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Humanism in Health and Healthcare

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    • Humanism in Health and Healthcare Homepage

         

      The course Humanism in Health and Healthcare provides foundational theoretical and practical knowledge and skills to help address the complex and multi-dimensional nature of health and illness. This course offers you the opportunity to plan practice humanistic techniques to assist patients during times of illness or stress and provides humanistic strategies to help you work collaboratively with patients to ensure positive outcomes and health behavior changes. 

      This Humanism in Health and Healthcare course was developed in partnership with the Oakland University -- William Beaumont School of Medicine and The Arnold P. Gold Foundation. Like all NextGenU.org courses, it is competency-based, using competencies from the American Association of Colleges of Nursing, the Association of American Medical Colleges, and the National Board of Osteopathic Medical Examiners. 

      This course was redesigned in 2022 by Anthony Schlaff MD, MPH; Magali Collonnaz MD, MPH, MSc; Pablo Baldiviezo Rodriguez, MD, MSc, DiplEd; Reisha Narine, MSc; Sherian Bachan, MSc; Seema Persaud, MSc. The original course developers were Jason Adam Wasserman, Ph.D., and Stephen Loftus, Ph.D.; additional content creators are Ashley Inez Garzaniti, MSIV; Nathan Loudon, MSIV; Matthew Drogowski, MD; Dorothy Levine, MD; Lesley Miller, MD; and Hedy S. Wald, Ph.D.


        OUWB              Gold Logo


      There are 13 modules to complete, which include: 

      • Module 1. History of Medicine, Modernism, and the Emergence of the Biomedical Model 
      • Module 2. The Epidemiological Transition and the Humanistic (Re)turn 
      • Module 3. Medicalization and social control 
      • Module 4. The Biopsychosocial Model
      • Module 5. The Birth of Bioethics and the Evolution of Humanism 
      • Module 6. The Science of Empathy
      • Module 7. Building Empathy:  Practices of the Senses
      • Module 8.. Empathy in Practice:  Narrative Medicine/Narrative Communication
      • Module 9. Self Care:  Caring for Self to Care for Others
      • Module 10. Problems of Otherness and Dilemmas of Difference
      • Module 11. Marginalization*
      • Module 12. From Cultural Competency to Cultural Humility: Habits of Respectful Curiosity 
      • Module 13. The Future of Humanism in Health and Health Care

      *For module 11, you are to choose at least five lessons to complete from those available, based on your interests as well as your educational and professional needs)

      The completion time for this course is estimated to be 69 hours which includes 39 hours of didactics and curated resources and 30 hours of work participating in activities and quizzes to assist the student in the synthesis of the materials. This course is equivalent to 2 credit hours.

      At the end of each module, there is a practice quiz with multiple-choice questions. At the end of the course, after you’ve completed each lesson, quiz, and learning activity, you’ll have access to a final exam with multiple-choice questions and a chance to evaluate this course. Once you’ve passed that last test, you will be able to download a certificate of completion from NextGenU.org. We keep all of your personal information confidential, never sell any of your information, and only use anonymized data for research purposes. We are also happy to report your testing information and share your work with anyone (your school, employer, etc.) at your request. 

      Engaging with this Course:

      This free course is primarily intended for public health students, public health professionals, medical students, and clinicians who would like to learn more about prevention and health promotion, as well as the importance of working collaboratively with patients to ensure that their individual needs are met. Clinicians and non-clinicians can take the course as there are resources listed as suitable for both audiences.

      To obtain a certificate, a learner must successfully complete:

      • all the reading requirements,
      • all required quizzes and pass with 70% having unlimited attempts,
      • all discussion forums
      • all peer activities
      • all reflection activities
      • a final examination
      • the self and course evaluation forms.

      NextGenU.org is happy to provide your institution with

      • a link to and description of the course training, so they can see all its components, including the cosponsoring universities and other professional organization cosponsors; 
      • your grade on the final exam;
      • your work products (e.g. case study activities), and any other required or optional shared materials that you produce and authorize to share with them;  
      • your evaluations -- course, and self-assessments;
      • a copy of your certificate of completion.

      To obtain a degree, NextGenU.org co-sponsors degree programs with institutional partners. To obtain a full degree co-sponsored with NextGenU.org, registrants must be enrolled in a degree program as a student of a NextGenU.org institutional partner. If you think that your institution might be interested in offering a degree with NextGenU.org, contact us.

      We hope that you will find this a rewarding learning experience, and we count on your assessment and feedback to help us improve this training for future students.

      Here are the next steps to take the course for credit:

      • Complete the registration form.
      • Take the pre-test.
      • Begin the course with Module 1: Introduction to Global Mental Health. In each lesson, read the description, complete all required readings and any required activity, and take the corresponding quizzes.

      This course meets nationally approved standards of education developed for the addiction/substance use disorders counseling profession. This course's participants are assured that the continuing education (CE) credits provided will be accepted toward national credentialing by the NAADAC Certification Commission for Addiction Professionals (NCC AP), as well as by many of the individual state licensing/certification bodies in the addiction and other helping professions.




      *The previous version of this course is also available here for your reference but is not available for registration. Only students that were registered prior to November 25th, 2022 may complete it.

      • Module 1: History of Medicine, Modernism, and the Emergence of the Biomedical Model

        Competencies covered in this module:

          Knowledge for Practice (AAMC)

        • Demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and social-behavioral sciences, as well as the application of this knowledge to patient care (AAMC 2)
        • Apply principles of epidemiological sciences to the identification of health problems, risk factors, treatment strategies, resources, and disease prevention/health promotion efforts for patients and populations (AAMC 2.4)

          Systems-Based Practice (AAMC)

        • Demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care. (AAMC 6)
        • Advocate for quality patient care and optimal patient care systems (AAMC 6.4)

          Professionalism (AACOM)

        • Knowledge - Demonstrate knowledge of the behavioral and social sciences that provide the foundation for the professional competency, including medical ethics, social accountability and responsibility, and commitment to professional virtues and responsibilities. ( AACOM V.)

          Systems-Based Practice

        • Demonstrate an understanding of how patient care and professional practices affect other healthcare professionals, healthcare organizations, and society.  (AACOM VII.) 
        • Demonstrate an understanding of how current issues in the world are affecting health care delivery to patients and the community.

          (AACN) 

        • Demonstrate an appreciation of the history of and contemporary issues in nursing and their impact on current nursing practice. ( AACN VIII.5)
        • Synthesize theories and concepts from liberal education to build an understanding of the human experience.
        • Module1: Lesson 1: The Emergence of Modern Medicine

          Learning Objectives:
          Upon completion of this module, students should be able to:
          • Describe the transition from pre-modern to modern medicine and its impact on humanism in health and healthcare.
          Approximate time required for the readings for this lesson (at 144 words/minute): 3 hours and 4 minutes.

          Click here to start this lesson

          2 URLs
          • Required Learning Resources and Activities
          • Innovation Through Tradition: Rediscovering the “Humanist” in the Medical Humanities URL

            Read the content under the headings "Introduction: origin narratives of the medical humanities", "The studia humanitatis and the crisis of American medicine", and "Conclusion: innovation through tradition". (49 minutes)

            J Med Humanit - 2016

          • How Clinicians Integrate Humanism in their Clinical Workplace—‘Just Trying to Put Myself in their Human Being Shoes’ URL

            Read the content under the headings Introduction, Discussion, and Conclusion. (9 minutes)

            Perspectives on Medical Education - 2018

        • Module 2. The Epidemiological Transition and the Humanistic (Re)turn

          Competencies covered in this module:

            Knowledge for Practice (AAMC) 

          • Demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and social-behavioral sciences, as well as the application of this knowledge to patient care.
          • Apply principles of epidemiological sciences to the identification of health problems, risk factors, treatment strategies, resources, and disease prevention/health promotion efforts for patients and populations ( AAMC 2.4 )

            Practice-Based Learning and Improvement (AACOM.)

          • Describe and apply systematic methods to improve population health. (AACOM VI.)
          • Identify the determinants of populations’ health.
          • Identify sources of disparities in populations’ health and access to care.

            Public Health Systems Competencies(AACOM.)

          • Assesses and addresses the determinants of health and illness factors contributing to health promotion and disease prevention (AACOM XII.)

            (AACN)

          • Demonstrate an appreciation of the history of and contemporary issues in nursing and their impact on current nursing practice. (AACN VIII.5)
          • Synthesize theories and concepts from liberal education to build an understanding of the human experience.
          • Module 2: Lesson 1:The Epidemiological Transition

            Learning Objectives:
            Upon completion of this module, students should be able to:
            • Define and discuss the epidemiological transition.
            • Analyze how shifts in the epidemiological profile of disease have caused shifts in the structure and function of the health care system.
            Approximate time required for the readings for this lesson (at 144 words/minute): 6 hours and 18 minutes.

            Click here to start this lesson

            2 URLs, 1 Forum
            • Required Learning Resources and Activities
            • The Epidemiological Transition (or What We Died, Die and Will Die From) URL

              Read the entire article. (8 minutes)

              IS Global: Barcelona Insitute for Public Health - 2017

            • Updating the Epidemiological Transition Model URL

              Read the following sections: Introduction, Development of models with stages of transition, and Divergence from the western transition model. (18 minutes)

              Epidemiology and Infection - 2018

            • Discussion Forum: Changes in the epidemiological profiles of outbreaks and its impact on health care systems (300 minutes)

              General Instructions

              In this learning activity you will select one of the identified outbreaks and discuss how shifts in the epidemiological profile of disease have caused shifts in the structure and function of the healthcare system.

              Step 1: Select and Reflect

              Select one of the public health emergencies below and reflect on how the diseases’ epidemiological profiles have caused shifts in the structure and function of health care systems.

              • COVID-19
              • Ebola
              • Monkey Pox

              Step 2: Respond

              Using supporting data, to back your arguments, prepare a 400-500 words written piece which discusses the epidemiological transition of the selected disease and how it caused shifts in the healthcare system. Ensure that your response includes the following:

              • Resources, that is, distribution of human and physical resources; ability to increase capacity to cope with a sudden surge in demand; and motivated and well-supported workforce.
              • Service delivery, that is, alternative and flexible approaches to delivering care.
              • The role of humanism in health care (i.e., how it may improve patient care and personal satisfaction, especially during challenging times).

              Step 3: Share 

              To share your work, click on the “Add a new discussion topic” button under this post and paste your work into the “Message” box. Make sure to reference others’ intellectual property when necessary. All references should follow 7th Edition APA formatting. For further instructions, see the resource on the Himmelfarb Health Sciences Library: APA citation resource (N.B.: references are excluded from word counts).

              Step 4: Interact 

              To complete the activity, you will need to reply to at least two posts made by your peers in a respectful and professional manner. Be sure that your post engages your peers' ideas by including a reflection on their comments, sharing ideas on other potential difficulties and parties involved, or asking thought-provoking questions. If a peer comments on your posting, please reply. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.”

          • Module 2: Lesson 2: The Impact of the Epidemiological Transition on Humanism in Health and Healthcare

            Learning Objectives:
            Upon completion of this module, students should be able to:
            • Describe how late modern epidemiological transitions have contributed to a re-emerging emphasis on humanism in health and healthcare.
            Approximate time required for the readings for this lesson (at 144 words/minute): 52 minutes.

