Integrating Medical Humanities into a Pharmaceutical Care Seminar on Dementia

By Zimmermann, Martina | American Journal of Pharmaceutical Education, February 2013 | Go to article overview

Integrating Medical Humanities into a Pharmaceutical Care Seminar on Dementia


Zimmermann, Martina, American Journal of Pharmaceutical Education


INTRODUCTION

The German curricula of health sciences--medicine and pharmaceutical sciences alike--do not plan to integrate medical humanities modules into their syllabi, even though the study of personal illness narratives significantly improves the attitudes of health professions students toward patients, (1) and is successfully used in the training of medical practitioners and nurses in the United States and United Kingdom. (2,3) Given that the pharmacy curriculum in Germany is heavily focused on chemistry, (4) pharmacy students do not benefit from extended teaching in clinical pharmacy. During the last 2 of 8 university-based semesters, 116 academic hours are allocated to chemistry. Only 24 hours are allotted to pharmaceutical care, defined as the responsible provision of drug therapy that achieves the improvement of a patient's quality of life and involves the pharmacist's purposeful interaction with the patient and other health care professionals. (5) Furthermore, lectures in pharmaceutical care usually take into account questions such as drug interactions and contraindications, handling of small medical equipment, or issues of treatment compliance. In comparison, little attention is placed on the actual interaction between patient and pharmacist, as highlighted in a nationwide opinion survey among pharmacy students. (6) Indeed, the patient's personal situation, difficulties in everyday life, and perception of illness and self, all of which impact on how (and whether) a patient will be able to interact with the pharmacist, are neglected in health sciences education in Germany and in the training of pharmacy students, in particular.

In view of the aging population, such considerations will play an increasingly important role. The number of elderly patients (who require the most support from pharmacists) will continue to increase. Because most health care systems will not adapt quickly enough to these changing demands, they will increasingly direct the patient to the pharmacy first, thereby making pharmacists the new gatekeepers. (7) Given that pharmacists will play a central role in filtering and relaying information to healthcare staff and concerned individuals, pharmacists and pharmacy educators must find a way to make care of patients and caregivers a high priority for pharmacy. This need for a greater emphasis on "humanistic parameters" in pharmacy education has been recognized by the Association of German Pharmacy Professors. (8) As part of these efforts, pharmacy students' preparation for actual patient contact must include more focus on patients' perceptions of their condition. Where direct contact with patients is not possible, (9) having students read and understand the writings of patients and caregivers is an effective alternative teaching approach.

Building on the author's earlier experience with the reorganization of a physiology course to include more active learning, (10) and the integration of narrative texts into the discussion rounds of students pursuing a doctoral life-science degree, (11) a 2-hour pharmaceutical care teaching module was devised that incorporated textual and visual narratives of dementia patients and caregivers. This approach follows Thomas Couser's insight that integrating the written testimony of those who are ill, by itself, will remove the condition as well as its sufferers from the margins of societal concerns. (12) Such teaching methods critically analyse both illness and patient presentation in narrative texts, considering the kind of information given and the ways in which author-narrators choose to tell their story, with the goal being to gain a deeper understanding of how the condition is perceived.

The specific aim of the course module described and discussed here was to guide pharmacy students to understand patients not only as receivers of pills and carriers of bodily symptoms, but as human beings with psychological needs.

DESIGN

Expected Outcomes and Learning Objectives

The core aim of the medical humanities teaching module was to further the students' understanding of patients' and caregivers' individual illness experiences and consequential needs for skilled and dedicated pharmaceutical care. …

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