Number of Citations: 0

Submitted: 19 September 2024
Accepted: 16 April 2025
Published online: 6 January, TAPS 2026, 11(1), 69-73
https://doi.org/10.29060/TAPS.2026-11-1/SC3524

Eng-Koon Ong^1-4,7, April Thant Aung^3,8, Min Chiam³, Lalit Kumar Radha Krishna^1,3,4, Yingxuan Chen¹⁰, Filomar Cortezano Tariao⁹, Faith Ng¹¹, Jamie Zhou^1,4 & Wen-Shan Sim^4-6

¹Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore; ²Office of Medical Humanities, SingHealth Medicine Academic Clinical Programme, Singapore; ³Division of Cancer Education, National Cancer Centre Singapore, Singapore; ⁴Duke-NUS Graduate Medical School, Singapore; ⁵Maternal Fetal Medicine, KK Women’s and Children’s Hospital, Singapore; ⁶PGY1 Programme, SingHealth, Singapore; ⁷Assisi Hospice, Singapore; ⁸School of Humanities, Nanyang Technological University, Singapore; ⁹School of Dance, Nanyang Academy of Fine Arts, Singapore; ¹⁰Shaw Heritage Arts and Wellbeing Studios, Singapore; ¹¹Checkpoint Theatre, Singapore

Abstract

Introduction: Through collaborative pedagogical initiatives, the medical humanities (MH) have the potential to support healthcare professionals in developing various competencies in medical education (ME). However, there is a lack of data on faculty development programmes specific to this field.

Methods: Based on our experience in designing a medical humanities workshop for medical students, we conducted two faculty development (FD) workshops that adopted an interdisciplinary approach towards faculty training. These FD workshops served to train fellow clinician educators in the integration of the MH in ME.

Results: A total of 17 participants completed two workshops over two years, with seven participants in 2023 and 6 in 2024 completing pre- and post-workshop surveys that evaluated their experience, knowledge and skills. The survey consisted of six self-rated questions based on a 5-point Likert scale from 1 (strongly disagree) to 5 (strongly agree) with an open-ended question embedded in the post-workshop survey. A paired t-test evaluation of the results suggests that there was an increase in awareness, knowledge, and confidence.

Conclusion: Our MH-based FD programme is limited by the lack of qualitative data and further studies are needed. Similar programmes should include an introduction to the medical humanities and its methodologies so that a train-the-trainers approach is adopted. Programmes should also look beyond teaching effectiveness to include developing systemic awareness and support, assess outcomes such as professional identity formation, and build communities of practice for faculty members.

Keywords:           Faculty Development, Medical Humanities, Medical Education, Health Professions Education

I. INTRODUCTION

The role of the medical humanities (MH) in healthcare is multifaceted, supported by its methodologies from the arts and humanities in promoting perspective-taking, reflective practice, and professional identity formation. Specifically, its relevance in aspects of medical education (ME) such as professionalism, communications, and humanistic care has rallied healthcare educators exploring the field to achieve educational goals in developing empathy, improving patient experience, and preventing burnout (Ong et al. 2024).

A vision to integrate MH within ME has gained prominence over the past decade, with articles describing its epistemological functions, guidelines on programme development, and emerging evidence of acceptability and effectiveness of pilot programmes. Despite this, there is a disproportionate lack of data on faculty development (FD) to support this vision. A white paper by Howley et al. (2020) advocates for interdisciplinary collaboration between clinician educators, humanities scholars and creative arts practitioners. However, little guidance was provided on the type of effort, support, and considerations needed to nurture an interdisciplinary team of faculty members to design, implement, and sustain MH programmes.

