Horton, Mary E. Kollmer (Author)
Risjord, Mark W. (Advisor)
The medical humanities have long been considered a valuable part of physician education. Yet, its standard inclusion in undergraduate medical education has been elusive. In the 1960's leaders in medical education began formal meetings with humanists to discuss concerns that medical students were increasingly cynical, and that the content of their curriculum had become highly scientific and technical to the exclusion of humanism. The Society for Health and Human Values, incorporated in 1969, formed from these concerns. The Institute on Human Values in Medicine, a project of the Society, was formed to consider the integration of human values content into medical curricula. With funding from the National Endowment for the Humanities leaders of the Institute worked tirelessly from 1971 to 1981 through a variety of well planned and executed activities to promote the teaching of human values content. Ultimately, the Institute lost its funding, which ended its active work. Lacking direction from its parent Society or professional associations, it closed. The Institute’s efforts drew attention to the medical humanities in medical education and laid some of the groundwork for the inclusion of ethics into the accredited undergraduate medical curriculum. Nonetheless, it fell short of its goal to integrate a spectrum of humanities content into the standard medical curriculum. This dissertation uses historical methods to examine the activities of the Institute to identify barriers in the standard inclusion of humanities in medical education. Barriers identified validate sociological theories of schools as complex open organizations with strongly institutionalized cultures. Sociological studies of mass global curricula also show the devaluation of humanities as an essential curricular element. The institutional scientific and corporate culture of academic medical centers makes the integration humanities difficult and ‘unnatural’. This study emphasizes the strength of social and professional belief systems, legitimizing agencies, and forces in constant interaction with the institution and supports a predictive model based on the sociological definition of professions and organizational theories. Calls for humanism in medicine and medical education have escalated in the current century. Recent efforts to integrate humanities cast in language acceptable to corporate and scientific culture predicts greater integrative success.
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