            Click here to start this lesson
            2 URLs, 1 Quiz
            • Required Learning Resources and Activities
            • Addressing Challenges in Humanistic Communication During COVID-19 Through Medical Education URL

              Read the content under the following sections: Introduction, Humanism in Medical Education and Practice, and Discussion. (14 minutes)

              Frontiers - 2021

            • Quiz: Module 1 and 2

              To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

            • Recommended Additional Readings
            • The End of Modern Medicine: The Evolution of Disease and Transformations in Medical Practice URL

              Please read the entire article. (34 minutes)

              Journal of Healthcare, Science, and the Humanities - 2012

          • Module 3. Medicalization and Social Control

            Competencies covered in this module:

              Knowledge for Practice (AAMC)

            • Demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and  social-behavioural sciences, as well as the application of this knowledge to patient care. (AAMC 2)
            • Apply principles of social-behavioural sciences to provision of patient care, including assessment of the impact of psycho-social and cultural influences on health, disease, care seeking, care compliance, and barriers to and attitudes toward care. (AAMC 2.5)

              Professionalism  (AAMC) 

            • Demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles. (AAMC 5)
            • Demonstrate a commitment to ethical principles pertaining to provision or withholding of care, confidentiality, informed consent, and business practices, including compliance with relevant laws, policies, and regulations. (AAMC 5.6)

              Professionalism: Ethics

            • Demonstrate knowledge of and the ability to apply ethical principles in the practice and research of osteopathic medicine, particularly in the areas of provision or withholding of clinical care, confidentiality of patient information, informed consent, business practices, the conduct of research, and the reporting of research results. (AACOM V. 6)

              (AACN)

            • Engage in ethical reasoning and actions to provide leadership in promoting advocacy, collaboration, and social justice as a socially responsible citizen. (AACN I. 6)
            • Module 3: Lesson 1: Medicalization and Social Control

              Learning Objectives:
              Upon completion of this module, students should be able to:
              • Define medicalization.
              • Describe how medicalization reflects power dynamics inherent to medicine and health care.
              Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour and 9 minutes.

              Click here to start this lesson
              2 URLs
              • Required Learning Resources and Activities
              • Medicalization Defined in Empirical Contexts – A Scoping Review URL

                Read the content under the following sections: Background, Results, and Discussion. (23 minutes)

                International Journal of Health Policy and Management - 2020

              • Recommended Additional Readings
              • Medicalization: A Historical Perspective URL

                Read the entire article. (20 minutes)

                Journal of General and Family Medicine - 2017

            • Module 3: Lesson 2: Medicalization and Overdiagnosis

              Learning Objectives:
              Upon completion of this module, students should be able to:
              • Identify how medicalization leads to over-diagnosis and articulate why this may negatively impact patient care.
              Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour and 1 minute.

              Click here to start this lesson
              2 URLs
              • Required Learning Resources and Activities
              • Medicalisation and Overdiagnosis: What Society Does to Medicine URL

                Read the content under the headings, from "Introduction" to "The Dual Relationship Between Overdiagnosis and Medicalisation." (17 minutes)

                Published by Kerman University of Medical Sciences in the International Journal of Health Policy and Management - 2016

              • Recommended Additional Readings
              • How to Distinguish Medicalization from Over-medicalization? URL

                Read the content under the following sections: Abstract, Introduction, Various effects of medicalization and over‑medicalization, and Over‑medicalization: a pragmatic approach. (10 minutes)

                Medicine, Health Care and Philosophy - 2018

            • Module 4: The Biopsychosocial Model

              Competencies covered in this module:

                Knowledge for Practice (AAMC)

              • Demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and social-behavioral sciences, as well as the application of this knowledge to patient care. (AAMC 2)
              • Apply principles of epidemiological sciences to the identification of health problems, risk factors, treatment strategies, resources, and disease prevention/health promotion efforts for patients and populations. (AAMC 2.4)

                Medical Knowledge (AACOM)

              • Articulate basic biomedical science and epidemiological and clinical science principles related to patient presentation. (AACOM II. 1)
              • Demonstrate an appreciation of the history of and contemporary issues in nursing and their impact on current nursing practice. (AACN VIII. 5)
              • Module 4: Lesson 1: An Overview of the Biopsychosocial Model

                Learning Objectives:
                Upon completion of this module, students should be able to:
                • Define each aspect of the biopsychosocial model and describe each interacts with the others to form a more robust picture of health and illness in contrast to the traditional biomedical model.
                • Describe potential shortcomings of the biopsyhosocial model; in particular, analyze whether it is a sufficient framework for humanism in health and healthcare.
                Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour and 22 minutes.

                Click here to start this lesson
                2 URLs, 1 Quiz
                • Required Learning Resources and Activities
                • The New Old (and Old New) Medical Model: Four Decades Navigating the Biomedical and Psychosocial Understandings of Health and Illness URL

                  Read the entire article from "Abstract" to "A Question of Method and Discipline: The Future of the Biopsychosocial Model through the Lens of Adolescence Medicine." (24 minutes)

                  National Center for Biotechnology Information (NCBI) - 2017

                • Quiz: Module 3 and 4

                  To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

                • Recommended Additional Readings
                • The Biopsychosocial Model and the New Medical Humanism URL

                  Read the content under the headings from "1. Engel’s biopsychosocial model" until " Updating the science and philosophy of the BPSM." (27 minutes)

                  Archives de Philosophie Volume 83 Issue 4 - 2020

              • Module 5: The Birth of Bioethics and the Evolution of Humanism

                Competencies covered in this module:

                  Professionalism (AAMC)

                • Demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles. (AAMC 5)
                • Demonstrate respect for patient privacy and autonomy. (AAMC 5.3)
                • Demonstrate a commitment to ethical principles pertaining to provision or withholding of care, confidentiality, informed consent, and business practices, including compliance with relevant laws, policies, and regulations. (AAMC 5.6)

                  Professionalism: Knowledge (AACOM)

                • Demonstrate knowledge of the behavioral and social sciences that provide the foundation for the professionalism competency, including medical ethics, social accountability and responsibility, and commitment to professional virtues and responsibilities. (AACOM V. 1)
                • Demonstrate social accountability and responsibility (i.e. the welfare of the patient or society should supersede the physician’s self-interest). (AACOM V. 1c)

                  Professionalism: Ethics (AACOM)

                • Demonstrate knowledge of and the ability to apply ethical principles in the practice and research of osteopathic medicine, particularly in the areas of provision or withholding of clinical care, confidentiality of patient information, informed consent, business practices, the conduct of research, and the reporting of research results. (AACOM V. 6)
                • Apply the ethical principles of autonomy, beneficence, non-malfeasance, fidelity, justice, and utility. (AACOM V. 6f)

                  (AACN)

                • Engage in ethical reasoning and actions to provide leadership in promoting advocacy, collaboration, and social justice as a socially responsible citizen. (AACN I. 6)
                • Module 5: Lesson 1: The Historical Evolution of Bioethics

                  Learning Objectives:
                  Upon completion of this module, students should be able to:
                  • Describe the origins of bioethics as a discipline, including watershed cases in both medical research and clinical medicine and the development of its foci from acute dilemmas to broader social and humanistic aspects of ethics.
                  Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour and 21 minutes.

                  Click here to start this lesson
                  1 URL
                  • Required Learning Resources and Activities
                  • The Rise of Bioethics: A Historical Overview URL

                    Read the entire webpage. (27 minutes)

                    National Center for Biotechnology Information (NCBI) - 2018

                • Module 5: Lesson 2: Clinical Ethics Analysis

                  Learning Objective:
                  Upon completion of this module, students should be able to:
                  • Discuss the principles of clinical ethics and articulate four key domains of analysis ("the four topics") of clinical ethics issues.
                    . Analyze the four key domains of clinical ethics analysis for where notions of humanism are manifest and where normative ethics analysis may not be fully humanistic.
                  Approximate time required for the readings for this lesson (at 144 words/minute): 2 hours and 1 minute.

                  Click here to start this lesson
                  1 URL
                  • Required Learning Resources and Activities
                  • Jonsen’s Four Topics Approach as a Framework for Clinical Ethics Consultation URL

                    Read the content under the headings "Abstract", "Introduction","Results" "Discussion", and "Conclusion." (37 minutes)

                    National Center for Biotechnology Information (NCBI) - 2018

                • Module 6: The Science of Empathy

                  Competencies covered in this module:

                    Patient Care (AAMC) 

                  • Provide patient-centered care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health.
                  • Counsel and educate patients and their families to empower them to participate in their care and enable shared decision-making.

                    Knowledge for Practice (AAMC) 

                  • Demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and social-behavioral sciences, as well as the application of this knowledge to patient care.
                  • Apply principles of social-behavioral sciences to the provision of patient care, including assessment of the impact of psychosocial and cultural influences on health, disease, care seeking, care compliance, and barriers to and attitudes toward care.

                    Interpersonal and Communication Skills (AAMC)

                  • Demonstrate interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families, and health professionals.
                  • Demonstrate insight and understanding about emotions and human responses to emotions that allow one to develop and manage interpersonal interactions.

                    Osteopathic Principles and Practices (AACOM) 

                  • Approach the patient with recognition of the entire clinical context, including mind-body and psychosocial interrelationships.
                  • Recognize and treat each patient as a whole person, integrating body, mind, and spirit.
                  • Demonstrate caring, compassionate, and empathetic behavior during the application of OMT in the clinical setting.
                  • Diagnose clinical conditions and plan patient care.
                  • Consider the patient’s perspective and values in diagnostic decision-making.

                    Patient Care  (AACOM) 

                  • Form a patient-centered, interprofessional, evidence-based management plan.
                  • Elicit the patient’s perspective on the current situation and modify the diagnostic and treatment plan as appropriate in response to the patient’s needs and preference.
                  • Recognize and respond appropriately to the ethical dimensions of clinical decision-making.

                    Interpersonal and Communication Skills  (AACOM) 

                  • Establish and maintain the physician-patient relationship.
                  • Explore the psychosocial, occupational, and biomechanical environment in which the patient lives and/or in which health care is administered.
                  • Conduct a patient-centered interview that includes the following.
                  • Communicate in a manner that demonstrates sensitivity to gender as well as to racial and cultural diversity.

                    Professionalism: Humanistic Behavior  (AACOM) 

                  • Demonstrate humanistic behavior, including respect, compassion, probity, honesty, and trustworthiness.
                  • Provide polite, considerate, and compassionate treatment to every patient.

                    (AACN)

                  • I.1:  Integrate theories and concepts from liberal education into nursing practice.
                  • I.2:  Synthesize theories and concepts from liberal education to build an understanding of the human experience.
                  • VIII.3: Promote the image of nursing by modeling the values and articulating the nursing profession's knowledge, skills, and attitudes.
                  • Module 6: Lesson 1: The Science of Empathy

                    Learning Objectives:
                    Upon completion of this module, students should be able to:
                    • Describe the notion of empathy, and how it differs from sympathy.
                    • Describe the scientific basis for empathy and its contributions to interpersonal interactions and relationships.
                    • Analyze how the concept of empathy is critical to medical practice, and particularly important after the epidemiological transition (you'll need to draw on concepts from previous modules in this course to do so adequately).
                    Approximate time required for the readings for this lesson (at 144 words/minute): 5 hours and 54 minutes.

                    Click here to start this lesson
                    2 URLs, 1 Forum
                    • Required Learning Resources and Activities
                    • Empathy, sympathy and compassion in healthcare: Is there a problem? Is there a difference? Does it matter? URL

                      Read the entire article. (24 minutes)

                      Journal of the Royal Society of Medicine - 2020

                    • The Science of Empathy URL

                      Read the entire article. (14 minutes)

                      Journal of Patient Experience - 2017

                    • Case Scenario: Differentiating between empathy and sympathy (240 minutes) Forum

                      General Instructions

                      In this learning activity, you will read and analyze the case scenario below and answer questions as it relates to empathy and sympathy in the medical setting.

                      Case Scenario

                      You are a doctor in a small town. You have been seeing patients all day; it is now your last appointment for the day. A 34-year-old woman presents to her primary care physician with fatigue and flu-like symptoms for the past two weeks. She reports that her temperature has been elevated to 37°C and has reduced energy levels and a poor appetite. She has also developed a rash on her chest and her body feels especially achy. She is generally feeling quite unwell. After completing a physical examination and ordering some blood tests, the doctor sits down with the patient to explain the results.