II. CONTEXT AND PROGRAMME

Since 2022, a one-day theatre-based MH workshop has been conducted for all medical students from Duke-NUS Graduate Medical School (Singapore) rotating through the Division of Supportive and Palliative Care at the National Cancer Centre Singapore. During the workshop held on the final day of their one-week clinical rotation, students watch a full recording of a local theatre play, A Good Death by the playwright Faith Ng, and participate in small group discussions on scenarios that depict pain crises experienced by oncology and hospice patients, difficult conversations about end-of-life care, and moral distress faced by palliative care practitioners and its impact on their mental wellbeing. Students also participate in a “hot-seating” activity where they embody the different characters of the play, and respond to questions from the class while in character. Prior to this core clinical rotation, most students had little prior exposure to end-of-life care and the activities were intended to promote perspective-taking, self-awareness, and professional identity formation through the use of theatre. The workshop is co-facilitated by a specialist palliative care physician with a master’s degree in medical education, a medical humanities doctorate fellow, a medical social worker trained in counselling and narrative therapy, and the director of the play. This interdisciplinary faculty team facilitated dynamic discussions and generated new insights for the students.

Based on our positive experience in developing this programme, we decided to conduct a yearly faculty development (FD) workshop for other educators who were keen on designing arts and humanities programmes within their specialities and settings. The workshop consisted of three segments. Firstly, an introduction to conceptual frameworks and principles within both MH and ME was presented by EKO and YC, listing frameworks such as adult learning, community of practice, and reflective practice. Principles such as the need to create a sense of agency, establish common goals, validate values of faculty members, and promote reflective processes were also identified. Secondly, YC described and explained theatre-based facilitation methods such as improvisation and applied theatre techniques. This provided refreshing insight on how MH programmes could be designed and conducted by arts practitioners like herself. The choice of teaching materials that considered learners’ receptivity, appropriateness to achieve learning objectives, and ease of access were also explored. Lastly, the team demonstrated how learning objectives and lesson plans could be written based on Bloom’s taxonomy and Gagne’s model of instruction respectively. The educators were then asked to practice doing the same in groups of three for an existing or potential MH-based ME programme.

We applied the conceptual framework of adult learning in the design of the FD workshop and the relevance of medical humanities in medical education was regularly alluded to in all three segments. This promoted a sense of agency towards self-directed learning. All staff from the SingHealth Academic Medicine Centre, the largest healthcare cluster in Singapore, were invited to participate in the FD workshops in 2023 and 2024. The same team of faculty members from the original medical students’ workshops conducted the FD workshops.

III. METHODS / RESULTS

A total of 17 participants completed the FD workshops over two years. We found a lack of validated evaluation methods for MH-based ME programmes and thus designed a questionnaire guided by Bloom’s taxonomy for our programme. This was similarly done by Kumagai et al. (2007) who investigated the effects of a forum theatre-based workshop for 29 medical school faculty members that facilitated discussions on race and gender through a self-designed survey pre- and post-workshop that assessed self-awareness and “critical consciousness”.

All 17 participants were invited to complete an online survey within one week before and after the FD workshops. The survey consisted of six self-rated questions based on a 5-point Likert scale from 1 (strongly disagree) to 5 (strongly agree) that alluded to the participants’ experience, knowledge, and skills gained from the workshop.

In total, 7 participants in 2023 and 6 in 2024 consented to and completed the surveys (Ong et al., 2024). The group consisted of seven doctors, a clinical psychologist, a clinical pastoral counsellor, a healthcare education executive, two pharmacists, and an assistant director of community outreach and philanthropy. Table 1 lists the questions and the outcomes of the survey. A paired t-test evaluation of the results suggests that there was an increase in awareness, knowledge, and confidence.

