Who will benefit from this research?
This proposal has been formulated with three distinct sets of beneficiaries in mind. In the first instance, we want to engage anyone involved in teaching the health humanities at UK universities, regardless of their primary disciplinary affiliation. Within this group we would number not only academics in medicine, nursing and the humanities but also arts-health practitioners of various kinds. In the second, we want to help funders of health humanities teaching and research to base their decisions on better evidence than is currently available to them. In this group we would number the AHRC, the ESRC, the MRC, the Wellcome Trust, the Leverhulme Trust, and the Calouste Gulbenkian Foundation. Abroad, we believe our findings could be of interest to the National Institutes of Health (NIH). Finally, we believe that this study will also be of interest to professional bodies involved in the training of clinicians. On the clinical side, this would encompass the Royal College of Nursing and all of the Royal Colleges associated with specific medical specialties. We also believe that certain subgroups of humanities scholars involved in interdisciplinary teaching and research with clinicians will be interested in our findings. Here we have in mind (in addition to the Association of Medical Humanities) the English Association, the Royal Historical Society, the British Society for the History of Medicine, the Society for the Social History of Medicine, and the Institute of Medical Ethics. These beneficiaries are either broadly in the public sector or heavily involved in funding the public sector. We do not envisage that our study will have any impact on the commercial private sector.
How will they benefit from this research?
Teachers of medical humanities may be able to strengthen the case for subject-specific disciplinary content in medical / health humanities courses. In the case of teachers of literature courses in medical / health humanities programmes, the anthology we will compile will provide an important teaching tool. This will be a key text for Medical Humanities courses, and of interest to a wider public in its engagement with issues of medicine, health, illness, and the body, and its challenge to the over simple uses of literature in these contexts. Funders will acquire a new kind of evidence to help inform their decisions. At the moment, the Wellcome Trust is the largest single funder of this kind of research in the UK. The applicants in this instance also have the advantage of running the two largest-scale Centres in the health humanities in the UK today (funded by the Wellcome Trust). Hurwitz is the director of King's College London's Centre for the Humanities and Health. Evans and Saunders are Co-Director and Associate Director of Durham's Centre for the Medical Humanities. Both of these Centres have ambitious programmes of public engagement and outreach, excellent connections with bodies such as the Royal College of Physicians and the NHS, strong community, schools and Arts in Health networks, and links with public policy. They also liaise regularly with the Wellcome Trust. Borsay and Evans are members of the Wellcome Trust Expert Review Group for Medical History and Humanities. They will be able to feed back the results of this study to that body directly. Our third set of beneficiaries will be able to use the template established in our two workshops to test the effectiveness of other humanities disciplines in clinicians' lives.
Lastly, the RA will acquire an insight into complex, multi-disciplinary research and research management.
Across the UK and Europe, medical or health humanities courses are becoming increasingly common in medical and nursing curricula, although there is little consensus as to what the health humanities encompass. In a survey of humanities curricula in 17 Canadian medical schools, Kidd (2008) found that 'Canadian medical humanities programs are largely shaped by individual educators' interests, experience and passions.' Moreover, while there is agreement that the health humanities should strive to foster empathy, respect, self-awareness, and reflective practice among students, there is not much hard evidence to show that humanities disciplines help cultivate any of these qualities.
Perhaps the most novel claim about a humanities discipline has been made on behalf of literary study. Charon et al (1995) argued that 1) 'literary accounts of illness can teach physicians concrete and powerful lessons about the lives of sick people; 2) great works of fiction about medicine enable physicians to recognize the power and implications of what they do; 3) through the study of narrative, the physician can better understand patients' stories of sickness and his or her own personal stake in medical practice; 4) literary study contributes to physicians' expertise in narrative ethics; and 5) literary theory offers new perspectives on the work and the genres of medicine.'
The investigators in this study wish to explore the possible differences a taught course in literary reading might make to clinicians in their professional lives and how any such differences might be measured. To that end, they will convene two interdisciplinary methodological workshops which will lay the ground for a randomised controlled trial involving a taught and an untaught group who will read the same literary works in the same sequence over a one year period. The first workshop will determine the best outcome and process measures of difference between the two groups. This will entail a dialogue between literary researchers and researchers with a scientific training in the conduct of comparative trials. The second workshop will have as its aim to devise a course composed exclusively of demanding texts, spanning a range of periods and cultural attitudes, which will call into question easy assumptions about medicine, illness, health, the body and human flourishing.
The study matters because large sums in higher education resources are currently being directed into the health humanities. Research funders in the UK and abroad are developing this area; the evidence base for their decisions is still underdeveloped.
Two international scholars will be invited to both workshops: Dr Rolf Ahlzén, from the University of Karlstad, Sweden, who has written a PhD thesis entitled 'Why Doctors Should Read' (not yet published); and Prof. Anne Scott, an internationally renowned health humanist at Dublin City University where she is professor and head of the School of Nursing. Prof. Scott has a strong interest in the role of the humanities in professional education and clinical practice. Each workshop will be carefully structured in advance and will last one day for a maximum of 10-12 participants.
The results will be disseminated to the Medical / Health Humanities community including funders. The investigators hope to use the outcome of this exploratory award to apply for funding for a large-scale, interdisciplinary study next year.