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"Crow, Sheila"
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The Chief Concern of Medicine
Unlike any existing studies of the medical humanities,The Chief Concern of Medicinebrings to the examination of medical practices a thorough---and clearly articulated---exposition of the nature of narrative. The book builds on the work of linguistics, semiotics, narratology, and discourse theory and examines numerous literary works and narrative \"vignettes\" of medical problems, situations, and encounters. Throughout, the book presents usable expositions of the ways storytelling organizes itself to allow physicians and other healthcare workers (and even patients themselves) to be more attentive to and self-conscious about the information---the \"narrative knowledge\"---of the patient's story.
eBook
Stepfamilies
\"This is a much-needed sociological review of stepfamily life, examining the particular issues and challenges which people in stepfamilies face. Combining published studies and original fieldwork, it focuses on the internal dynamics of stepfamily households as well as the relationships sustained with those outside the household\"--Provided by publisher.
Book
Obstetrics and gynecology clerkship for males and females: similar curriculum, different outcomes?
To determine if performance differences exist between male and female students on a 6-week obstetrics and gynecology (Ob/Gyn) clerkship and to evaluate potential variables that might underlie any observed variations.
Final clerkship grades and component scores (clinical evaluations, objective structured clinical examination [OSCE], oral examination, and National Board of Medical Examiners [NBME] subject examination) from July 2007 to June 2010 were matched by student and analyzed by gender. Basic science grade point average (GPA) and initial United States Medical Licensing Exam (USMLE) Step 1 scores were used to establish students' baseline medical knowledge. On a post-clerkship questionnaire, a subset of students reported the numbers of procedures they performed during the clerkship; students also completed online pre- and post-clerkship questionnaires reflecting their self-assessed confidence in women's health clinical skills.
Scores were analyzed for 136 women and 220 men. Final clerkship grades were significantly higher for females than for males (89.05 vs. 87.34, p=0.0004, η
2
=0.08). Specifically, females outscored males on the OSCE, oral, and NBME subject examination portions of the clerkship but not clinical evaluations. Males reported completing fewer breast examinations (p=0.001, η
2
=0.14). Pre-clerkship, males were significantly less confident than females in women's health clinical skills (p<0.01) but reached similar levels upon completion of the clerkship. No gender differences were detected for basic science GPA and USMLE Step 1 scores.
Student gender is associated with final grades on an Ob/Gyn clerkship. Further research regarding these differences should be explored.
Journal Article
The Foretelling
This narrative symposium examines the relationship of bioethics practice to personal experiences of illness. A call for stories was developed by Tod Chambers, the symposium editor, and editorial staff and was sent to several commonly used bioethics listservs and posted on the Narrative Inquiry in Bioethics website. The call asked authors to relate a personal story of being ill or caring for a person who is ill, and to describe how this affected how they think about bioethical questions and the practice of medicine. Eighteen individuals were invited to submit full stories based on review of their proposals. Twelve stories are published in this symposium, and six supplemental stories are published online only through Project MUSE. Authors explore themes of vulnerability, suffering, communication, voluntariness, cultural barriers, and flaws in local healthcare systems through stories about their own illnesses or about caring for children, partners, parents and grandparents. Commentary articles by Arthur Frank, Bradley Lewis, and Carol Taylor follow the collection of personal narratives.
Journal Article
Obstetrics and gynecology clerkship for males and females: similar curriculum, different outcomes?
Objective To determine if performance differences exist between male and female students on a 6-week obstetrics and gynecology (Ob/Gyn) clerkship and to evaluate potential variables that might underlie any observed variations. Study Design Final clerkship grades and component scores (clinical evaluations, objective structured clinical examination [OSCE], oral examination, and National Board of Medical Examiners [NBME] subject examination) from July 2007 to June 2010 were matched by student and analyzed by gender. Basic science grade point average (GPA) and initial United States Medical Licensing Exam (USMLE) Step 1 scores were used to establish students' baseline medical knowledge. On a post-clerkship questionnaire, a subset of students reported the numbers of procedures they performed during the clerkship; students also completed online pre- and post-clerkship questionnaires reflecting their self-assessed confidence in women's health clinical skills. Results Scores were analyzed for 136 women and 220 men. Final clerkship grades were significantly higher for females than for males (89.05 vs. 87.34, p=0.0004, η
=0.08). Specifically, females outscored males on the OSCE, oral, and NBME subject examination portions of the clerkship but not clinical evaluations. Males reported completing fewer breast examinations (p=0.001, η
=0.14). Pre-clerkship, males were significantly less confident than females in women's health clinical skills (p<0.01) but reached similar levels upon completion of the clerkship. No gender differences were detected for basic science GPA and USMLE Step 1 scores. Conclusion Student gender is associated with final grades on an Ob/Gyn clerkship. Further research regarding these differences should be explored.