	Questions	Mean score (n=13)		t-score difference	p-value
		Pre-workshop	Post-workshop
1.	I would recommend this workshop to my fellow colleagues.	3.62	4.23	2.309	0.04
2.	I am keen to attend similar workshops again in the future.	3.85	4.62	2.993	0.011
3.	I agree that the arts and humanities have valuable knowledge to offer to medical education.	4.38	4.62	0.478	0.641
4.	I can identify potential content, materials and facilitation needed for medical education programs involving the arts and humanities.	2.54	3.92	4.454	<0.001
5.	I am able to pursue the design and implementation of a medical education program involving the arts and humanities confidently as part of a team.	2.46	3.69	6.121	<0.001
6.	I am able to pursue the design and implementation of a medical education program involving the arts and humanities confidently as an education lead, alongside arts practitioners.	1.92	2.77	4.430	<0.001

Table 1. Survey questions and results

IV. LIMITATIONS

Programme evaluation is limited by the small number of participants and lack of a validated measure. While there may be apparent statistical significance to the improvement of the scores collected, a solely quantitative outcome measure may not be adequate to provide insight on the success of the programme. Future programme evaluations with bigger cohorts coupled with qualitative data are needed.

V. DISCUSSION

Existing publications in FD focus on broader teaching competencies such as facilitation and communication skills, curriculum development, education leadership, and scholarship (Steinert et al. 2016), suggesting that faculty members could translate what they have learnt into individual fields of interest. Based on our experience, we posit that further considerations are needed for FD programmes in the field of the medical humanities.

Firstly, a low awareness of the relevance of the MH in ME (Ong, 2021), the need for faculty members to achieve basic understanding of content from diverse theoretical and practical frameworks from both fields, distinct but complementary roles of co-faculty members from medicine and the arts and humanities (Ong et al. 2024), and a lack of agreement on how teaching effectiveness is defined can affect faculty members’ decision to enrol in FD workshops and subsequently how they experience FD in MH. Thus, equipping faculty members with teaching skills may not be adequate. A “train-the-trainers” approach where teaching competencies are complemented with knowledge about MH’s content, methodologies, theoretical frameworks, and assessment tools may be preferable. This approach ensures that faculty members not only develop the skills required to co-facilitate MH programmes, but also reinforces the value of MH when employed within ME.

Secondly, Steinert et al.’s (2016) Best Evidence Medical Education (BEME) guide on faculty development in ME concludes that the outcomes of FD programmes should include the development of a community of practice that can affect organisational and cultural change towards education. In countries such as Singapore where the field of MH within ME is still in its nascent stage, building a community of practice (COP) is essential. A COP can increase awareness and promote endorsement by both senior leadership and peer educators, ensuring programme sustainability beyond initial “pilot” programmes. We hope that this study can inspire like-minded educators to develop FD programmes in tandem to the novel MH programmes that they implement.

Finally, we would also like to remind readers that with its unique methodologies like narrative inquiry, close reading, and experiential learning frameworks, the FD programmes for MH for medical educators have the potential to contribute to professional identity formation and foster wellbeing (Ong et al., 2024). These outcomes though not listed as the learning objectives of our study, have been consistently expressed by the participants during our workshops.

VI. CONCLUSION

In summary, we have described and presented the quantitative outcomes of a faculty development (FD) workshop specific to the field of medical humanities. Qualitative data is still needed for programme evaluation. Addressing gaps in the current literature, we recommend that all MH FD programmes incorporate an introduction to MH and its methodologies, look beyond teaching effectiveness to include systemic awareness and support, assess outcomes such as professional identity formation, and build communities of practice. Future research into these aspects and the development of validated learning outcome measures that include qualitative data will enhance current insight on FD and support the call for integrating MH within the medical education landscape.

Notes on Contributors

OEK conceptualised the outline of the paper and focused mainly on the perspectives from clinicians and clinician educators. He also designed and taught at the faculty development workshops, reviewed and approved the final draft of the manuscript, and agree to be accountable for all aspects of the paper.

LKRK conceptualised the outline of the paper and focused mainly on the perspectives from clinicians and clinician educators. He also designed and taught at the faculty development workshops, reviewed and approved the final draft of the manuscript, and agree to be accountable for all aspects of the paper.

JZ conceptualised the outline of the paper and focused mainly on the perspectives from clinicians and clinician educators. She also designed and taught at the faculty development workshops, reviewed and approved the final draft of the manuscript, and agree to be accountable for all aspects of the paper.

