The inclusion of humanities in medical school curriculum has generated much pedagogic experimentation and assessment. Publications in medical journals in the past decade reflect the experience of teaching humanities in medical schools and the motives for which they are taught. As Ousager and Johannessen demonstrate elsewhere in this issue, short- and medium-range outcomes are available for examination, but the author of this commentary argues that the long view of change in clinical practice will not be available for another decade or more as the undergraduate student slowly becomes a full-fledged clinician. Rather than beg off the need to measure these teaching efforts, teachers in the humanities can embrace the demanding task of delineating how medicine changes when fortified by narrative competence and humanities-derived skills. To do so requires an examination of the institutional cultures in which patients and clinicians together try to address problems of the sick.
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