                      The tests indicate that the patient has a rare and aggressive form of cancer that has already spread throughout her body. There is no cure and the prognosis is poor, with most patients only surviving for a few months after diagnosis. As the doctor, you must remain professional and stoic, but you cannot help but feel empathy for the patient and their situation. You sit down with the patient and their family and can see the pain in their eyes. You can feel their grief, and you know that they are struggling. You take a deep breath and try to be as present as possible. You explain the situation to the patient and her family and provide them with information about treatment options and end-of-life care. You listen to their stories, and you offer them your condolences. You try to be as understanding and compassionate as possible. 

                      Step 1: Reflect

                      Read and reflect on the case scenario below as it relates to sympathy and empathy in a medical setting.

                      Step 2: Respond

                      Based on the case scenario above, prepare a 300-400 words written response that answers the following key questions:

                      1. What is empathy and how was it portrayed in the scenario above?
                      2. What is sympathy and how was it portrayed in the scenario above?
                      3. How is empathy critical to medical practice, and why is it particularly important after the epidemiological transition?
                      4. How do you maintain professionalism and appropriate expression of empathy when breaking bad news?

                      Step 3: Share 

                      To share your work, click on the “Add a new discussion topic” button under this post and paste your work into the “Message” box. Make sure to reference others’ intellectual property when necessary. All references should follow 7th Edition APA formatting. For further instructions, see the resource on the Himmelfarb Health Sciences Library: APA citation resource (N.B.: references are excluded from word counts).

                      Step 4: Interact 

                      To complete the activity, you will need to reply to at least two posts made by your peers in a respectful and professional manner. Be sure that your post engages your peers' ideas by including a reflection on their comments, sharing ideas on other potential difficulties and parties involved, or asking thought-provoking questions. If a peer comments on your posting, please reply. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.”

                  • Module 6: Lesson 2: Empathy in Patient Care

                    Learning Objective:
                    Upon completion of this module, students should be able to:
                    • Describe how empathy affects measurable patient outcomes and the evidence supporting this in the research literature.
                    Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour and 16 minutes.

                    Click here to start this lesson
                    1 URL, 1 Quiz
                    • Required Learning Resources and Activities
                    • The Role of Empathy in Health and Social Care Professionals URL

                      Read the entire article. (22 minutes)

                      Healthcare Journal - 2020

                    • Quiz: Module 5 and 6

                      To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

                    • Recommended Additional Readings
                  • Module 7: Building Empathy: Practices of the Senses

                    Competencies covered in this module:

                      Knowledge for Practice (AAMC)

                    • Demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and social-behavioral sciences, as well as the application of this knowledge to patient care.
                    • Apply principles of social-behavioral sciences to the provision of patient care, including assessment of the impact of psychosocial and cultural influences on health, disease, care seeking, care compliance, and barriers to and attitudes toward care.

                      Interpersonal and Communication Skills (AAMC)

                    • Demonstrate interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families, and health professionals.
                    • Demonstrate sensitivity, honesty, and compassion in difficult conversations, including those about death, end of life, adverse events, bad news, disclosure of errors, and other sensitive topics.

                      Professionalism (AAMC)

                    • Demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles.
                    • Demonstrate compassion, integrity, and respect for others.

                       Personal and Professional Development  (AAMC)

                    • Demonstrate the qualities required to sustain lifelong personal and professional growth.
                    • 8.1 Develop the ability to use self-awareness of knowledge, skills, and emotional limitations to engage in appropriate help-seeking behaviors.
                    • 8.2 Demonstrate healthy coping mechanisms to respond to stress.
                    • 8.3 Manage conflict between personal and professional responsibilities.
                    • 8.8 Recognize that ambiguity is part of clinical health care and respond by utilizing appropriate resources in dealing with uncertainty.

                      Osteopathic Principles and Practices (AACOM) 

                    • Approach the patient with recognition of the entire clinical context, including mind-body and psychosocial interrelationships.
                    • Recognize and treat each patient as a whole person, integrating body, mind, and spirit.

                      Professionalism - Knowledge  (AACOM) 

                    • Demonstrate knowledge of the behavioral and social sciences that provide the foundation for the professionalism competency, including medical ethics, social accountability and responsibility, and commitment to professional virtues and responsibilities.
                    • a. Explain why a physician must demonstrate honesty, integrity, and respect for the patient in every interaction.
                    • b. Recognize personal values, attitudes, and biases as they influence patient care.
                    • c. Demonstrate social accountability and responsibility (i.e., the welfare of the patient or society should supersede the physician’s self-interest).
                    • d. Assess the context of a patient’s social and economic situation, capacity for self-care, and ability to participate in shared decision-making.

                      Professionalism- Humanistic Behavior-  (AACOM) 

                    • Demonstrate humanistic behavior, including respect, compassion, probity, honesty, and trustworthiness.
                    • Provide polite, considerate, and compassionate treatment to every patient.

                      Professional and Personal Self-Care (AACOM) 

                    • Demonstrate understanding that he/she is a representative of the osteopathic profession and is capable of making valuable contributions as a member of this society; lead by example; provide for personal care and well-being by utilizing principles of wellness and disease prevention in the conduct of professional and personal life.
                    • Ensure that his/her mental, physical, or health condition does not have a negative impact on patient care or welfare. 
                    • Identify personal sources of stress and apply appropriate interventions.

                      (AACN)

                    • Required I: Liberal Education for Baccalaureate Generalist Nursing Practice
                    • Integrate theories and concepts from liberal education into nursing practice.
                    • Synthesize theories and concepts from liberal education to build an understanding of the human experience.
                    • Demonstrate tolerance for the ambiguity and unpredictability of the world and its effect on the healthcare system.

                    • Module 7: Lesson 1: Working with literature

                      Learning Objectives:
                      Upon completion of this module, students should be able to:
                      • Practice deep reading and introspection while reading narrative and articulate resulting insights that relate to the experience of illnesses and healthcare practice.
                      • Articulate the value of literature as a source of appreciation for the richness, diversity, and complexity of the human condition.
                      Approximate time required for the readings for this lesson (at 144 words/minute): 7 hours and 24 minutes.

                      Click here to start this lesson
                      1 URL, 1 Forum
                      • Required Learning Resources and Activities
                      • Three Things to Do With Stories Using Literature in Medical, Health Professions, and Interprofessional Education URL

                        Read the entire article. (28 minutes)

                        Academic Medicine - 2015

                      • Peer Activity: Literature Reflection on Illness and Disease (360 minutes) Forum

                        General Instructions:

                        In this learning activity, you will select a story or illness from Health Story Collaborative.

                        Step 1: Select & Reflect

                        Select a story of illness from the Health Story Collaborative and apply the three exercises described in the previous reading by Blackie and Wear.  

                        You are required to deeply reflect on the selected story by doing the following

                        • Read deeply
                        • Engage in moral inquiry
                        • Draw out their illustrations, particularly of illness and the experiences of healthcare that are represented

                        Step 2: Respond 

                        Based on your selection above, prepare a 400-500 words written piece reflecting on the following key points:

                        • Describe how the story you read closely has impacted your assumptions about the illness experience.
                        • Describe any empathic connections with the author that you sensed in yourself while reading it. 
                        • How do you imagine this type of close reading activity might shape your interactions with your current or future patients?
                        • How does the selected story help you understand or appreciate the diversity and complexities of human conditions?

                        Step 3: Share 

                        To share your work, click on the “Add a new discussion topic” button under this post and paste your work into the “Message” box. Make sure to reference others’ intellectual property when necessary. All references should follow 7th Edition APA formatting. For further instructions, see the resource on the Himmelfarb Health Sciences Library: APA citation resource (N.B.: references are excluded from word counts).

                        Step 4: Interact

                        To complete the activity, you will need to reply to at least two posts made by your peers in a respectful and professional manner. Be sure that your post engages your peers' ideas by including a reflection on their comments, sharing ideas on other potential difficulties and parties involved, or asking thought-provoking questions. If a peer comments on your posting, please reply. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.”

                    • Module 7: Lesson 2: Working with Visual Art

                      Learning Objectives:
                      Upon completion of this module, students should be able to:
                      • Practice deliberate meditation and introspection while observing visual art articulate resulting insights that relate to the experience of illenss and healthcare practice.
                      • Describe what visual art may represent about the individual that chose it.
                      Approximate time required for the readings for this lesson (at 144 words/minute): 6 hours and 21 minutes.

                      Click here to start this lesson
                      2 URLs, 1 Forum
                      • Required Learning Resources and Activities
                      • How Art Can Heal URL

                        Read the entire article. (17 minutes)

                        American Scientist - 2020

                      • Photograph Reflection: Reflecting on the work of Hrair Sarkissian (330 minutes) Forum

                        General Instructions:

                        In this learning activity, you will be required to closely examine at least five (5) photographs from the artist Hrair Sarkissian and introspect on each selected photograph following a set of guiding questions.

                        Step 1: Reflect and Select

                        Health care workers learn to probe the intimate depths of an individual often through a dispassionate, scientific lens and language: measuring and interpreting blood serum chemistries, taking a history of illicit drug use, and episodes of heart disease within the family. These questions are important for understanding the biomedical aspects of the disease, but humanistic healthcare requires understanding the social, psychological, affective, and existential aspects of illness as well. Art can help us expand the boundaries of our exploration beyond the body further, to the individual beyond the pathology. The artist Hrair Sarkissian describes their piece ’Last Scene’ (2016) as “a series of 47 photographs of places in The Netherlands that were chosen by terminally ill patients to go and see as their last wish. The project centers on the power of a well-loved place to compress an outlook on life into a telling scene that is at once melancholic and joyful. The simplicity of each landscape or scene heightens attention to an inner journey of remembering the past and envisioning a future that no longer includes you. In contemporary culture, the notion of death and dying is often consciously ignored. This project gives the viewer a way to grapple with the question of where we come from, and where we are going. The images turn into mirrors: on the one hand, you try to imagine the person who looked at the scene for the last time, while at the same  time it encourages introspection: “what would my wish be?” These scenes were photographed at the date and time of the actual last visit.”

                        Please view and select at least five (5) photographs from the collection of the Last Scene. Spend some time reflecting on each photograph individually. Even when you think you have taken in everything that one has to offer you, reflect a while longer and see if additional thoughts or insights emerge. 

                        Step 2: Respond 

                        Prepare a 200-300 words written piece and answer the following questions about each photograph you have selected.

                        • What sort of image (physical, emotional, spiritual, mental, etc.) of each patient associated with each photograph comes to your mind?
                        • How might those insights help you provide more humanistic care to those patients?

                        Step 3: Share 

                        To share your work, click on the “Add a new discussion topic” button under this post and paste your work in the “Message” box. Make sure to reference others’ intellectual property when necessary. All references should follow 7th Edition APA formatting. For further instructions, see the resource on the Himmelfarb Health Sciences Library: APA citation resource (N.B.: references are excluded from word counts).

                        Step 4: Interact

                        To complete the activity, you will need to reply to at least two posts made by your peers in a respectful and professional manner. Be sure that your post engages your peers' ideas by including a reflection on their comments, sharing ideas on other potential difficulties and parties involved, or asking thought-provoking questions.If a peer comments on your posting, please reply. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.”
                      • Recommended Additional Readings
                      • The Connection Between Art, Healing, and Public Health: A Review of Current Literature URL

                        Read the content under the heading "Visual Arts". (11 minutes)

                        National Center for Biotechnology Information (NCBI) - 2010

                    • Module 7: Lesson 3: Working with Poetry

                      Learning Objectives:
                      Upon completion of this module, students should be able to:
                      • Describe how your understanding of your purpose and identity has been impacted by your experiences in medicine.
                      • Discuss what you have learned about yourself by reading poetry written by others.
                      Approximate time required for the readings for this lesson (at 144 words/minute): 8 hours and 54 minutes.

