Skip to main content
Log in

Centering Patients, Revealing Structures: The Health Humanities Portrait Approach

  • Published:
Journal of Medical Humanities Aims and scope Submit manuscript

Abstract

This paper introduces an innovative curricular approach—the Health Humanities Portrait Approach (Portrait Approach)—and its pedagogical tool—the Health Humanities Portrait (HHP). Both enable health professions learners to examine pressing social issues that shape, and are shaped by, experiences of health and illness. The Portrait Approach is grounded in a set of “critical portraiture” principles that foster humanities-driven analytical skills. The HHP’s architecture is distinctively framed around a pressing social theme and utilizes a first-person narrative and scholarship to explore how the dimensions of the personal and the structural are mutually constituted. We argue that when creator-educators adopt the Portrait Approach and its critical portraiture principles to design and teach the HHP, they enable learners to become proficient in synthesizing and analyzing—with both depth and breadth—the human and social dimensions of patients’ lives. This inventive curricular intervention provides a needed contribution to health professions education in that it utilizes health humanities methodologies to elucidate the multiple aspects of health, illness, disability, and healthcare.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Notes

  1. https://aquifer.org/resources-tools/enhancing-students-clinical-reasoning/.

References

  • Aquifer Case Library. n.d. “Case Analysis Tool.” Accessed February 25, 2019 and March 4, 2019. https://www.aquifer.org/resources-tools/enhancing-learners-clinical-reasoning/.

  • Borrell-Carrió, Francesc, Anthony Suchman, and Ronald Epstein. 2004. “The Biopsychosocial Model 25 Years Later: Principles, Practice, and Scientific Inquiry.” Annals of Family Medicine 2 (6): 576-582.

    Article  Google Scholar 

  • Cameron, Donald, Sayantani DasGupta, Jonathan Metzl, and Kristen Eckstand. 2017. “Queer Frontiers in Medicine: A Structural Competency Approach.” Academic Medicine 92 (3): 345-350.

    Article  Google Scholar 

  • Colon, Edgar Rivera. 2019. “This Ain’t No Tool This Ain’t no Tool Box.” In Structural Competency in Mental Health and Medicine: a Case-Based Approach to Treating the Social Determinants of Health, edited by Helena Hansen and Jonathan Metzl, 27-33. Switzerland: Springer.

    Chapter  Google Scholar 

  • DasGupta, Sayantani. 2008. “Narrative Humility.” Lancet 371 (9617): 980-981.

    Article  Google Scholar 

  • Downer, Ann and Sue Swindells. 2003. Developing for Clinical Case Studies: A Guide for Teaching. AETC National Resource Center and International AIDS Society USA.

    Google Scholar 

  • Email Correspondence from learner to Joanna Michel. (2018).

  • Epstein, Ronald and Richard Street. 2011. “The Values and Value of Patient-Centered Care.” Annals of Family Medicine 9 (2): 100-103.

    Article  Google Scholar 

  • Farmer, Paul, Bruce Nizeye, Sara Stulac, and Salmaan Keshavjee. 2006. “Structural Violence and Clinical Medicine.” PLoS Medicine 3 (10): e449.

    Article  Google Scholar 

  • Garden, Rebecca. 2010, “Telling Stories about Illness and Disability: The Limits and Lessons of Narrative.” Perspectives in Biology and Medicine 53 (1): 121-35.

    Article  Google Scholar 

  • _____. 2015. “Who Speaks for Whom? Health Humanities and Ethics of Representation.” Medical Humanities 41:77-80.

  • _____. 2018. "Health Humanities Portrait Teaching Guide, Immigration and Identity.” Submitted in the role of expert consultant for the National Endowment for the Humanities Humanities Initiative Grant, 2018-2020.

  • Giddens, Anthony. 1979. Central Problems in Social Theory: Action, Structure, and Contradiction in Social Analysis. Berkeley: University of California Press.

    Book  Google Scholar 

  • Halpern, Jodi. 2001. From Detached Concern to Empathy: Humanizing Medical Practice. Oxford: Oxford University Press.

    Book  Google Scholar 

  • Hansen, Helena and Jonathan Metzl, eds. 2019. Structural Competency in Mental Health and Medicine: a Case-Based Approach to Treating the Social Determinants of Health. Switzerland: Springer.

    Google Scholar 

  • Jones, Therese, Delese Wear, and Lester Friedman, eds. 2014. Health Humanities Reader. New Brunswick: Rutgers University Press.

    Google Scholar 

  • King, Katie. 2012. Network Reenactments: Stories Transdisciplinary Knowledges Tell. Durham: Duke University Press.

    Book  Google Scholar 

  • Koestler, Jennifer and Lyuba Konopasek. 2017. “Culture in Health Care 02: 2-year-old male with fever and headache.” Bao Nyugen. Aquifer Case Library, Updated July 1, 2017. Accessed February 25 and June 26, 2019. https://www.aquifer.org; https://uillinois-md.meduapp.com/documents/412.

  • Kumagai, Arno and Monica Lyson. 2009. “Beyond Cultural Competency: Critical Consciousness, Social Justice, and Multicultural Education.” Academic Medicine 84 (6): 782-787.

    Article  Google Scholar 

  • Kumagai, Arno, Mehreen Kakwan, Soud Sedique, and Monica DiMagno. 2010. “Actors’ Personal Stories in Case-based Multicultural Medical Education.” Med Educ 44 (5): 506-507.