Journal Article
Taking Bioethics Personally
This narrative symposium examines the relationship of bioethics practice to personal experiences of illness. A call for stories was developed by Tod Chambers, the symposium editor, and editorial staff and was sent to several commonly used bioethics listservs and posted on the Narrative Inquiry in Bioethics website. The call asked authors to relate a personal story of being ill or caring for a person who is ill, and to describe how this affected how they think about bioethical questions and the practice of medicine. Eighteen individuals were invited to submit full stories based on review of their proposals. Twelve stories are published in this symposium, and six supplemental stories are published online only through Project MUSE. Authors explore themes of vulnerability, suffering, communication, voluntariness, cultural barriers, and flaws in local healthcare systems through stories about their own illnesses or about caring for children, partners, parents and grandparents. Commentary articles by Arthur Frank, Bradley Lewis, and Carol Taylor follow the collection of personal narratives.
Journal Article
Multimedia education focusing on the role of narrative and virtues in the everyday ethical practices of medicine
Most Americans would agree that our medical care system and the physicians that practice within that system need a more humanistic, patient-centered approach to care. In response to this concern, there is a movement underway in medical education to teach and evaluate the professionalism and humanism of medical students and practicing physicians. While most medical schools use a principle-based framework for discussing ethical issues and concerns, there is a resurrected interest in focusing on virtues and a relatively new interest in focusing on the role of narrative, particularly to improve the patient-physician encounter. This creative Project Demonstrating Excellence describes the development of a multimedia, educational DVD-ROM chapter that explores the role of narrative and virtue ethics in the everyday ethical practice of medicine. Narrative refers to a coherent written, spoken or enacted account of occurrences, whether historical or fiction that can be grasped as a whole. It was the intent of the project to highlight how narrative, especially when conceived of in relation to \"virtue ethics,\" is not only beneficial, but necessary for the student or physician to thoroughly and competently reflect on the everyday ethical issues. To establish a scholarly foundation for this project, the literature relevant to medical ethics, especially principle-based ethics, virtue ethics, and narrative ethics was reviewed. Additionally, literature related to behaviorist, cognitivist, and constructivist learning theory and literature pertinent to the use of multimedia technology were examined. After completion of the chapter, a descriptive study using a mixed-methods approach was conducted with senior medical students and faculty to explore (1) what they learned from the chapter \"Narrative and the Everyday Ethical Practices of Medicine,\" and (2) how they experienced the DVD-ROM as a multimedia educational tool. Results of the study revealed that medical students and faculty were able, through Chapter 5 of the DVD-ROM, to identify a new framework using narrative and virtues for responding to the everyday ethical concerns in the practice of medicine. The \"Narrative and the Everyday Ethical Practices of Medicine\" chapter provides a unique resource for medical students and faculty. It can be used as a standalone, multimedia text or in conjunction with a course focusing on the role or narrative and virtues in medical ethics.
Dissertation
Helping Medical Students Understand Postpartum Psychosis Through the Prism of \The Yellow Wallpaper\ by Charlotte Perkins Gilman
Objective: We assessed the use of literature to illustrate a postpartum depression lecture. Methods: Medical students and faculty facilitators were surveyed after small group discussions. Results: Students' ratings and comments were positive, and faculty comments were neutral to positive. Conclusion: Students valued this teaching method, while faculty observations reflected challenges of assessing literature's contributions to medical education in improving empathy and treatment outcome.
Journal Article
READING THE DEATH OF IVAN ILYCH
Leo Tolstoy’s novellaThe Death of Ivan Ilychis a significant literary text that brings together many of the themes ofThe Chief Concern of Medicine.it is a story that resonates with the experience of health care workers—with the experience of physicians, nurses, and others confronted with suffering and dying—and at the same time provokes powerful feelings about our shared knowledge and, indeed, our shared lives as human beings. in significant ways, Tolstoy’sThe Death of Ivan Ilychis a modern version, in novelistic prose narrative, of the ancient themes of the pity and terror of suffering
Book Chapter