                      Click here to start this lesson
                      2 URLs, 2 Forums
                      • Required Learning Resources and Activities
                      • More Than Words: Why Poetry is Good for Our Health URL

                        Read the entire web page and watch the Youtube video titled "Capturing Our Resilience in Poetry". (12 minutes)

                        International Arts + Mind Lab (IAM Lab) - 2022

                      • National Poetry Month: Poetry and Medicine URL

                        Read the content under the headings from "Section One: The Expanding Awareness of Music in Healthcare," "Section Three: The Potential and Path to the Future of Music in Healthcare," and "Recommendations and Conclusions". (6 minutes)

                        Unversity of St. Augustine for Health Sciences - 2022

                      • Peer Activity: Poetry Reflection I (240 minutes) Forum

                        General Instructions:

                        In this learning activity, you will reflect on the poem identified below and answer questions as it relates to your interpretation and experiences in the field of medicine.

                        Step 1: Read and Reflect

                        Read the poem Kindness by Naomi Shihab Nye and reflect on the excerpt below regarding poetry as a means of self-expression and a brief background on the poem.

                        Reading and writing poetry is as much a tool for self-expression as a tool for self-exploration. While reading the works provided below, connect with the memories, associations, and emotions that the poems bring forward for you personally. 

                        As you read, think about how your own relationship with loss/death/suffering changed because of your experiences in healthcare (either as a patient, a student, or a practitioner).  Do you feel your capacity for empathy has deepened or dulled?  How do these experiences impact the way you view yourself and your patients?

                        Naomi Shihab Nye wrote this poem shortly after a horrific experience during her honeymoon. She and her husband planned to spend a few weeks in South America but shortly after arriving the entire bus they were traveling with was robbed. One man on the bus was killed during the incident. Later, a local man approached them, sensing their distress, and asked what happened. He listened and was kind. While her husband hitchhiked to a nearby town, with night approaching quickly, penniless, without a passport, sitting alone in an empting small town plaza Naomi Shihab Nye wrote this poem. Here kindness is connected with experiences of sorrow and as one deepens, often so does the other. This connection is later reiterated as kindness being both a friend, and a shadow. It is not sorrow alone that deepens our appreciation of kindness but rather we must “speak to it until your voice catches the thread of all sorrows and you see the size of the cloth;” it is when we allow our sorrow to connect us to the universal experience of suffering, with others, and with what we love. How does the sorrow you experience connect you with others and what does it bring you to more deeply appreciate?

                        Step 2: Respond

                        Once you have meticulously reflected on the poem, prepare a 200-300 words written piece which addresses the following key questions:

                        • How does the sorrow you experience connect you with others and what does it bring you to more deeply appreciate?  
                        • How might the experience of sorrow help you connect with your current/future patients?

                        Step 3: Share 

                        To share your work, click on the “Add a new discussion topic” button under this post and paste your work in the “Message” box. Make sure to reference others’ intellectual property when necessary. All references should follow 7th Edition APA formatting. For further instructions, see the resource on the Himmelfarb Health Sciences Library: APA citation resource (N.B.: references are excluded from word counts).

                        Step 4: Interact

                        To complete the activity, you will need to reply to at least two posts made by your peers in a respectful and professional manner. Be sure that your post engages your peers' ideas by including a reflection on their comments, sharing ideas on other potential difficulties and parties involved, or asking thought-provoking questions. If a peer comments on your posting, please reply. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.

                      • Peer Activity: Poetry Reflection II (240 minutes) Forum

                        General Instructions:

                        In this learning activity, you will reflect on the poem identified below and answer questions as it relates to your interpretation and experiences in the field of medicine.

                        Step 1: Read and Reflect

                        Read the poem  "The Journey" by Mary Oliver and reflect on the excerpt below regarding poetry as a means of self-expression and a brief background on the poem. 

                        Mary Oliver’s poem focuses on the journey we take to become an individual. Realizing what we know we need to do to thrive and accepting responsibility for the path we take is the first step that propels us toward growth. Initially, the traveler is met with voices that try to sway them from the path they know they must take. These voices may be society’s expectations, family expectations, obligations we feel toward others that come at the cost of our wellbeing. She writes “You knew what you had to do… through their melancholy was terrible” which emphasizes how our sympathy can sometimes lead us to betray ourselves. It is a confusing and uncomfortable journey. The house is a metaphor for the self; when we venture on this journey the very foundation of how we understand our self is shaken. The road is “full of branches and stones” but “little by little” our own voice becomes clearer. The further along on our journey we go, the easier it becomes to know our true self and go where our individual conscious, our own internal voice, leads us.

                        As you read the poem, reflect on whether unrealistic expectations from patients or their family members have undermined the confidence you have in your capacity to carry out your duties as a practitioner. If you have ever cared for a patient that could not be “saved,” did you blame yourself or feel it was a reflection of your capacity? If you have not yet had this experience, think about how you might feel.

                        Step 2: Respond

                        Once you have meticulously reflected on the poem, prepare a 200-300 words written piece which addresses the following key question:

                        • As a health care practitioner, what bad advice/voices/pleas/expectations do you think you must ignore in order to thrive in your profession?

                        Step 3: Share 

                        To share your work, click on the “Add a new discussion topic” button under this post and paste your work in the “Message” box. Make sure to reference others’ intellectual property when necessary. All references should follow 7th Edition APA formatting. For further instructions, see the resource on the Himmelfarb Health Sciences Library: APA citation resource (N.B. references are excluded from word counts).

                        Step 4: Interact 

                        To complete the activity, you will need to reply to at least two posts made by your peers in a respectful and professional manner. Be sure that your post engages your peers' ideas by including a reflection on their comments, sharing ideas on other potential difficulties and parties involved, or asking thought-provoking questions .If a peer comments on your posting, please reply. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.”
                    • Module 7: Lesson 4: Working with Music

                      Learning Objectives:
                      Upon completion of this module, students should be able to:
                      • Articulate the parallels between music and health care practice.
                      • Analyze how a practitioner might, using a deep analytical listening of music might, at least over time, develop greater facility with the humanistic aspects of patient care.
                      Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour and 58 minutes.

                      Click here to start this lesson
                      2 URLs
                      • Required Learning Resources and Activities
                      • The Expanding Scope, Inclusivity, and Integration of Music in Healthcare: Recent Developments, Research Illustration, and Future Direction URL

                        Read the content under the headings from "Section One: The Expanding Awareness of Music in Healthcare," "Section Three: The Potential and Path to the Future of Music in Healthcare," and "Recommendations and Conclusions". (36 minutes)

                        Multidisciplinary Digital Publishing Institute (MDPI)- Healthcare Journal - 2021

                      • Recommended Additional Readings
                      • Music, Computing, and Health: A Roadmap for the Current and Future Roles of Music Technology for Health Care and Well-Being URL
                        Read the content under the following sections: Abstract, Introduction, and Various Use Cases of Music Technology in Health Settings. (96 minutes)
                        SAGE journals - 2021
                    • Module 8: Empathy in Pracice: Narrative Medicine/Narrative Communication

                      Competencies covered in this module:

                        Patient Care (AAMC:)   

                      • Provide patient-centered care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health.
                      • Counsel and educate patients and their families to empower them to participate in their care and enable shared decision-making.

                        Knowledge for Practice (AAMC)

                      • Demonstrate knowledge of established and evolving biomedical, clinical, epidemiological and social-behavioral sciences, as well as the application of this knowledge to patient care.
                      • Apply principles of social-behavioral sciences to provision of patient care, including assessment of the impact of psychosocial and cultural influences on health, disease, care seeking, care compliance, and barriers to and attitudes toward care.

                        Interpersonal and Communication Skills (AAMC)

                      • Demonstrate interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families, and health professionals.
                      • 4.1 Communicate effectively with patients, families, and the public, as appropriate, across a broad range of socioeconomic and cultural backgrounds.
                      • 4.6 Demonstrate sensitivity, honesty, and compassion in difficult conversations, including those about death, end of life, adverse events, bad news, disclosure of errors, and other sensitive topics.
                      • 4.7 Demonstrate insight and understanding about emotions and human responses to emotions that allow one to develop and manage interpersonal interactions.

                        Osteopathic Principles and Practices (AACOM)

                      • Approach the patient with recognition of the entire clinical context, including mind-body and psychosocial interrelationships.
                      • Recognize and treat each patient as a whole person, integrating body, mind, and spirit.
                      • Demonstrate caring, compassionate, and empathetic behavior during the application of OMT in the clinical setting.
                      • Diagnose clinical conditions and plan patient care.
                      • Consider the patient’s perspective and values in diagnostic decision-making.

                        Patient Care (AACOM) 

                      • Form a patient-centered, interprofessional, evidence-based management plan.
                      • Elicit the patient’s perspective on the current situation and modify the diagnostic and treatment plan as appropriate in response to the patient’s needs and preference.
                      • Recognize and respond appropriately to the ethical dimensions of clinical decision-making.

                        Interpersonal and Communication Skills (AACOM) 

                      • Establish and maintain the physician-patient relationship.
                      • Explore the psychosocial, occupational, and biomechanical environment in which the patient lives and/or in which health care is administered.
                      • Conduct a patient-centered interview that includes the following.
                      • Communicate in a manner that demonstrates sensitivity to gender as well as to racial and cultural diversity.

                        Professionalism (AACOM)

                      • Humanistic Behavior - Demonstrate humanistic behavior, including respect, compassion, probity, honesty, and trustworthiness.
                      • Provide polite, considerate, and compassionate treatment to every patient.

                        (AACN) 

                      • I.1:  Integrate theories and concepts from liberal education into nursing practice.
                      • I.2:  Synthesize theories and concepts from liberal education to build an understanding of the human experience.
                      • VI.3: Incorporate effective communication techniques, including negotiation and conflict resolution, to produce positive professional working relationships.

                      • Module 8: Lesson 1: Narrative Medicine: Connecting with Patients

                        Learning Objectives:
                        Upon completion of this module, students should be able to:
                        • Articulate the way in which narrative can enable a richer understanding of patients and their illness experiences.
                        • Describe how a narrative approach to patience care can help connect the patient and the clinician in a relationship.
                        • Define 7 key concepts necessary to eliciting a patient's narrative.
                        • Describe key questions that are useful for eliciting and elaborating patient narrative in a clinical "conversation."
                        Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour and 40 minutes.

                        Click here to start this lesson
                        3 URLs, 1 Quiz
                        • Required Learning Resources and Activities
                        • Role of narrative-based medicine in proper patient assessment URL

                          Read the entire article. (13 minutes)

                          2017

                        • What is Narrative Based Medicine URL

                          Read the entire article (Content in English only). (17 minutes)

                          Canadian Family Physician - 2018

                        • Quiz: Module 7 and 8

                          To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

                        • Recommended Additional Readings
                        • Empathy in patient care: from ‘Clinical Empathy’ to ‘Empathic Concern’ URL

                          Read the entire article. (57 minutes)

                          Medicine, Health Care and Philosophy - 2021

                      • Module 9: Self Care: Caring for Self to Care for Others

                        Competencies covered in this module:

                          Knowledge for Practice (AAMC)

                        • Demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and social-behavioral sciences, as well as the application of this knowledge to patient care. (AAMC 2)
                        • Apply principles of social-behavioral sciences to the provision of patient care, including assessment of the impact of psychosocial and cultural influences on health, disease, care seeking, care compliance, and barriers to and attitudes toward care. (AAMC 2.5)

                          Personal and Professional Development (AAMC)

                        • Demonstrate the qualities required to sustain lifelong personal and professional growth. (AAMC 8)
                        • Develop the ability to use self-awareness of knowledge, skills, and emotional limitations to engage in appropriate help-seeking behaviors. (AAMC 8.1)
                        • Demonstrate healthy coping mechanisms to respond to stress. (AAMC 8.2)

                          Professionalism: Professional and Personal Self-Care  (AACOM) 

                        • Ensure that his/her mental, physical, or health condition does not have a negative impact on patient care or welfare. (AACOM V. 8b)
                        • Identify personal sources of stress, and apply appropriate interventions. (AACOM V. 8f)

                          (AACN) 

                        • Recognize the relationship between personal health, self-renewal, and the ability to deliver sustained quality care. (AACN 14)

                        • Module 9: Lesson 1: Understanding Burnout in Healthcare: Causes and Consequences

                          Learning Objective:
                          Upon completion of this module, students should be able to:
                          • Define burnout and articulate its various causes among health care professionals.
                          Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour and 27 minutes.

