Introduction to SingHealth Duke-NUS Medical Humanities Institute

May 3, 2024

Why are the medical humanities relevant?
Medical humanities is an interdisciplinary field which includes the human sciences (philosophy, bioethics, history of medicine, literary studies, and theology), the social sciences (psychology, sociology, anthropology, cultural studies, health geography), and the arts (literature, theater, film, and visual arts). The medical humanities involve the application of these academic disciplines in research, medical education and clinical practice. Our institute aims to respond to the depersonalization of modern healthcare, develop humanistic practice of medicine and support ethical analysis. We also aim to reinforce concepts of the person-centeredness and a biopsychosocial model where each patient is seen as a unique individual with unique responses to disease. This emerging field drives the understanding and transformation of healthcare towards well-being and humanistic values and can improve the quality of care provided to patients.

Why a joint institute of medical humanities? 
A joint academic institute between SingHealth and Duke-NUS Medical School was created in October 2023 to drive the development of medical humanities in both these institutions. Prof. Victor Dzau, a member of our Academic Medicine Advisory Council proposed a bench-to-bedside-to-population-to-society model that extends the academic mission to population health and social responsibility. In this model, a convergence approach is needed to engage non-health disciplines to address community health and equity with a commitment to social responsibility and the greater good. Prof. Victor Dzau proposed that future clinicians should be educated to become community-oriented and socially connected. They should be taught not only to provide direct care, but also to provide scientific, medical and social leadership. 

These ideas have been echoed by the Association of American Medical Colleges in its publication of “The Fundamental Role of the Arts and Humanities in Medical Education.” There is a belief that the arts and the humanities can play a unique and unrealized role in preparing and equipping physicians for 21st-century challenges. Practical steps forward include the assertion that the practice of medicine is an art as well as a science, requiring a grounding in humanistic values, principles, and skills. Increased collaboration among medical professionals, arts organizations, creative arts therapists, artists, humanities scholars, and patients’ needs to be fostered.

The SingHealth Duke-NUS Medical Humanities Institute (SDMHI) is envisioned to connect the academic strengths of Duke-NUS Medical School with the clinical wealth of the SingHealth institutions. It is with this bold vision that we venture forward with a community of committed pioneers.

What has been accomplished?
SDMHI runs three signature programs in bioethics, health professions education and narratives in medicine. In bioethics, the institute has played a pivotal role in rolling out education of professionalism and practical ethics through a series of workshops, webinars and colloquia. By partnering with the Office of Ethics in Healthcare, we provide academic support for a network of ethics committees across SingHealth institutions. The program also aims to develop locally relevant ethics casebooks and link its courses into an executive certificate in medical ethics. In addition, we have pushed for a move towards bedside ethics consultations by introducing deconflict deescalation techniques to clinicians in collaboration with Assoc. Prof. Autumn Fiester from University of Pennsylvania.

In health professions education, the institute leads the education of medical students through the teaching of professionalism, ethics and communication skills. We are also involved in the informal curriculum through signature events such as the White Coat Ceremony. SDMHI also co-organizes the annual Singapore Medical Humanities Conference that attracts a regional audience. We have also utilized social media to introduce medical humanities through the MH101 program.

SDMHI has built capacity by sponsoring the training of our faculty through the Columbia University online certification. We run a Substack post called HEART to bind a local community of practice. We have also run art therapy-based facilitation for neonatologists, leadership from Eastern General Hospital and primary care physicians. In addition, there is an ongoing faculty building process in introducing narrative medicine to residency training.