SWS conceptualised the outline of the paper and focused mainly on the perspectives from clinicians and clinician educators. She also reviewed and approved the final draft of the manuscript, and agree to be accountable for all aspects of the paper.

ATA contributed to the layout of the paper and focused on perspectives as medical humanities scholars and teachers. She also designed and taught at the faculty development workshops, reviewed and approved the final draft of the manuscript, and agree to be accountable for all aspects of the paper.

CM contributed to the layout of the paper and focused on perspectives as medical humanities scholars and teachers. She also designed and taught at the faculty development workshops, reviewed and approved the final draft of the manuscript, and agree to be accountable for all aspects of the paper.

FCT contributed to the layout of the paper and focused on perspectives as performing arts practitioners and tutors. He also designed and taught at the faculty development workshops, reviewed and approved the final draft of the manuscript, and agree to be accountable for all aspects of the paper.

CYX contributed to the layout of the paper and focused on perspectives as performing arts practitioners and tutors. She also designed and taught at the faculty development workshops, reviewed and approved the final draft of the manuscript, and agree to be accountable for all aspects of the paper.

NF contributed to the layout of the paper and focused on perspectives as performing arts practitioners and tutors. She also designed and taught at the faculty development workshops, reviewed and approved the final draft of the manuscript, and agree to be accountable for all aspects of the paper.

Ethical Approval

The project was submitted to the SingHealth centralised institutional review board (IRB) but exempted from review due to its nature as a medical education programme evaluation (CIRB number 2023/2036).

Data Availability

The data that support the findings of this study are openly available in the Figshare repository https://doi.org/10.6084/m9.figshare.27038086 (Ong et al. 2024).

Acknowledgement

We would like to thank Ms Eve Seraphina Low for setting up the online survey form and correspondence with the participants, and logistical support of the conduct of the workshop.

Funding

The faculty development workshop was supported by the SingHealth Oncology Academic Clinical Programme Education Support Grant (project number 08/FY2022/P2/09-A75).

Declaration of Interest

All of the authors state no conflicts of interest.

References

Howley, L., Gaufberg, E., & King, B. (2020). The fundamental role of the arts and humanities in medical education. Washington, DC: AAMC.

Kumagai, A. K., White, C. B., Ross, P., Purkiss, J. A., O’Neal, C. M., & Steiger, J. A. (2007). Use of interactive theater for faculty development in multicultural medical education. Medical Teacher, 29(4), 335-340. https://doi.org/10.1080/01421590701378662

Ong, E. K. (2021). HAPPE – A pilot programme using humanities to teach junior doctors empathy in a palliative medicine posting. The Asia Pacific Scholar, 6(1), 83-92. https://doi.org/10.29060/TAPS.2021-6-1/OA2251

Ong, E. K., Tan, E. U., Min, C., & Sim, W. S. (2024). The employment of art therapy to develop empathy and foster wellbeing for junior doctors in a palliative medicine rotation – A qualitative exploratory study on acceptability. BMC Palliative Care, 23(1), 84. https://doi.org/10.1186/s12904-024-01414-6

Ong, E. K., Aung, A. T., Min, C., Krishna, L. K. R., Chen, Y., Tariao, F. C., Ng, F., Zhou, J., & Sim, W. S. (2024). Data from pre- and post-surveys of participants [Dataset]. Figshare. https://doi.org/10.6084/m9.figshare.27038086

Steinert, Y., Mann, K., Anderson, B., Barnett, B.M., Angel., C., Naismith, L., Prideaux, D., Spencer, J., Tullo, E., Viggiano, T., Ward, H., & Dolmans, D. (2016). A systematic review of faculty development initiatives designed to enhance teaching effectiveness: A 10-year update: BEME Guide No. 40. Medical Teacher, 38(8), 769-786. https://doi.org/10.1080/0142159X.2016.1181851

*Ong Eng Koon
National Cancer Centre Singapore
30 Hospital Blvd, Singapore 168583
Email: ong.eng.koon@assisihospice.org.sg