                          Click here to start this lesson
                          2 URLs
                          • Required Learning Resources and Activities
                          • Burnout in Healthcare Workers: Prevalence, Impact and Preventative Strategies. URL

                            Read the entire article. (29 minutes)

                            Dove Press journal: Local and Regional Anesthesia - 2020

                          • Recommended Additional Readings
                          • Burnout in United States Healthcare Professionals: A Narrative Review URL

                            Read the entire article. (20 minutes)

                            Cureus - 2018

                        • Module 9: Lesson 2: Self-care and Patient Care

                          Learning Objectives:
                          Upon completion of this module, students should be able to:
                          • Describe ways that burnout can be mitigated in healthcare, both at the individual and system levels.
                          • Describe the potential consequences of burnout for both the provider and for patient care.
                          Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour and 39 minutes.

                          Click here to start this lesson
                          3 URLs
                          • Required Learning Resources and Activities
                          • Developing resilience to combat nurse burnout URL

                            Read the entire article - 13 minutes

                            The Joint Commission - 2019

                          • Factors Related to Physician Burnout and Its Consequences: A Review: URL

                            Read the entire article - 20 minutes

                            Behavioural Sciences Journal - 2018

                          • Recommended Additional Readings
                          • Effect of burnout among physicians on observed adverse patient outcomes: a literature review. URL

                            Read the entire article. (29 minutes)

                            BMC Health Serv - 2021

                        • Module 9: Lesson 3: Empathy and Self-care at Odds?: Thinking Realistically and Critically

                          Learning Objective:
                          Upon completion of this module, students should be able to:
                          • Analyze the dilemmas of empathy among health professionals with respect to humanistic commitment to patients and maintaining an appropriate professional detachment.
                          Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour and 22 minutes.

                          Click here to start this lesson
                          3 URLs
                          • Required Learning Resources and Activities
                          • Empathy and Burnout in Medicine: Acknowledging Risks and Opportunities URL

                            Read the entire article. (10 minutes)

                            Springer - 2018

                          • "Goodbye … Through a Glass Door"Emotional Experiences of Working in COVID-19 Acute Care Hospital Environments. URL

                            Read the content under the headings " Background and Purpose", "Discussion", "Implications,". (14 minutes)

                            SAGE Journals- Canadian Journal of Nursing Research - 2021

                          • Recommended Additional Readings
                          • Compassion and self-compassion in medicine: Self-care for the caregiver URL

                            Read the entire article. (16 minutes)

                            Australian Medical Journal - 2016

                        • Module 10: Problems of Otherness and Dilemmas of Difference

                          Competencies covered in this module:

                            Knowledge for Practice (AAMC)

                          • Demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and social-behavioral sciences, as well as the application of this knowledge to patient care.
                          • Apply principles of social-behavioral sciences to the provision of patient care, including assessment of the impact of psychosocial and cultural influences on health, disease, care seeking, care compliance, and barriers to and attitudes toward care.

                            Interpersonal and Communication Skills (AAMC)

                          • Demonstrate interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families, and health professionals.
                          • Communicate effectively with patients, families, and the public, as appropriate, across a broad range of socioeconomic and cultural backgrounds.

                            Interprofessional Collaboration (AAMC)

                          • Demonstrate the ability to engage in an interprofessional team in a manner that optimizes safe, effective patient- and population-centered care.
                          • Work with other health professionals to establish and maintain a climate of mutual respect, dignity, diversity, ethical integrity, and trust.

                             Patient Care (AACOM) 

                          • Gather accurate data related to the patient encounter.
                          • Apply appropriate knowledge to the medical interview and demonstrate the ability to identify and/or address psychosocial, cultural, religious, health maintenance, and risk factor issues.
                          • Health promotion and disease prevention (HPDP).
                          • Demonstrate cultural awareness and sensitivity when communicating with the patient, family, and caregivers.

                            Professionalism (AACOM)

                          • Accountability -Demonstrate accountability to patients, society, and the profession, including the duty to act in response to the knowledge of professional behavior of others.
                          • Demonstrate commitment to underserved, vulnerable, disadvantaged, disenfranchised, and special populations.
                          • Cultural Competency - Demonstrate awareness of and proper attention to issues of culture, religion, age, gender, sexual orientation, and mental and physical disabilities.
                          • Treat all patients, colleagues, and others fairly, ensuring that no group is favored at any other expense.
                          • Openly discuss cultural issues, and be responsive to cultural cues.
                          • Demonstrate how to cope with differences in people in a constructive way.

                            Practice-Based Learning and Improvement  (AACOM)

                          • Describe and apply systematic methods to improve population health.
                          • a.Identify the determinants of populations’ health.
                          • b. Identify sources of disparities in populations’ health and access to care.
                          • c.Identify vulnerable or marginalized populations within those served, and respond appropriately.

                            Required VII: Clinical Prevention and Population Health (AACN)

                          • Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations.
                          • Advocate for social justice, including a commitment to the health of vulnerable populations and the elimination of health disparities.

                            Required VIII: Professionalism and Professional Values (AACN)

                          • Reflect on one’s own beliefs and values as they relate to professional practice.
                          • Communicate to the healthcare team one’s personal bias on difficult healthcare decisions that impact one’s ability to provide care.

                          • Module 10: Lesson 1: Problematics of Otherness

                            Learning Objectives:
                            Upon completion of this module, students should be able to:
                            • Identify the notion of otherness/othering and how it manifests in the health care setting.
                            • Describe the dilemma of otherness with respect to attempts to address social inequalities and analyze whether it is possible to engage inequality without contributing to the othering of marginalized groups.
                            Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour and 52 minutes.

                            Click here to start this lesson
                            2 URLs, 1 Quiz
                            • Required Learning Resources and Activities
                            • Ethics Explainer: The Other URL

                              Read the entire webpage. (8 minutes)

                              The Bioethics Centre - 2017

                            • Othering in the Nursing Context: A Concept Analysis URL

                              Read the content from "Inclusionary concepts" until "Alternatives to othering". (26 minutes)

                              College of Nursing - 2017

                            • Quiz: Module 9 and 10

                              To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

                          • Module 11. Marginalization (Choose at least 5 lessons to complete from those available, based on your interests and educational and professional needs.)

                            Competencies covered in this module:

                            Knowledge for Practice (AAMC) 

                            • Demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and social-behavioral sciences, as well as the application of this knowledge to patient care. (AAMC 2)

                            • Apply principles of epidemiological sciences to the identification of health problems, risk factors, treatment strategies, resources, and disease prevention/health promotion efforts for patients and populations. (AAMC 2.4)

                            • Apply principles of social-behavioral sciences to provision of patient care, including assessment of the impact of psychosocial and cultural influences on health, disease, care seeking, care compliance, and barriers to and attitudes toward care. (AAMC 2.5)

                            Professionalism (AAMC)

                            • Demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles. (AAMC 5)

                            • Demonstrate accountability to patients, society, and the profession. (AAMC 5.4)

                            • Demonstrate sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation. (AAMC 5.5)

                            Patient Care (AACOM) 

                            • Demonstrate cultural awareness and sensitivity when communicating with the patient, family, and caregivers. (AACOM III. 5g)

                            Professionalism: Cultural Competency (AACOM) 

                            • Demonstrate awareness of and proper attention to issues of culture, religion, age, gender, sexual orientation, and mental and physical disabilities. (AACOM V. 7)

                            • Demonstrate how to cope with differences in people in a constructive way. (AACOM V. 7d)

                            Practice-Based Learning and Improvement (AACOM) 

                            • Describe and apply systematic methods to improve population health. (AACOM VI. 5)

                            • Identify the determinants of populations’ health. (AACOM VI. 5a)

                            • Identify sources of disparities in populations’ health and access to care.  (AACOM VI. 5b)

                            • Identify vulnerable or marginalized populations within those served, and respond appropriately. (AACOM VI. 5c)

                            Cultural Competencies (AACOM) 

                            • Demonstrate an understanding of the scope of culture and the elements that form and define it. (AACOM IX. 1)

                            • Recognize personal and professional tendencies toward bias and stereotyping and work to counter them. (AACOM IX. 2)

                            • Understand the public health implications of cultural competence in health care. (AACOM IX. 3)

                            • Demonstrate familiarity with basic religious and cultural beliefs that affect patients’ understanding of the etiology of their illness and/or the efficacy of their treatment. (AACOM IX. 4)

                            • Use the cultural profile and history in the treatment of individual patients and record them appropriately in the medical record. (AACOM IX. 10)

                            • Use the cultural profile and history with individual patients to assess healthcare needs in the community. (AACOM IX. 11)

                            Public Health Systems Competencies (AACOM) 

                            • Assesses and address the determinants of health and illness factors contributing to health promotion and disease prevention. (AACOM X11. 2)

                            • Apply basic public health principles, practices, and sciences to the practice of osteopathic medicine.(AACOM X11. 4)

                            • Understand and apply knowledge of cultural differences to improve public health among divergent populations. (AACOM X11. 7)

                            Global Health Competencies (AACOM)

                            • Identify and treat individual patients with varying cultural beliefs regarding health, disease, and patient care. (AACOM XIII. 6)

                            • Essential VII: Clinical Prevention and Population Health - Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. (AACN 3)

                            Essential VIII: Professionalism and Professional Values (AACN 6)

                            • Reflect on one’s own beliefs and values as they relate to professional practice. (AACN 6)

                            • Professionalism: Demonstrate sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation (AAMC 5.5)


                            • Module 11: Lesson 1: Global Health and Cross-Cultural Practice

                              Learning Objectives:
                              Upon completion of this module, students should be able to:
                              • Articulate best practices for conducting ethical and humanistic global health work.
                              • Analyze the ethical dilemmas inherent to global health work and offer insights into how to navigate the potential for harm by medical volunteers to underresourced countries by drawing on global health best practices.
                              • Identify the causes and ethical dilemmas posed by medical “brain drain” (the migration of health professionals from relatively resource poor nations to weathier nations with less actual need).
                              Approximate time required for the readings for this lesson (at 144 words/minute): 2 hours and 45 minutes.

