematic review.Eligibility criteriaPeer-reviewed articles in English presenting a new or adapted model of SDM.Information sourcesAcademic Search Premier, Cochrane, Embase, Emcare, PsycINFO, PubMed, and Web of Science were systematically searched for articles published up to and including September 2, 2019.ResultsForty articles were included, each describing a unique SDM-model. Twelve models were generic, the others were specific to a healthcare setting. Fourteen were based on empirical data, 26 primarily on analytical thinking. Fifty-three different elements were identified and clustered into 24 components. Overall, Describe treatment optionswas the most prominent component across models. Components present in >50% of models were:Make the decision (75%),Patient preferences (65%),Tailor information (65%),Deliberate (58%), Create choice awareness (55%), andLearn about the patient(53%). In the majority of the models (27/40), both healthcare professional and patient were identified as actors. Over time,Describe treatment optionsandMake the decisionare the two components which are present in most models in any time period.Create choice awarenessstood out for being present in a markedly larger proportion of models over time.ConclusionsThis review provides an up-to-date overview of SDM-models, showing that SDM-models quite consistently share some components but that a unified view on what SDM is, is still lacking. Clarity about what SDM constitutes is essential though for implementation, assessment, and research purposes. A map is offered to identify SDM-components seen as key.Trial registrationPROSPERO registration CRD42015019740

scholarly journals Healthcare professionals’ behaviour regarding the implementation of shared decision-making in screening programmes: A systematic review

2021 ◽  
Author(s):  
María José Hernández-Leal ◽  
María José Pérez-Lacasta ◽  
María Feijoo-Cid ◽  
Vanesa Ramos-García ◽  
Misericòrdia Carles-Lavila
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Shared Decision Making ◽  
Healthcare Professionals ◽  
Shared Decision

Shared Decision Making in Psoriasis: A Systematic Review of Quantitative and Qualitative Studies

2018 ◽  
Vol 20 (1) ◽  
pp. 13-29 ◽  
Author(s):  
Marie Hamilton Larsen ◽  
Kåre Birger Hagen ◽  
Anne Lene Krogstad ◽  
Astrid Klopstad Wahl
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Shared Decision Making ◽  
Qualitative Studies ◽  
Shared Decision

scholarly journals Shared decision making for the initiation and continuation of dialysis: a proposal from the Japanese Society for Dialysis Therapy

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Kazuyoshi Okada ◽  
Ken Tsuchiya ◽  
Ken Sakai ◽  
Takahiro Kuragano ◽  
Akiko Uchida ◽  
...  
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Japanese Society ◽  
Healthcare Management ◽  
Maintenance Hemodialysis ◽  
Decision Making Process ◽  
Healthcare Team ◽  
Shared Decision ◽  
Dialysis Therapy ◽  
Terminal Stage

Abstract Background In Japan, forgoing life-sustaining treatment to respect the will of patients at the terminal stage is not stipulated by law. According to the Guidelines for the Decision-Making Process in Terminal-Stage Healthcare published by the Ministry of Health, Labor and Welfare in 2007, the Japanese Society for Dialysis Therapy (JSDT) developed a proposal that was limited to patients at the terminal stage and did not explicitly cover patients with dementia. This proposal for the shared decision-making process regarding the initiation and continuation of maintenance hemodialysis was published in 2014. Methods and results In response to changes in social conditions, the JSDT revised the proposal in 2020 to provide guidance for the process by which the healthcare team can provide the best healthcare management and care with respect to the patient's will through advance care planning and shared decision making. For all patients with end-stage kidney disease, including those at the nonterminal stage and those with dementia, the decision-making process includes conservative kidney management. Conclusions The proposal is based on consensus rather than evidence-based clinical practice guidelines. The healthcare team is therefore not guaranteed to be legally exempt if the patient dies after the policies in the proposal are implemented and must respond appropriately at the discretion of each institution.

scholarly journals Strategies to facilitate shared decision-making about pediatric oncology clinical trial enrollment: A systematic review

2018 ◽  
Vol 101 (7) ◽  
pp. 1157-1174 ◽  
Author(s):  
Eden G. Robertson ◽  
Claire E. Wakefield ◽  
Christina Signorelli ◽  
Richard J. Cohn ◽  
Andrea Patenaude ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trial ◽  
Decision Making ◽  
Shared Decision Making ◽  
Pediatric Oncology ◽  
Shared Decision ◽  
Oncology Clinical Trial ◽  
Clinical Trial Enrollment

Compassion and Responsibility

2020 ◽  
pp. 205-256
Author(s):  
Joshua Hordern
Keyword(s):  
Decision Making ◽  
Christian Theology ◽  
Shared Decision ◽  
Preventive Healthcare ◽  
Second Person ◽  
Clinical Communication ◽  
Book Of Job ◽  
Conceptual Clarity ◽  
The Relationship ◽  
Over Time

This chapter explores how responsibility, fault, and desert matter for the content of compassion with particular reference to the idea of rationing by fault, shared decision-making, and recent UK law regarding the relationship between responsibility, risk, and consent. Conceptual clarity is sought through exploring how tragedy differs from Christian theology by deploying the contrasting categories of the ‘undeserving sick’, the ‘obstinate sick’ and the ‘sad sick’, as applied to clinical communication, pastoral discretion, and mercy. The chapter considers what may be learnt for the interrelation of responsibility with compassion from the Book of Job. This analysis deepens the earlier account of second-person relatedness and compassion, by considering the category of ‘remonstration’. This is then applied to practice through a discussion of the constraints on certain forms of public and preventive healthcare. The chapter concludes by drawing on ecclesiological motifs to describe how compassionate relationships can persevere over time.

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