Ethics of care and humanistic learning in the training of cardiologists: a semi-systematic review
DOI:
https://doi.org/10.5281/zenodo.20133555Keywords:
ethics of care, humanistic learning, clinical cardiology, medical resident, professional competencies of the cardiologist, doctor-patient relationshipAbstract
This article aimed to reflect on the ethics of care and humanistic learning in the training of cardiologists. The theoretical development was conceived around three core aspects: ethical foundations of care in cardiology practice, humanistic learning in specialized medical education, and the formative and institutional implications of cardiology specialization. The methodological approach was carried out through a semi-systematic review of the English-language literature, focusing on the theoretical aspects investigated. The analysis covered publications between 2019 and 2025, applying the PRISMA guideline for abstract selection. The search was conducted in the PubMed/MEDLINE, Scopus, Web of Science, Embase, and DOAJ databases, using Boolean operators (AND, OR) and specific keywords. The findings revealed that the ethics of care and humanistic learning are manifested in the training of cardiologists through empathy, respect, professionalism, and ethical and social commitment. Furthermore, the need for a transformative curriculum that integrates embodiment, gratitude, and collaborative humanistic learning experiences is highlighted. It is concluded that humanistic learning and its educational implications in clinical cardiology demand an integration of technical knowledge, the ethics of care, and emotional sensitivity. The future vision of this academic production is oriented toward achieving specialized medical education that evolves toward dual certification with a humanistic approach, strengthening cardiologists' capacity to face complex challenges.
Downloads
References
Chen L, Zhang R, Yu D, Liang J, Zhao J, Zhao Y. The practice of medical students’ humanistic education in volunteerism. Med Educ Online. 2023 Dec;28(1):2182691. doi: 10.1080/10872981.2023.2182691. PMID: 36840966; PMCID: PMC9970200
Guidi C, Traversa C. Empathy in patient care: from 'Clinical Empathy' to 'Empathic Concern'. Med Health Care Philos. 2021 Dec;24(4):573-585. Doi: 10.1007/s11019-021-10033-4. Epub 2021 Jul 1. PMID: 34196934; PMCID: PMC8557158.
Varkey B. Principles of clinical ethics and their application to practice. Med Princ Pract. 2021; 30(1):17-28. doi: 10.1159/000509119. Epub 2020 Jun 4. PMID: 32498071; PMCID: PMC7923912.
Pereira Dutra EP, Quagliato LA, Nardi AE. Improving the perception of respect for and the dignity of inpatients: a systematic review. BMJ Open. 2022 May 13;12(5): e059129. PMID: 35568491; PMCID: PMC9109089.
Hull SC, Mullen JB, Kirkpatrick JN. Proposal and rationale for a cardioethics curriculum. JACC Adv. 2024 Feb 2;3(3):100845. doi:10.1016/j.jacadv.2024.100845. PMID: 38938837; PMCID: PMC11198507.
Sahay A, Mittman BS, Gholami P, Finley E, Nichols LO, Woodward-Hagg H, et al. How successful was the use of a community of practice for the implementation of evidence-based practices for heart failure within the United States Department of Veterans Affairs: insights from a formative evaluation. Health Res Policy Syst. 2022; 20:79. doi:10.1186/s12961-022-00880-9.
Alegria JR, Wilson BH, Wright RS. Ethics in Cardiovascular Care: A Call to Action. J Am Coll Cardiol. 2023 Sep 26;82(13):1373-1376. doi: 10.1016/j.jacc.2023.08.004. PMID: 37730294.
Bridges C, Duenas DM, Lewis H, Anderson K, Opel DJ, Wilfond BS, Kraft SA. Patient perspectives on how to demonstrate respect: Implications for clinicians and healthcare organizations. PLoS One. 2021;16(4):e0250999. doi:10.1371/journal.pone.0250999. PMID: 33914815; PMCID: PMC8084197.
Tokuc B, Varol G. Medical Education in the Era of Advancing Technology. Balkan Med J. 2023 Oct 20;40(6):395-399. doi: 10.4274/balkanmedj.galenos.2023.2023-7-79. PMID: 37706676; PMCID: PMC10613744.
Douglass PL, Itchhaporia D, Bozkurt B, Roswell RO, Khandelwal A, Capers Q 4th, Berlacher K, Ogunniyi MO, Bailey AL, Levy PD, Grant AJ, Tocco J, Natcheva A, Asare AG, Bhatt AB, Mieres JH, Disch MF, Echols MR. Achieving Equitable Cardiovascular Care for All: ACC Board of Trustees Health Equity Task Force Action Plan. JACC Adv. 2024 jul 31;3(7):101050. doi: 10.1016/j.jacadv.2024.101050. PMID: 39130032; PMCID: PMC11313050.
Kuehn BM. Centering equity in cardiovascular care. Circulation. 2021;144(25). doi:10.1161/CIRCULATIONAHA.121.058471.