                              Click here to start this lesson
                              3 URLs
                              • Required Learning Resources and Activities
                              • Virtue and Care Ethics & Humanism in Medical Education: a Scoping Review URL

                                Read the contents under the heading "Background, Results, and Discussion". (7 minutes)

                                BMC Medical Education - 2022

                              • More Harm Than Good? The Questionable Ethics of Medical Volunteering and International Student Placements URL

                                Read the content from "Ethical Concerns in Medical Volunteering" until "Evaluating the outcome of medical volunteering on local health" (36 minutes)

                                Tropical Diseases, Travel Medicine and Vaccines, published by BioMed Central - 2017

                              • Medical “Brain Drain” and Health Care Worker Shortages: How Should International Training Programs Respond? URL

                                Read the content under the heading from "Medical Brain Drain as Exploitation of Wealth Disparities" until "Funding and Policy Solutions to Medical Brain Drain" (12 minutes)

                                AMA Journal of Ethics - 2016

                            • Module 11: Lesson 2: Issues of Class and Poverty

                              Learning Objectives:
                              Upon completion of this module, students should be able to:
                              • Articulate the impact of socioeconomic status on patients’ health status and health behaviors.
                              • Demonstrate critical thinking about the needs of patients who face socioeconomic disadvantage and articulate creative approaches to clinical care that are sensitive to the challenges they face.
                              Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour and 33 minutes.

                              Click here to start this lesson
                              1 URL
                              • Required Learning Resources and Activities
                              • Explaining Socioeconomic Disparities in Health Behaviours: A Review of Biopsychological Pathways Involving Stress and Inflammation URL

                                Read the following sections "2.1. Social inequality in health" "2.2. Social inequality in stress" "2.3. Social inequality in health behaviours,"'5.2. Different SES indicators may reflect different types of resources and adversities which may tap into different causal explanations of health behaviours" (31 minutes)

                                Science Direct- Neuroscience & Biobehavioral Reviews - 2021

                            • Module 11: Lesson 3: Race/Ethnictiy and Health

                              Learning Objectives:
                              Upon completion of this module, students should be able to:
                              • Identify racial or ethnic minorities in a society that are marginalized.
                              • Identify multiple pathways by which structures of marginalization directed at ethnic and racial minorities lead to poorer health.
                              Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour and 9 minutes.

                              Click here to start this lesson
                              3 URLs, 1 Forum
                              • Required Learning Resources and Activities
                              • Racism and Health: Evidence and Needed Research URL

                                Read the following sections: Abstract, Racism and Health, Racial Residential Segregation, Epidemiological Evidence Linking Segregation to Health, Cultural Racism, Cultural Racism and Health and Discrimination. (23 minutes)

                                National Library of Medicine: National Centre for Biotechnology Information - 2019

                              • Recommended Additional Readings
                              • Achieving Racial and Ethnic Equity in U.S. Health Care URL

                                Read from the Introduction to Conclusion. (29 minutes)

                                The Commonwealth Fund - 2021

                              • Racial and Ethnic Differences in Presentation and Outcomes for Patients Hospitalized With COVID-19: Findings From the American Heart Association’s COVID-19 Cardiovascular Disease Registry URL

                                Please read Introduction, Discussion, and Conclusion. (11 minutes)

                                AHA Journals - 2020

                              • Peer Activity 1: Race/Ethnicity and Health (270 minutes) Forum

                                In this activity, you will compare and contrast the health status and experiences of two different races and discuss, focused on substance use disorders, how race influences a patient’s health status and experiences.

                                Step 1. Select (10 minutes)

                                Select one racial minority in your country or region. 

                                Example: Hispanics in the United States

                                Step 2. Compare and contrast (30 minutes)

                                Compare and contrast your selected racial minority with a racial privileged or majority, i.e., “White” Americans, in terms of the following indicators:

                                • Health status
                                • Health care access and affordable coverage
                                • Access to substance use and abuse care and treatment

                                Step 3. Respond (210 minutes)

                                Imagine yourself as a contributing writer for a medical journal, tasked to write an article for this month’s theme on Race and Health. 

                                Prepare a 300-700 word article that discusses the following key components:

                                • Difference between your selected racial minority and racially privileged group in terms of
                                  • Health status
                                  • Health care access and affordable coverage
                                  • Access to substance use and abuse care and treatment
                                • Needs of the racial minority facing health disadvantages
                                • Creative approaches to address the problem and promote racial health equity and better access to substance use and abuse care and treatment.

                                Step 4. Share (10 minutes)

                                To share your audio recording, click on the “Add a new discussion” button under this post and paste your work into the “Message” box. Make sure to reference others’ intellectual property when necessary. All references should follow 7th Edition APA formatting. For further instructions, see the resource on the Himmelfarb Health Sciences Library: APA citation resource (N.B. references are excluded from word counts).

                                Step 5. Interact (10 minutes)

                                Evaluate and categorize the work from one of your peers based on items A - E of the rubric below. Provide a rationale for the grade you have provided, as well as comments or suggestions for improvement. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.” You can use the list below as an example:

                                Item A is  .…. because….  My suggestions for improvement are….
                                Item B is  .…. because….  My suggestions for improvement are….
                                Item C is  .…. because….  My suggestions for improvement are….
                                Item D is  .…. because….  My suggestions for improvement are….
                                Item E is  .…. because….  My suggestions for improvement are….

                            • Module 11: Lesson 4: The Health of Immigrants, Refugees, and Displaced Persons

                              Learning Objectives:
                              Upon completion of this module, students should be able to:
                              • Discuss different perspectives on the ethical obligation to provide health care to undocumented immigrants.
                              • Articulate the impact of immigration and/or refugee status on patients’ health and their experiences with health and health care.
                              • Demonstrate critical thinking about the needs of patients who face health disadvantages because of their immigrant/refugee status and articulate creative approaches to clinical care that are sensitive to the
                              • challenges they face.
                              Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour and 18 minutes.

                              Click here to start this lesson
                              3 URLs
                              • Required Learning Resources and Activities
                              • Access to Health Care for Illegal Migrants: Ethical Implications of a New Health Policy in the UK URL

                                Read the entire article. (9 minutes)

                                British Journal of General Practice - 2019

                              • Barriers to Accessing Health Care Among Undocumented Migrants in Sweden - a Principal Component Analysis URL

                                Read the content under the heading "Background", "Barriers to health care", "Large need for health care and risk factors for illness" and "Discussion". (17 minutes)

                                BMC Health Services Research - 2021

                              • Recommended Additional Readings
                              • Immigration as a Social Determinant of Health URL

                                Read the entire article. (4 minutes)

                                Annual Review of Public Health - 2015

                            • Module 11: Lesson 5: Gender and Health

                              Learning Objectives:
                              Upon completion of this module, students should be able to:
                              • Articulate the impact of gender on patients’ health and their experiences with health and health care.
                              • Demonstrate critical thinking about the needs of patients who face health disadvantages because of gender norms and associated stigmas and articulate creative approaches to clinical care that are sensitive to the challenges they face.
                              Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour and 6 minutes.

                              Click here to start this lesson
                              2 URLs
                              • Required Learning Resources and Activities
                              • Gender Disparities in Clinical Practice: Are There Any Solutions? Scoping Review of Interventions to Overcome or Reduce Gender Bias in Clinical Practice (2020) URL

                                Read from the Introduction to Conclusion. (22 minutes)

                                International Journal for Equity in Health - 2020

                              • Recommended Additional Readings
                              • The Promises and Limitations of Gender-Transformative Health Programming with Men: Critical Reflections from the Field URL

                                Read the entire article. (47 minutes)

                                Informa UK Limited, Taylor & Francis Group - 2015

                            • Module 11: Lesson 6: LGBTQ+ Persons and Health

                              Learning Objectives:
                              Upon completion of this module, students should be able to:
                              • Articulate the social and humanistic factors affecting the health of patients who identify as LGBTQ+, including their experiences in society at large, and the health care system in particular.
                              • Demonstrate critical thinking about the needs of patients who face health disadvantages because of their identification as LGBTQ+ and associated stigmas and articulate creative approaches to clinical care that are sensitive to the challenges they face.
                              Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour and 24 minutes.

                              Click here to start this lesson
                              2 URLs
                              • Required Learning Resources and Activities
                              • Understanding the Health Needs of LGBT People URL

                                Read the report. (28 minutes)

                                National LGBT Health Education Center, A project of the Fenway Institute - 2016

                              • Recommended Additional Readings
                              • Health Inequities in LGBT People and Nursing Interventions to Reduce Them: A Systematic Review (2021) URL

                                Read the Introduction and Discussion. (23 minutes)

                                International Journal of Environmental Research and Public Health - 2021

                            • Module 11: Lesson 7: Incarcerated and Formerly Incarcerated Persons

                              Learning Objectives:
                              Upon completion of this module, students should be able to:
                              • Articulate the social and humanistic factors affecting the health of patients who are incarcerated or formerly incarcerated, including their experiences in society at large, and the health care system im particular.
                              • Describe ethical dilemmas that can emerge for clinical practitioners caring for patients who are incarcerated or were formerly incarcerated.
                              • Demonstrate critical thinking about the needs of patients who face health disadvantages because of incarceration status and associated stigmas and articulate creative approaches to clinical care that are sensitive to the challenges they face.
                              • Compare the difference between the minimum care a physician is obligated to provide within a criminal justice setting from the standard they are held to in the free world and describe measures that you could take as a physician to anticipate and meet the health needs of incarcerated or formerly incarcerated patients (see in particular the AMA Journal of Ethics case study.
                              Approximate time required for the readings for this lesson (at 144 words/minute): 3 hours.

                              Click here to start this lesson
                              6 URLs
                              • Required Learning Resources and Activities
                              • Caring for Ex-prisoners Presents Management Challenges URL

                                Read the entire article. (12 minutes)

                                ACP Internist and American College of Physicians - 2017

                              • What Does Health Justice Look Like for People Returning from Incarceration? URL

                                Read the content under the headings "Incarceration and Health in the United States" Assessing the Needs of All Persons and Populations Equally", "Recognize and Rectify Historical Health System Injustices, Advocate for the Provision of Resources According to Patient and Community Needs", "Conclusion" (11 minutes)

                                American Medical Association - 2017

                              • Assessing Incarcerated Women’s Physical and Mental Health Status and Needs in a Swiss Prison: a Cross-Sectional Study URL

                                Read the Background, Discussion, and Conclusion. (22 minutes)

                                Health and Justice Journal - Biomedcentral.com - 2022

                              • "Who Should Make Decisions for Unrepresented Patients Who Are Incarcerated? " URL

                                Read the entire article. (15 minutes)

                                AMA Journal of Ethics - 2019

                              • Recommended Additional Readings
                              • Linkages Between Health and Incarceration URL

                                Read the entire article. (24 minutes)

                                Sage, Association of Schools and Programs of Public Health - 2019

                              • Do Prisoners Trust the Healthcare System? URL

                                Read the Background, Discussion, Limitations, and Conclusion. (17 minutes)

                                Health and Justice Journal -Biomedcentral.com - 20221

                            • Module 11: Lesson 8: Disability, Health, and Healthcare

                              Learning Objectives:
                              Upon completion of this module, students should be able to:
                              • Articulate the social and humanistic factors affecting the health of patients who are living with disability.
                              • Describe different models used for understanding disability and the advantages and disadvantages that come with seeing disability in terms of each of these models.
                              • Demonstrate critical thinking about the clinical needs of patients who are living with disabilities and articulate creative approaches to clinical care that are sensitive to the challenges they face.
                              Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour and 33 minutes.

                              Click here to start this lesson
                              3 URLs
                              • Required Learning Resources and Activities
                              • Disability: Definitions, Models, Experience URL

                                Read the content under the headings from "1. Models of Disability" until "1.3 Models, Decisions, and Policies". (18 minutes)

                                The Stanford Encyclopedia of Philosophy - 2022

                              • Three Things Clinicians Should Know About Disability URL

                                Read the entire article. (13 minutes)

                                AMA Journal of Ethics: Illuminating the Art of Medicine - 2018

                              • Recommended Additional Readings
                              • Prevalence of Disabilities and Health Care Access by Disability Status and Type Among Adults — United States, 2016 URL

                                Read the entire report. (13 minutes)

                                Centers for Disease Control and Prevention - 2016

                            • Module 11: Lesson 9: Health, Humanism, and Aging

                              Learning Objectives:
                              Upon completion of this module, students should be able to:
                              • Articulate the social and humanistic aspects of aging, particularly with respect to how older people experience aging.
                              • Describe ways that ageism manifests in the health care setting at both systemic and clinical levels and articulate ways that practitioners can challenge ageism and its effects.
                              Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour and 24 minutes.