    Article  Google Scholar 

  • Lawrence-Lightfoot, Sarah and Jessica Hoffmann Davis. 1997. The Art and Science of Portraiture. San Francisco: Jossey-Bass.

    Google Scholar 

  • Lo, Bernard. 2013. Resolving Ethical Dilemmas: A Guide for Clinicians. 5th ed. Philadelphia: Lippincott, Williams and Wilkins.

    Google Scholar 

  • Metzl, Jonathan. 2012. “Structural Competency.” American Quarterly 64 (2): 215.

    Article  Google Scholar 

  • Metzl, Jonathan and Helena Hansen. 2014. “Structural Competency: Theorizing a New Medical Engagement with Stigma and Inequality.” Social Science & Medicine 103 (2014): 126-133.

    Article  Google Scholar 

  • Metzl, Jonathan and Dorothy Roberts. 2014. “Structural Competency Meets Structural Racism: Race, Politics, and the Structure of Medical Knowledge.” Virtual Mentor 16 (9): 674-690.

    Article  Google Scholar 

  • Meyer, Richard. 2018. “Critical Portraiture: Research that Challenges the Status Quo.” Sage Research Methods Cases. https://doi.org/10.4135/9781526449108.

  • Montgomery, Kathryn. 1991. Doctors’ Stories. Princeton: Princeton University Press.

    Google Scholar 

  • Neistadt, Maureen and Ruth Smith. 1997. “Teaching Diagnostic Reasoning: Using a Classroom-as-Clinic Methodology with Videotapes.” American Journal of Occupational Therapy 51 (5): 360-8.

    Article  Google Scholar 

  • Nguyen, Viet Than, ed. 2018. Introduction. In The Displaced: Writers on Refugee Lives, edited by Viet Than Nguyen, 11-22. New York: Henry N. Abrams.

  • Scott, Joan. 1991. “The Evidence of Experience.” Critical Inquiry 17 (4): 773-797.

    Article  Google Scholar 

  • Shapiro, Johanna. 2011. “Illness Narratives: Reliability, Authenticity and the Empathic Witness.” Medical Humanities 37 (2): 68-72.

    Article  Google Scholar 

  • Stonington, Scott et al. 2018. “Case Studies in Social Medicine – Attending to Structural Forces in Clinical Practice.” New England Journal of Medicine 379 (2): 1958.

    Article  Google Scholar 

  • Tervalon, Melanie, and Murray-Garcia, Jann. 1998. “Cultural Humility versus Cultural Competence: A Critical Distinction and Defining Physician Training Outcomes in Multicultural Education.” Journal of Health Care for the Poor and Underserved 9 (2): 117-125. doi: https://doi.org/10.1353/hpu.2010.0233.

    Article  Google Scholar 

  • Trautmann (Banks), Joanne. 1979. “The Wonders of Literature in Medical Education.” In The Role of the Humanities in Medical Education, edited by Donnie J. Self, 32-44. Norfolk, VA: BioMedical Ethics Program, Eastern Virginia Medical School.

    Google Scholar 

  • Tsai, Jennifer, Laura Ucik, Nell Baldwin, Christopher Hasslinger, and Paul George. 2016. “Race Matters: Examining and Rethinking Race Portrayal in Preclinical Medical Education.” Academic Medicine 91 (7): 916-20.

    Article  Google Scholar 

  • UIC Learner Survey for Testing of Health Humanities Portrait. 2018. National Endowment for the Humanities, Humanities Initiative Grant, 2018-2020.

  • Weiner, Saul and Alan Schwartz. 2016. “Contextual Errors in Medical Decision Making: Overlooked and Understudied.” Academic Medicine 91 (5): 657-662.

  • Yang, Kao Kalia. 2016. The Song Poet: A Memoir of my Father. New York: Metropolitan Books, Henry Holt and Company.

  • Zumsteg, Jennifer et al. 2011. “Publishing Clinical Cases: Who Owns the Story? Is the Patient's Consent Needed?” Phys Med Rehab 3 (7): 657-663.

Download references

Acknowledgements

We would like to thank the National Endowment for the Humanities (NEH) for the Humanities Initiative grant that enabled the portrait approach to be developed. Thank you to Deborah Hurtt (program officer) for believing in and supporting us throughout this work. Thank you to the Department of Medical Education at the University of Illinois-Chicago College of Medicine for supporting this project as well. We would also like to thank the NEH participating experts (Rebecca Garden, Jodi Halpern, Gretchen Case, Ellen Amster, and Jonathan Metzl) and faculty core (Aly Patsavas, Carrie Sandahl, Kristi Kirshner, Laura Hirshfield, Gwyneth Milbrath, Matthew Gambino, Anna Maria Grammelspacher, Erica Laethem and Elsa Vasquez-Menendez, Joanna Michel, Michael Blackie and Sandy Sufian) who have been involved in this process for being thoughtful and committed to making the project so successful. We would also like to thank Madeline Lee for designing the project logo and our website and Lauren Zahn for her citation work. We deeply appreciate Lily Zheng, Shay Phillips, and Jay Mueller for their brilliant management of the project.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sandy Sufian.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sufian, S., Blackie, M., Michel, J. et al. Centering Patients, Revealing Structures: The Health Humanities Portrait Approach. J Med Humanit 41, 459–479 (2020). https://doi.org/10.1007/s10912-020-09640-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10912-020-09640-8

Keywords

Navigation