Purpose Tzu Chi University’s anatomy curriculum incorporates interaction with donors’ families and regards body donors as silent teachers and altruistic role models. In this silent mentor program (SMP), students learn about their donor’s life before dissection to better appreciate the selfless donation. This study explores the influence of the program on students’ humanistic literacy based on student letters to silent mentors, which students wrote near the end of the program and laid by the silent mentor during the coffining ceremony. Method The study included 125 letters from third-year medical students who took the gross anatomy curriculum in academic years 2015, 2016, and 2017. With student consent, the program collated and published the letters in the open-access SMP yearbook. Using thematic analysis, the authors manually analyzed the letters in their original Mandarin, with the names of students made anonymous to ensure the authors were blind to students’ identity throughout the study. Results The analysis identified 3 themes and 11 subthemes. Theme 1, my silent mentor, included 3 subthemes: life characteristics, altruistic attitude, and expectation of offering body. Theme 2, connection to silent mentor and family, included 4 subthemes: intersubjective bonding, emotive first encounter, spiritual communication, and encouragement from silent mentor. Theme 3, reflection and transformation, included 4 subthemes: reflection on life and death, professional self-expectation, inner transformation, and feedback action. Conclusions The findings suggest that interactions with donors’ families increased students’ appreciation of the donation and enhanced students’ humanistic literacy. Further, the letters seem to indicate that the SMP inspired students to develop a grateful, respectful, and empathic attitude toward life and their career. Thus, by implementing similar programs, gross anatomy curricula could go beyond the acquisition of structural knowledge to the cultivation of medical students’ humanistic literacy.

Background Tzu Chi University in Taiwan offers a unique mentoring program. This program differs from others as it comprises triple mentorship, namely, faculty mentors, Tzu Cheng/Yi De (TC/YD; senior volunteers), and school counselors. This study aimed to survey the role functions of the mentors from the perspective of medical students. Methods The Role Functions of the Mentoring Program Scale (RFMPS) was developed on the basis of literature reviews and focus groups and it underwent exploratory factor analysis for internal consistency and reliability. RFMPS comprises four role functions, namely, mental, educational, career, and humanistic/moral guidance counseling. The survey was distributed to 171 medical students via an online network with two-month intervals and was analyzed using multivariate analysis of variance. Results The overall response rate was 64% (116/171). The mean scores of the four role functions in descending order belonged to faculty mentors, TC/YD, and school counselors. For humanistic/moral guidance, students had an equal preference for the faculty mentors and TC/YD over school counselors. As for educational, career, and mental guidance counseling, students preferred faculty mentors over TC/YD and school counselors. Faculty mentors provided students with the required guidance counseling for all the four role functions, especially educational guidance; TC/YD in particular offered prominent humanistic/moral guidance and career counseling; school counselors were less preferred but guided students in need. Conclusions Medical students value different role functions provided by faculty mentors, TC/YD, and school counselors. A diversified focus could be provided by the faculty mentors, particularly in educational, career, mental, and humanistic/moral counseling; TC/YD specialized in humanistic/moral guidance; and the school counselors carried out their role function only when needed. Humanistic/moral guidance is equally preferred to other types of guidance, which can be equally valuable in future mentoring programs.

Introduction: Curative modalities for early hepatocellular carcinoma (HCC) include liver resection (LR) and transplantation. For patients with portal hypertension (PH), liver transplantation (LT) is the preferred treatment but is oftentimes limited by organ shortage and can lead candidates to drop off due to disease progression, while hepatectomy has a higher risk of complications. This would pose a dilemma as to whether wait for donor organs or prioritize hepatectomy.Patient concerns: The patient was a 56-year-old male, a case of liver cirrhosis due to hepatitis C with sustained virological response following direct-acting antiviral agents. He was a liver transplant candidate, presented to the gastroenterology outpatient department for a recently-diagnosed liver tumor during a regular follow-up session. Pre-operative survey revealed PH manifested by thrombocytopenia, splenomegaly, huge splenorenal shunt and varices. The patient's Child-Pugh score was 7. Interventions and diagnosis:Considering the patient's overall condition, tumor size and location, and a shortage of grafts, he underwent segment 5 and 6 partial hepatectomy. The pathological diagnosis was moderately differentiated HCC.Outcomes: His postoperative course was complicated by refractory intraabdominal infection (IAI) and recovered under aggressive antibiotics treatment. He remained recurrence-free for over a year. Conclusion:For patients with early resectable HCC, the approach of having a minor hepatectomy followed by salvage transplantation should serve as a compromising strategy. Tumor resection retards the progression of the disease. Comprehensive healthcare can expectantly improve clinical outcomes.

Background: Tzu Chi University (TCU) in Taiwan offers a mentoring program that differs from others since it comprises triple mentors: faculty mentors, Tzu Cheng/Yi De (TC/YDs who are senior volunteers), and school counselors. This study aimed to analyze medical student’s perceptions of the triple mentors’ role functions using a self-developed assessment tool.Methods: The Role Functions of the Mentoring Program Scale (RFMPS) was developed through literature reviews, focus groups, and underwent exploratory factor analysis for internal consistency and reliability. The RFMPS consists of 16 items measuring the triple mentors’ role functions on a five-point Likert scale. Items covered four role functions: mental counseling, educational guidance, career counseling, and humanistic/moral guidance. Student’s perceptions were collected through an online survey and analyzed using a multivariate analysis of variance (MANOVA).Results: The overall response rate was 64% (116/171). Faculty mentors provided students with preferable guidance counseling in all four role functions; TC/YDs particularly offered prominent humanistic/moral guidance and career counseling; school counselors were less preferred and guided students in need. Besides, students were evenly guided regarding their gender and year. The RFMPS was a reliable tool for evaluating the mentoring program as a whole.Conclusions: Faculty mentors, TC/YDs, and school counselors comprehensively performed their role functions in the mentoring program. Humanistic/moral guidance is current and comparable to educational, career, and mental guidance counseling; the mentoring program can extend its scope by including humanistic, moral, or spiritual connotations.