We received 123 responses of which 14 were excluded as incomplete, resulting in 109 fully completed questionnaires, (109/123, 88.6%). The average age of participants was 22, and the distribution across years and genders are displayed in Figure 1 and Figure 2. There was no significant difference between the population of this study and the population of the medical school in terms of gender, based on statistics provided by the admissions data.
Gender distribution of study population
Figure 1: Pie chart of gender distribution within the study population. Percentage of students per option stated.
Academic year distribution of study population
Figure 2: Pie chart of academic year distribution within the study population. Percentage of students per option stated.
In relation to the types of humanities different groups of students were interested in, those who engaged in the university’s elective, extra-curriculum, humanities programme were found to be more likely to have engaged with the visual arts (p=0.031). There was a significant difference between senior (years 5 & 6) and younger medical students (years 1-4), with a smaller proportion of senior students engaging in performing arts compared to their younger counterparts (p=0.005).
Medical students at Imperial College study an intercalated bachelor of science (BSc) degree in a selected module of their choice. One of the largest influences on interest in the humanities was found to be participation in the Medical Humanities, Philosophy and Law BSc. These students were significantly more interested in the humanities (p=0.016) and likelier to support the integration of more humanities into the course (p=0.044). Quantitative analysis of factors prior to medical school, including study of humanities subjects, did not show any significant impact on students’ views of the medical humanities.
We found that students recommended the inclusion of additional humanities subjects in the first year most and final year least (Figure 3). The majority of students (71.98%) recommended humanities incorporation in the earlier years (years 1-3).
Academic year in which humanities should be introduced according to medical students
Figure 3: Recommended academic year for the introduction of a humanities course, split by current year group. (Relating to Q17: If more humanities subjects were introduced to the curriculum, in your opinion which academic year(s) would be most appropriate?) Bar chart split to represent response rates from different MBBS Year Groups.
Results from the qualitative questions, 17 - 19, are shown in Tables 1 - 3, along with some exemplar quotations. Three main themes identified by students’ written responses included: (1) time, (2) use and (3) vertical learning. These themes were then separated into subthemes and these, along with their frequency and representative quotes are summarized in Table 1. 23 responses were deemed unusable due to either being blank or incomprehensible.
Medical students’ thoughts on which year of medical school humanities should be introduced into
Theme
|
Subthemes
|
Quantity
|
Quotes
|
Time
|
More spare time in pre-clinical years
More spare time in 3rd year
More room for choice in 4th year
Break from very science-focused younger years
|
22
14
10
5
|
“Early enough that there is still time to focus on it”
“First proper clinical experience so allows for more holistic view of patient”
“That’s the year you have a break from clinical medicine”
“To get a taster view on why medicine is beyond the molecular science”
|
Use
|
Useful in clinical years to use in practice
Pre-clinical years not enough empathy currently
More open-minded in younger years
|
8
8
4
|
“Need clinical appreciation to best integrate”
“Get an early start to open discussion and help keep the mindset open”
“Earlier exposure would spark an interest sooner”
|
Vertical Learning
|
Useful to integrate early and late years
Logistics
Continuous learning
|
18
2
12
|
“Theory in early years, applied in clinical years”
“Years in which lectures feature heavily and you’re mostly centrally based”
“Core throughout entire degree”
|
Table 1: Question 17 “If more humanities subjects were introduced to the curriculum, in your opinion which academic year would be most appropriate?”
|
We found that 31 students prefer humanities to be compulsory (‘No’) and 38 students showed preference in an elective course (‘Yes’). 40 students were indifferent and 64 written responses were unusable (Table 2). We found that the most common reasons for humanities to be an elective component were disinterest in the subject and that it was deemed unnecessary to the course. The themes, where given, are thematically summarized in Table 2.
Medical students’ opinions on whether humanities should be an elective module or not
Answer
|
Themes
|
Quantity
|
Quotes
|
Yes
|
Disinterest
Unnecessary
|
17
11
|
“Not everyone has an interest or aptitude for humanities”
“Forcing someone to do humanities benefits no one”
|
No
|
Produce well-rounded doctors
Humanities are important
Too many people would opt out
People need to do it
|
3
8
11
4
|
“Helps to be a well-rounded person and enable to be a better doctor”
“They are as important as other compulsory subjects”
“Optional teaching is generally badly attended”
“The people who don’t want to do it need it most”
|
Table 2: Question 18 “If humanities subjects were integrated into the course, should they be elective?”
|
The final qualitative question related to whether the course, if introduced, should be assessed or not. In general, 18 students thought it should, 71 students thought it shouldn’t and 20 students were indifferent. 61 written reasons were unusable. The reasons, where given, are thematically summarized in Table 3.
Medical students’ opinions on the assessment of humanities subjects
Answer
|
Themes
|
Quantity
|
Quotes
|
Yes
|
To ensure attendance and engagement
Emphasise importance of humanities
All course material should be examined
|
9
1
1
|
“Provide motivation”
“They have the same importance and weighting as other parts of medicine”
“If it is in the course it should be examined”
|
No
|
Too many exams already
Humanities are subjective
Engagement is more important than exams
Humanities are not vital to role of doctor
Exams detract from enjoyment
Unfair to include in rankings
|
4
11
7
12
6
2
|
“There are enough exams to worry about”
“Hard to examine, based on opinions and perspectives”
“Allows people to engage with no pressure”
“Important to consider but not an integral part of passing the course”
“Assessment detracts from creativity and enjoyment”
“Better to have a formative discussion or something where attendance is graded but not marked”
|
Table 3: Question 19 “If humanities subjects were integrated into the course, should they be assessed?”
Regarding ranking the important qualities of a doctor, senior medical students (years 5 and 6) rated ‘importance of empathy’ lower (p=0.0001) with the ‘ability to manage a patient’ ranked significantly higher (p=0.001). Finally, senior students are significantly more likely to agree that humanities play an important role in the MBBS course (p=0.001).
There was no significant difference between the genders in engagement or interest in humanities. The median values between all cohorts were similar and a study involving a larger sample size and perhaps qualitative reasoning behind answers given would be needed in order to draw meaningful conclusions.