                              Click here to start this lesson
                              3 URLs
                              • Required Learning Resources and Activities
                              • Ageism in the Health Care System: Providers, Patients, and Systems URL

                                Read the content under the headings, from " Introduction" until "13.2.4 Self-Ageism in the Health Care Setting". (28 minutes)

                                Springer Link: International Perspectives on Aging Book - 2018

                              • Recommended Additional Readings
                              • Inequalities in Later Life: The Issue and the Implications for Policy and Practice URL

                                Read the report. (18 minutes)

                                Centre for Ageing Better - 2017

                              • “Tho’ Much is Taken, Much Abides”: A Good Life Within Dementia URL

                                Read the entire article. (21 minutes)

                                Wiley Online Library- The Hastings Center Report - 2018

                            • Module 11: Lesson 10: Children, Health, and Humanism

                              Learning Objectives:
                              Upon completion of this module, students should be able to:
                              • Articulate the social and humanistic aspects of childhood, particularly with respect to how children experience illness.
                              • Describe ways that clinical care for children can use humanistic practices to improve childrens illness experiences and coping.
                              Approximate time required for the readings for this lesson (at 144 words/minute): 2 hours and 3 minutes.

                              Click here to start this lesson
                              2 URLs
                              • Required Learning Resources and Activities
                              • Connecting a Sociology of Childhood Perspective with the Study of Child Health, Illness and Wellbeing: Introduction URL

                                Read the content under the headings "Abstract", "Themes of this issue" "Theme 2: practices of children's health and wellbeing", "Theme 3 – Children as health actors". (23 minutes)

                                Wiley Online Library- Sociology of Health and Illness Journal - 2015

                              • Minimizing Pediatric Healthcare-Induced Anxiety and Trauma URL

                                Read the content from "Introduction" to " A new way to care". (18 minutes)

                                World Journal of Clinical Pediatrics- NCBI - 2016

                            • Module 11: Lesson 11: Religion/Spirituality and Health

                              Learning Objectives:
                              Upon completion of this module, students should be able to:
                              • Articulate how religion and spirituality affect patient experiences of illness and their relationships with their health care practitioners.
                              • Describe ways that clinical care for children can use humanistic practices to improve childrens illness experiences and coping.
                              Approximate time required for the readings for this lesson (at 144 words/minute): 9 hours and 22 minutes.

                              Click here to start this lesson
                              3 URLs, 1 Forum, 1 Quiz
                              • Required Learning Resources and Activities
                              • How Should Clinicians Respond to Requests from Patients to Participate in Prayer? URL

                                Read the webpage. (16 minutes)

                                AMA Journal of Ethics - 2018

                              • Defining Spirituality in Healthcare: A Systematic Review and Conceptual Framework URL

                                Read the content under the headings " Introduction" Connection: Narrower or Broader, Interpretation of Life: Meaning and Purpose, Beliefs, Practices, and Experiences, Spirituality Sensations, Spirituality as an Intrinsic Component of Human Beings and Proposed Framework for Spirituality in Healthcare. (22 minutes)

                                Fronteirs in Psychology - 2021

                              • The Role of Spirituality and Religiosity in Healthcare During the COVID-19 Pandemic: An Integrative Review of the Scientific Literature URL

                                Read the content under the headings "Abstract", "Background" and "Discussion" (12 minutes)

                                Springer Nature Switzerland - Journal of Religion and Health - 2022

                              • A journal submission on Race/ Ethnicity, Gender, and Health. (450 minutes) Forum

                                General Instructions

                                In this learning activity, you will compare and contrast the health status and experiences of two (2) different races and/or ethnic groups regarding mental health and substance use disorders and discuss how race/ethnicity influences a patient’s health status and experiences.

                                Step 1: Select  

                                Select one racial/ ethnic minority in your country or region. 

                                • Examples include: Hispanics in the United States,  African Americans, Asian Americans etc.

                                Step 2: Compare and contrast

                                Compare and contrast your selected racial/ ethnic minority above with a racially privileged group or majority, i.e., “White” Americans etc., in terms of the following indicators:

                                • Health status 
                                • Healthcare access and affordable coverage
                                • Access to substance use and abuse care and treatment

                                Step 3: Respond 

                                Imagine you are a contributing writer for a medical journal tasked with writing an article for this month’s issue on Race/Ethnicity, Gender, and Health. You are asked to write a piece that focuses explicitly on the health outcomes and experiences of the identified groups as it relates to Substance use and mental health. Prepare a 500-700 words written piece that discusses the following key components:

                                • Differences between your selected racial/ethnic minority group and racially privileged group in terms of: 
                                1. Health status 
                                    • Are they are eligible for coverage through the Health Insurance? 
                                    • Are there any special provisions in place for the minority groups?
                                    • What type of disadvantages/challenges does the selected group face in meeting their health needs? 
                                2. Healthcare access and affordable coverage 
                                    • How does access to treatment differ according to a patient’s gender?
                                3. Access to substance use and abuse care and treatment

                                • Health needs of the racial/ethnic minority groups and any disadvantages they may face
                                • Propose creative approaches to address the problem, promote health equity, and better access to substance use and abuse care and treatment.

                                Step 4: Share 

                                To share your work, click on the “Add a new discussion topic” button under this post and paste your work in the “Message” box. Make sure to reference others’ intellectual property when necessary. All references should follow 7th Edition APA formatting. For further instructions, see the resource on the Himmelfarb Health Sciences Library: APA citation resource (N.B. references are excluded from word counts).

                                Step 5: Interact 

                                Evaluate and categorize the work from one of your peers based on items A - E of the rubric below. Provide a rationale for the grade you have provided, as well as comments or suggestions for improvement. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.” You can use the list below as an example:

                                Item A is  .…. because….  My suggestions for improvement are….
                                Item B is  .…. because….  My suggestions for improvement are….
                                Item C is  .…. because….  My suggestions for improvement are….
                                Item D is  .…. because….  My suggestions for improvement are….
                                Item E is  .…. because….  My suggestions for improvement are….

                              • Quiz: Module 11

                                To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

                            • Module 12: From Cultural Competency to Cultural Humility: Habits of Respectful Curiosity

                              Competencies covered in this module:


                                Knowledge for Practice (AAMC)

                              • Demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and social-behavioral sciences, as well as the application of this knowledge to patient care. (AAMC 2)
                              • Apply principles of epidemiological sciences to the identification of health problems, risk factors, treatment strategies, resources, and disease prevention/health promotion efforts for patients and populations. (AAMC 2.4)
                              • Apply principles of social-behavioral sciences to provision of patient care, including assessment of the impact of psychosocial and cultural influences on health, disease, care seeking, care compliance, and barriers to and attitudes toward care. (AAMC 2.5)

                              • Professionalism  (AAMC) 

                              • Demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles. (AAMC 5)
                              • Demonstrate accountability to patients, society, and the profession. (AAMC 5.4)
                              • Demonstrate sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation. (AAMC 5.5)

                              • Professionalism: Cultural Competency (AACOM) 

                              • Demonstrate awareness of and proper attention to issues of culture, religion, age, gender, sexual orientation, and mental and physical disabilities. (AACOM V. 7)
                              • Treat all patients, colleagues, and others fairly, ensuring that no group is favored at the expense of any other. (AACOM V. 7a)
                              • Openly discuss cultural issues, and be responsive to cultural cues. (AACOM V. 7c)
                              • Demonstrate how to cope with differences in people in a constructive way. (AACOM V. 7d)
                              • Demonstrate an understanding of the scope of culture and the elements that form and define it. (AACOM IX. 1)
                              • Recognize personal and professional tendencies toward bias and stereotyping and work to counter them. (AACOM IX. 2)
                              • Understand the public health implications of cultural competence in health care. (AACOM IX. 3)
                              • Demonstrate familiarity with basic religious and cultural beliefs that affect patients’ understanding of the etiology of their illness and/or the efficacy of their treatment. (AACOM IX. 4) 
                              • Use the cultural profile and history with individual patients to assess healthcare needs in the community. (AACOM IX. 11)

                                  Essential VII: Clinical Prevention and Population Health (AACN)  

                              • Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. (AACN 3)

                              • Essential VIII: Professionalism and Professional Values (AACN) 

                              • Reflect on one’s own beliefs and values as they relate to professional practice. (AACN 6)
                              • Communicate to the healthcare team one’s personal bias on difficult healthcare decisions that impact one’s ability to provide care. (AACN 8)

                              • Module 12: Lesson 1: From cultural competence to cultural humility

                                Learning Objectives:
                                Upon completion of this module, students should be able to:
                                • Interrogate and discuss the limits of cultural competence as a humanistic enterprise in healthcare.
                                • Analyze and describe the differences between cultural competency and cultural humility.
                                Approximate time required for the readings for this lesson (at 144 words/minute): 4 hours and 24 minutes.

                                Click here to start this lesson
                                2 URLs, 1 Forum
                                • Required Learning Resources and Activities
                                • Cultural Competency Interventions During Medical School: a Scoping Review and Narrative Synthesis URL

                                  Read the Abstract, Introduction, Discussion, Conclusion. (8 minutes)

                                  Springer Link - Journal of General Internal Medicine - 2019

                                • Addressing Culture Within Healthcare Settings: The Limits of Cultural Competence and the Power of humility" URL

                                  Read the entire article. (10 minutes)

                                  National Center for Biotechnology Information, U.S. National Library of Medicine, National Institutes of Health - 2019

                                • Reflection Activity: A reflection on cultural competency and humility (210 minutes) Forum

                                  General Instructions

                                  In this activity, you will complete the checklist below and reflect on key aspects as it relates to your knowledge, skills, and awareness in interacting with others. You will also discuss ways of enhancing cultural humility and structural competency.

                                  Step 1: Review and Reflect

                                  Review the relevant learning materials for this lesson and complete the self-assessment checklist included below.

                                  758

                                  NB- This self-assessment tool is designed to help individuals explore their awareness/ understanding of cultural and structural 

                                  competency when interacting with others in a diverse environments. It was developed and adapted by borrowing components from
                                  the American Speech-Language-Hearing Association checklist.

                                  Step 2: Respond

                                  Based on the self-assessment results prepare a reflection piece of 300 - 350 words that addresses the following key components:

                                  • Identify any personal strengths and weaknesses you have in interacting or working with others in a diverse environment.
                                  • Discuss how you plan to continue developing and practicing your cultural humility (i.e., how you plan to enhance your dialogue or communication skills, self-reflection skills, and skills to respond and relate to others of different ethnicities, cultures, and socio-economic backgrounds).
                                  • Discuss the importance of developing these skills for your practice and/or professional development to ensure healthcare equity and effectively construct treatment plans that are patient-centered and culturally sensitive.

                                  Step 3: Share 

                                  To share your work, click on the “Add a new discussion topic” button under this post and paste your work into the “Message” box. Make sure to reference others’ intellectual property when necessary. All references should follow 7th Edition APA formatting. For further instructions, see the resource on the Himmelfarb Health Sciences Library: APA citation resource (N.B.: references are excluded from word counts).

                                  Step 4: Interact 

                                  To complete the activity, you will need to reply to at least two posts made by your peers in a respectful and professional manner. Be sure that your post engages your peers' ideas by including a reflection on their comments, sharing ideas on other potential difficulties and parties involved, or asking thought-provoking questions. If a peer comments on your posting, please reply. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.”

