Reclaiming the ‘person’ and advocacy for good clinical care in psychiatric residency training through medical humanities

The COVID-19 pandemic brought attention to the dangers of burnout in healthcare professionals and the loss of the ‘person’ in patient care. With rising patient loads, increased time pressure, virtualisation of consultations and digitalisation of medical records, there remains a risk of ‘impersonalisation’ of clinical practice. Incorporating medical humanities (MH) into training can potentially improve perspective-taking and personal insight, resulting in improved clinician well-being and patient advocacy.1 In August 2021, we introduced bi-monthly 75-min sessions entitled ‘Humanities in Psychiatry’ (HIP) for psychiatry residents in Singapore, conducted during lunchtime via teleconferencing. Sessions were facilitated by a senior psychiatrist, following a format comprising of sharing a narrative, close reading and reflective writing. Sessions commenced with facilitators introducing the narrative (chosen for their relevance to patient care, focusing on the human experience of psychological distress), which residents then read aloud. Residents then participated in close reading, reflecting on the piece's context, form, time, plot and author's motivations. Residents were invited to share their reflections, particularly on the relevance of the material to their own clinical experiences. Finally, they were requested to write short reflections, to be shared with the group before the session concluded. After 18 months, residents provided anonymised quantitative and qualitative feedback via an online form. All residents agreed that HIP improved their listening skills, empathy, personal well-being and perceived ability to care for patients. The majority of the respondents (81.8%) agreed that the reflective writing component was cathartic. The three main themes related to the qualitative feedback on each of the three questions were summarised as follows: (1) What aspect of HIP has been most helpful? (participants being able to openly share and listen to each other in a safe space; time given to slow down and reflect; Lack of hierarchy in the reflective space); (2) how can HIP improve well-being? (allows learners to connect with their own and others' feelings; Allows learners to be vulnerable and support each other; Allows learners to focus on the human side of the medical and psychiatric practice); (3) how can HIP improve patient care? (reminds learners about the importance of maintaining empathy for patients, though being busy with clinical work; allows learners to learn from each other on how to be sensitive to needs of patients; allows learners to articulate what holistic care means and involves). Incorporating MH into resident teaching requires careful and intentional planning, including recruiting a small but dedicated group of facilitators, forecasting sessions in advance and careful selection of narrative pieces (e.g. articles from reflection sections of major medical journals such as Piece of My Mind in the Journal of American Medical Association and Art of Medicine in Lancet, nouvella). It is important to persevere with sessions despite busy clinical schedules (scheduling sessions during lunchtime was helpful), as these sessions have added value in moving beyond fostering empathy and improved well-being to also facilitating advocacy for good clinical care for our patients.1 The data that support the findings of this study are available from the corresponding author upon reasonable request

Library science · Medical education · Medical library · Child and Adolescent Health · Computer Science · Empathy and Medical Education · Medicine · Mental Health and Psychiatry · Psychology