Batchelor WB, Anwaruddin S, Wang DD, Perpetua EM, Krishnaswami A, Velagapudi P, Wyman JF, Fullerton D, Keegan P, Phillips A, Ross L, Maini B, Bernacki G, Panjrath GS, Lee J, Geske JB, Welt F, Thakker PD, Deswal A, Park K, Mack MJ, Leon M, Lewis S, Holmes D. The Multidisciplinary Heart Team in Cardiovascular Medicine: Current Role and Future Challenges. JACC Adv. 2023 Jan 11;2(1):100160. doi: 10.1016/j.jacadv.2022.100160. PMID: 38939019; PMCID: PMC11198656.
Montgomery L, Loue S, Stange KC. Linking the heart and the head: humanism and professionalism in medical education and practice. Fam Med. 2017 May;49(5):378-383. PMID: 28535319.
Guo K, Luo T, Zhou LH, et al. Cultivation of humanistic values in medical education through anatomy pedagogy and gratitude ceremony for body donors. BMC Med Educ. 2020; 20:440. https://doi.org/10.1186/s12909-020-02292-1.
Rico-Mesa JS, Atluri SM, Rico-Mesa MA. The mental health of cardiology fellows in training. Tex Heart Inst J. 2025;52(1): e248541. doi: 10.14503/THIJ-24-8541. PMID: 39968303; PMCID: PMC11833151
Hazrati H, Bigdeli S, Gavgani VZ, et al. Humanism in clinical education: a mixed methods study on the experiences of clinical instructors in Iran. Philos Ethics Humanit Med. 2020; 15:5.
Chong JH, Chahal A, Ricci F, Klarich K, Ferrari V, Narula J, Khanji MY. The transformation of cardiology training in response to the COVID-19 pandemic: Enhancing current and future standards to deliver optimal patient care. Can J Cardiol. 2021 Mar;37(3):519-22. doi: 10.1016/j.cjca.2021.01.009. Epub 2021 Jan 18. PMID: 33476752; PMCID: PMC7951563.
Desai MK, Kapadia JD. Medical professionalism and ethics. J Pharmacol Pharmacother. 2022;13(2):113-118. doi:10.1177/0976500X221111448.
Vallabhajosyula S, Mehta A, Bansal M, Jentzer JC, Applefeld WN, Sinha SS, et al. Training paradigms in critical care cardiology: a scoping review of current literature. JACC Adv. 2024 Mar;3(3):100850. doi:10.1016/j.jacadv.2024.100850.
Sinha SS, Geller BJ, Katz JN, Arslanian-Engoren C, Barnett CF, Bohula EA, Damluji AA, Menon V, Roswell RO, Vallabhajosyula S, Vest AR, van Diepen S, Morrow DA; American Heart Association Acute Cardiac Care and General Cardiology Committee of the Council on Clinical Cardiology; Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation; Council on Cardiovascular and Stroke Nursing; Council on Kidney in Cardiovascular Disease. Evolution of critical care cardiology: an update on structure, care delivery, training, and research paradigms: a scientific statement from the American Heart Association. Circulation. 2025 Mar 11;151(10). doi: 10.1161/CIR.0000000000001300
Faiella W, Navjot S, Ramer S. Competency-based cardiology training: a simple approach to improve supervisor completion of entrustable professional activities. CJC Open. 2024 jul 18;6(10):1248-1253. https://doi.org/10.1016/j.cjco.2024.07.007
Brusca SB, Barnett C, Barnhart BJ, Weng W, Morrow DA, Soble JS, Katz JN, Wiley BM, van Diepen S, Gomez AD, Solomon MA. Role of critical care medicine training in the cardiovascular intensive care unit: survey responses from dual certified critical care cardiologists. J Am Heart Assoc. 2019 Mar 19;8(6):e011721. doi: 10.1161/JAHA.118.011721. PMID: 30879373; PMCID: PMC6475069.
Snyder H. Literature review as a research methodology: An overview and guidelines. J Bus Res. 2019; 104:333-9. doi: 10.1016/j.jbusres.2019.07.039.
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021 Mar 29;372: n71. doi: 10.1136/bmj. n71.
Published
How to Cite
Issue
Section
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Derechos del/de autor/es a partir del año de publicación
Esta obra está bajo la licencia:
Creative Commons Reconocimiento-NoComercial-CompartirIgual 4.0 Internacional (CC BY-NC-SA 4.0)
Las opiniones expresadas por los autores no necesariamente reflejan la postura del editor de la publicación ni de la UCLA. Se autoriza la reproducción total o parcial de los textos aquí publicados, siempre y cuando se cite la fuente completa y la dirección electrónica de esta revista. Los autores(as) tienen el derecho de utilizar sus artículos para cualquier propósito siempre y cuando se realice sin fines de lucro. Los autores(as) pueden publicar en internet o cualquier otro medio la versión final aprobada de su trabajo, luego que esta ha sido publicada en esta revista.