                              • Module 12: Lesson 2: Practices of Humility in Healthcare

                                Learning Objective:
                                Upon completion of this module, students should be able to:
                                • Describe best practices for integrating cultural humility into patient care.
                                Approximate time required for the readings for this lesson (at 144 words/minute): 33 minutes.

                                Click here to start this lesson
                                2 URLs
                                • Required Learning Resources and Activities
                                • Practicing Cultural Competence and Cultural Humility in the Care of Diverse Patients URL

                                  Read the entire article. (11 minutes)

                                  National Center for Biotechnology Information, U.S. National Library of Medicine, National Institutes of Health - 2020

                                • Recommended Additional Readings
                                • Not Missing the Opportunity: Strategies to Promote Cultural Humility Among Future Nursing Faculty URL

                                  Read the entire article. (31 minutes)

                                  Science Direct - Journal of Professional Nursing - 2020

                              • Module 12: Lesson 3: From Cultural Humility to Structural Competency and Social Justice

                                Learning Objectives:
                                Upon completion of this module, students should be able to:
                                • Describe the limitations of "cultural humility" even insofar as it improves on the concept of "cultural competency."
                                • Analyze and describe the implications of "structural competency" for patient care.
                                Approximate time required for the readings for this lesson (at 144 words/minute): 49 minutes.

                                Click here to start this lesson
                                1 URL
                                • Required Learning Resources and Activities
                                • Structural Competency in Health Care URL

                                  Read the contents under the headings "Introduction", "Individual Level: Self-Reflection and Awareness", "Interpersonal Level: Patient Assessment and Care Planning", "Clinic/Institutional Level: Diverse Hiring and Staff Training", "Community Level: Collaboration", and "Summary". (13 minutes)

                                  PMC - 2022

                              • Module 13: The Future of Humanism in Health and Health Care

                                Competencies covered in this module:

                                  Professionalism (AAMC) 

                                • Demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles. (AAMC 5)
                                • Demonstrate a commitment to ethical principles pertaining to provision or withholding of care, confidentiality, informed consent, and business practices, including compliance with relevant laws, policies, and regulations. (AAMC 5.6)

                                • Systems-Based Practice (AAMC) 

                                • Demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care. (AAMC 6)

                                • Personal and Professional Development (AAMC)

                                • Demonstrate the qualities required to sustain lifelong personal and professional growth. (AAMC 8)
                                • Provide leadership skills that enhance team functioning, the learning environment, and/or the health care delivery system. (AAMC 8.6)

                                • Professionalism: HUMANISTIC BEHAVIOR (AACOM)

                                • Demonstrate humanistic behavior, including respect, compassion, probity, honesty, and trustworthiness. (AACOM V. 2)
                                • Demonstrate openness, honesty, and trustworthiness during direct communication with patients and their families and in the writing of reports, the signing of forms, and the provision of evidence in litigation or other formal inquiries. (AACOM V. 2d)

                                • Systems-Based Practice (AACOM)

                                • Demonstrate understanding of how patient care and professional practices affect other health care professionals, health care organizations, and society. (AACOM VII. 2)
                                • Demonstrate understanding of how current issues in the world are affecting the delivery of health care to patients and to the community. (AACOM VII. 2g)

                                • (AACN) 

                                • Engage in ethical reasoning and actions to provide leadership in promoting advocacy, collaboration, and social justice as a socially responsible citizen. (AACN I. 6)

                                • Module 13: Lesson 1: The Future of Humanism in Medicine

                                  Learning Objective:
                                  Upon completion of this module, students should be able to:
                                  • Revisit and describe the value of humanism for health and health care now and in the coming decades (in ways that now draw on all that you've learned in this course).
                                  Approximate time required for the readings for this lesson (at 144 words/minute): 24 minutes.

                                  Click here to start this lesson
                                  2 URLs
                                  • Required Learning Resources and Activities
                                  • Humanism increasingly important in a changing health care landscape URL

                                    Read the entire article. (8 minutes)

                                    American Association of Medical Colleges - 2017

                                  • Recommended Additional Readings
                                  • Is Medical Humanism a Humanism? URL

                                    Read the entire article. (13minutes)

                                    In-Training.org - 2016

                                • Module 13: Lesson 2: Humanism and Technology: Threat or Opportunity

                                  Learning Objective:
                                  Upon completion of this module, students should be able to:
                                  • Discuss how increasing technocratization and autonomation may threaten the humanistic elements, but also how technology might be used to amplify the humanistic elements, of health and healthcare.
                                  Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour and 24 minutes.

                                  Click here to start this lesson
                                  2 URLs
                                  • Required Learning Resources and Activities
                                  • The Digital Transformation of Medicine Can Revitalize the Patient-Clinician Relationship URL

                                    Read the entire article. (12 minutes)

                                    Springer Nature Limited - 2018

                                  • Pursuing Humanistic Medicine in a Technological Age URL

                                    Read the entire article. (16 minutes)

                                    Journal of Patient Experiences - 2017

                                • Module 13: Lesson 3: Directions Forward

                                  Learning Objective:
                                  Upon completion of this module, students should be able to:
                                  • Describe goals and strategies for integrating the insights throughout this course into clinical practice, particularly at the bedside, but also within the structures and functions of your institutions and the workflow of your practices.
                                  Approximate time required for the readings for this lesson (at 144 words/minute): 58 minutes.

                                  Click here to start this lesson
                                  1 URL, 1 Quiz
                                  • Required Learning Resources and Activities
                                  • Jeffrey Silver Humanism in Healthcare Research Roundup URL

                                    Read the articles related to humanism in healthcare. (16 minutes)

                                    Gold Foundation for Humanistic Healthcare - 2022

                                  • Quiz: Module 12 and 13

                                    To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

                                • Final Exam

                                  Click here to start Final Examination

                                  • Final Exam Quiz
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                                    • All of:
                                      • All of:
                                        • The activity Course Registration is marked complete
                                        • The activity Pre-Test is marked complete
                                        • The activity Quiz: Module 1 and 2 is marked complete
                                        • The activity Quiz: Module 3 and 4 is marked complete
                                        • The activity Quiz: Module 5 and 6 is marked complete
                                        • The activity Quiz: Module 7 and 8 is marked complete
                                        • The activity Quiz: Module 9 and 10 is marked complete
                                        • The activity Quiz: Module 12 and 13 is marked complete
                                      • All of:
                                        • The activity Discussion Forum: Changes in the epidemiological profiles of outbreaks and its impact on health care systems (300 minutes) is marked complete
                                        • The activity Case Scenario: Differentiating between empathy and sympathy (240 minutes) is marked complete
                                        • The activity Peer Activity: Literature Reflection on Illness and Disease (360 minutes) is marked complete
                                        • The activity Photograph Reflection: Reflecting on the work of Hrair Sarkissian (330 minutes) is marked complete
                                        • The activity Peer Activity: Poetry Reflection I (240 minutes) is marked complete
                                        • The activity Peer Activity: Poetry Reflection II (240 minutes) is marked complete
                                        • The activity A journal submission on Race/ Ethnicity, Gender, and Health. (450 minutes) is marked complete
                                        • The activity Reflection Activity: A reflection on cultural competency and humility (210 minutes) is marked complete
                                    • You belong to Miami Med

                                    To take the final exam, you must complete all quizzes and complete all the required activities. The final exam consists of 40 questions, and you will have 40 minutes to complete it. When the time is over, you will have two minutes to submit your attempt before it expires, and your progress is discarded. You will not be able to answer additional questions in the grace period.

                                    To access the exam, click on the name of the exam provided above. On the following screen, click the attempt quiz button to respond to the questions.


                                • Course and Self Evaluation & Certificate

                                  In this section, you can provide feedback about this course to help us make NextGenU.org better. Once evaluations are completed, you will be able to download your certificate of completion.

                                  Click here give your feedback

                                  • Course Evaluation Questionnaire
                                    Restricted Not available unless: The activity Final Exam is marked complete
                                  • Self Evaluation Questionnaire
                                    Restricted Not available unless: The activity Final Exam is complete and passed
                                • Course Activities

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                                Course Activities and Resources

                              • Syllabus
                              • Resources
                              • Activities
                              • Quizzes
                                • HHH22
                                • General
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                                • Humanism in Health and Healthcare Homepage
                                • Module 1: History of Medicine, Modernism, and the Emergence of the Biomedical Model
                                • Module1: Lesson 1: The Emergence of Modern Medicine
                                • Module 2. The Epidemiological Transition and the Humanistic (Re)turn
                                • Module 2: Lesson 1:The Epidemiological Transition
                                • Module 2: Lesson 2: The Impact of the Epidemiological Transition on Humanism in Health and Healthcare
                                • Module 3. Medicalization and Social Control
                                • Module 3: Lesson 1: Medicalization and Social Control
                                • Module 3: Lesson 2: Medicalization and Overdiagnosis
                                • Module 4: The Biopsychosocial Model
                                • Module 4: Lesson 1: An Overview of the Biopsychosocial Model
                                • Module 5: The Birth of Bioethics and the Evolution of Humanism
                                • Module 5: Lesson 1: The Historical Evolution of Bioethics
                                • Module 5: Lesson 2: Clinical Ethics Analysis
                                • Module 6: The Science of Empathy
                                • Module 6: Lesson 1: The Science of Empathy
                                • Module 6: Lesson 2: Empathy in Patient Care
                                • Module 7: Building Empathy: Practices of the Senses
                                • Module 7: Lesson 1: Working with literature
                                • Module 7: Lesson 2: Working with Visual Art
                                • Module 7: Lesson 3: Working with Poetry
                                • Module 7: Lesson 4: Working with Music
                                • Module 8: Empathy in Pracice: Narrative Medicine/Narrative Communication
                                • Module 8: Lesson 1: Narrative Medicine: Connecting with Patients
                                • Module 9: Self Care: Caring for Self to Care for Others
                                • Module 9: Lesson 1: Understanding Burnout in Healthcare: Causes and Consequences
                                • Module 9: Lesson 2: Self-care and Patient Care
                                • Module 9: Lesson 3: Empathy and Self-care at Odds?: Thinking Realistically and Critically
                                • Module 10: Problems of Otherness and Dilemmas of Difference
                                • Module 10: Lesson 1: Problematics of Otherness
                                • Module 11. Marginalization (Choose at least 5 lessons to complete from those available, based on your interests and educational and professional needs.)
                                • Module 11: Lesson 1: Global Health and Cross-Cultural Practice
                                • Module 11: Lesson 2: Issues of Class and Poverty
                                • Module 11: Lesson 3: Race/Ethnictiy and Health
                                • Module 11: Lesson 4: The Health of Immigrants, Refugees, and Displaced Persons
                                • Module 11: Lesson 5: Gender and Health
                                • Module 11: Lesson 6: LGBTQ+ Persons and Health
                                • Module 11: Lesson 7: Incarcerated and Formerly Incarcerated Persons
                                • Module 11: Lesson 8: Disability, Health, and Healthcare
                                • Module 11: Lesson 9: Health, Humanism, and Aging
                                • Module 11: Lesson 10: Children, Health, and Humanism
                                • Module 11: Lesson 11: Religion/Spirituality and Health
                                • Module 12: From Cultural Competency to Cultural Humility: Habits of Respectful Curiosity
                                • Module 12: Lesson 1: From cultural competence to cultural humility
                                • Module 12: Lesson 2: Practices of Humility in Healthcare
                                • Module 12: Lesson 3: From Cultural Humility to Structural Competency and Social Justice
                                • Module 13: The Future of Humanism in Health and Health Care
                                • Module 13: Lesson 1: The Future of Humanism in Medicine
                                • Module 13: Lesson 2: Humanism and Technology: Threat or Opportunity
                                • Module 13: Lesson 3: Directions Forward
                                • Final Exam
                                • Course and Self Evaluation & Certificate
                                • Course Activities
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