Digital Technologies to Provide Humanization in the Education of the Healthcare Workforce: A Systematic Review

Round 1

Reviewer 1 Report

The article addresses medical humanities education, concentering on how education in humanization is delivered to undergraduate health sciences students and whether or not they are using digital technologies for the training. 

The review is based on a sample of six papers retrieved (following a rigorous selection process) from the professional literature concerning the humanization of healthcare, which refers, according to the authors, to personal competencies of respecting and ensuring dignity and respect for human beings. They further state that those competencies can be measured by the Healthcare Professional Humanization Scale’s five factors of optimistic disposition, sociability, emotional understanding, self-efficacy, and affection.

The authors indicate two primary goals for their study: 1) identify what type of education in humanization is provided to health sciences university students, and 2) determine its strengths and weaknesses.

Despite the importance of the topic and the worthy goals presented by the authors, I have a couple of reservations regarding the article in its current form, which I list below:

1. The scope of the review

The bibliographic search was limited to two terms ('humanization of care' and 'humanization of healthcare'), retrieving a final sample of six papers for the review, all involving nursing students. Such a sample size does not enable making valid inferences. However, the article's title refers to Medical humanities (MH), a frequently used term in the professional literature (Wald et al., 2019). Adding that term to the search could have enlarged the sample size of retrieved papers for the review, thus strengthening its inferences.

2. The technology addressed

The Special Issue calls for AI-integrated biomedical technology, whereas the authors referred to digital technologies used for training in humanization. Nevertheless, as Table 1 reveals, only in one study was digital technology used (a virtual online video conferencing platform employed to develop six simulated scenarios related to basic healthcare at patients’ homes.) The other five studies used no digital technology for the training.

Minor comments

1. On p. 3 (Sec. 2.2), the authors state that qualitative papers were excluded from the search, yet on page 5 (last box in Fig. 1), they indicate that half of the studies included in the review were qualitative. 

2. More rigorous text editing could help eliminate a few typos and glitches encountered.

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Wald, H. S., McFarland, J., & Markovina, I. (2019). Medical humanities in medical education and practice, Medical Teacher, 41(5), 492-496, DOI: 10.1080/0142159X.2018.1497151

(To link to the paper:  https://doi.org/10.1080/0142159X.2018.1497151)

_{The quality of English is fine, but more rigorous text editing could help eliminate a few typos and glitches.}

Author Response

Dear reviewer.

We do really appreciate your kind report about our manuscript.

Please find attached the point-by-point response to each comment suggested.

Kind regards,

Authors.

Author Response File: Author Response.pdf

Reviewer 2 Report

The article is relevant to the journal's mission. The work is relevant for several reasons. 1. It is a study that contributes to increase the field of knowledge in relation to education in medical humanities. 2. It is of vital importance to provide an insight into possible lines of research in this field of knowledge.
The study is also interesting for seeking new ways to encourage the humanization of health professionals.
The title "Digital technologies to improve medical humanities education: A Systematic Review" is in line with the content of the article, as well as the abstract, which clearly explains the objectives, results and findings.
The keywords used are appropriate, as well as the databases analyzed (EBSCO, Ovid, Pub Med, Scopus and Web of Science).
The theoretical basis is based on the objective of the study. Nevertheless, it should be expanded with more updated bibliographic references on other studies directed in the same direction.
The objectives of the study are well defined: (1) to identify what type of humanization education is provided to undergraduate health sciences students; and (2) to determine its strengths and weaknesses. The authors propose a curriculum focused on undergraduate students to strengthen the humanization skills of future health professionals.
The document is well structured, facilitating the understanding of the study conducted.
Regarding the methodological section, the methodology used is in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).
The research phases are presented in a clear and structured manner.
The results are presented in a structured way according to importance (primary and secondary).
In short, I consider that this is a good work that contributes knowledge to the scientific community, but that requires some minor improvements.

Author Response

Dear reviewer.

We do really appreciate your kind report about our manuscript.

Please find attached the point-by-point response to each comment suggested.

Kind regards,

Authors.

Author Response File: Author Response.pdf

Reviewer 3 Report

This is an interesting study. However, to me the difference between the search words humanization of care and humanization of health care as used by the authors and the medical or the health humanities is unclear. What is the difference between humanities courses in healthcare and humanization of care? Will humanities courses not lead to the humanization of care? Why are different terminologies required?

Are the authors looking at studies regarding the education in humanization of care or those where digital technologies were used to educate in humanization of care? How do the authors define humanized skills.

These questions should be answered clearly.

The title does not seem to be congruent with the description in the text.

The detailed description using the adopted PRISMA-P and PROSPERO checklists is detailed and very useful.

Author Response

Dear reviewer.

We do really appreciate your kind report about our manuscript.

Please find attached the point-by-point response to each comment suggested.

Kind regards,

Authors.

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

I have read the authors' responses to my previous review and their revised article. It is evident that much work was put into correcting and editing the current version. The authors' position and choices are now justified and based on relevant literature; the points they sought to stress are clearly presented. I have no further comments.

Author Response

Dear reviewer.

Thanks a lot for helping us to improve the manuscript.

We do really appreciate your time and kind report.

Kind regards,

Authors.

Reviewer 3 Report

The title can be modified to Digital technologies to provide humanization in health workforce education: A Systematic Review

The quality of written English is good, but edits may be required in a few places. 

A few edits may be required. 

Author Response

Dear reviewer.

Thanks a lot for helping us to improve the manuscript. It has been modified based on English editing service recommendations.

Kind regards,

Authors.