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Bansal E, Rice T. Teaching Moral Courage & Rights-Based Leadership in Medicine: A Cross-Disciplinary Exploration. TEACHING AND LEARNING IN MEDICINE 2024:1-11. [PMID: 38956858 DOI: 10.1080/10401334.2024.2369611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 05/24/2024] [Indexed: 07/04/2024]
Abstract
Clinical medicine's complexities and demands often surpass the scope of formal ethics and leadership training that medical schools and residency programs provide. The discrepancy between medical education and the realities of clinical work may contribute to ethical erosion among learners, namely, medical students and residents. Unlike traditional approaches to teaching professional ethics and leadership in medicine, rights-based (aspirational) pedagogies approach trainees as autonomous moral agents, whose work has moral value to themselves and others, who live with the ethical consequences of their professional choices, and whose work shapes their individual moral character. By incorporating teaching strategies that intentionally build learners' rights-based leadership through the development of moral courage, medical educators may counter important aspects of ethical erosion while promoting learner preparedness, outcomes, and well-being. Military teaching approaches offer a valuable example to medical educators seeking to create structured curricula that foster moral courage to promote rights-based leadership, given the high level of moral and managerial complexity present in both medicine and the military. Through a comparative analysis of professional ethics in the medical and military disciplines, this Observation article explores the validity of applying precedents from military ethics and leadership education to medical training. Through arguments rooted in moral philosophy, military history, and military organizational research, we explore the expansion of rights-based teaching methods within the predominantly traditional and rules-based norms of medical education. In relating these findings to real-life clinical scenarios, we offer six specific, rights-based modifications to medical ethics curricula that have potential to promote morally courageous leadership and counteract the ethical erosion medical students and residents face.
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Affiliation(s)
- Esha Bansal
- Internal Medicine Residency Program, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Timothy Rice
- Departments of Psychiatry and Medical Education, Icahn School of Medicine at Mount Sinai, Gustave L Levy Place, New York, New York, USA
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Bekele A, Regnier D, Paul T, Waka TY, Bradley EH. Advancing Global Health Equity: The Role of the Liberal Arts in Health Professional Education. THE JOURNAL OF MEDICAL HUMANITIES 2024; 45:185-192. [PMID: 38102336 PMCID: PMC11068827 DOI: 10.1007/s10912-023-09827-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/29/2023] [Indexed: 12/17/2023]
Abstract
Much innovation has taken place in the development of medical schools and licensure exam processes across the African continent. Still, little attention has been paid to education that enables the multidisciplinary, critical thinking needed to understand and help shape the larger social systems in which health care is delivered. Although more than half of medical schools in Canada, the United Kingdom, and the United States offer at least one medical humanities course, this is less common in Africa. We report on the "liberal arts approach" to medical curricula undertaken by the University of Global Health Equity beginning in 2019. The first six-month semester of the curriculum, called Foundations in Social Medicine, includes courses in critical thinking and communication, African history and global political economy, medical anthropology and social medicine, psychology and health, gender and social justice, information technology and health, and community-based training. Additionally, an inquiry-based pedagogy with relatively small classes is featured within an overall institutional culture that emphasizes health equity. We identify key competencies for physicians interested in pursuing global health equity and how such competencies relate to liberal arts integration into the African medical school curriculum and pedagogical approach. We conclude with a call for a research agenda that can better evaluate the impact of such innovations on physicians' education and subsequent practices.
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Affiliation(s)
- Abebe Bekele
- University of Global Health Equity, Kigali, Rwanda
| | | | - Tomlin Paul
- University of Global Health Equity, Kigali, Rwanda
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Wangding S, Lingard L, Haidet P, Vipler B, Sukhera J, Moniz T. Disorienting or Transforming? Using the Arts and Humanities to Foster Social Advocacy. PERSPECTIVES ON MEDICAL EDUCATION 2024; 13:192-200. [PMID: 38496362 PMCID: PMC10941688 DOI: 10.5334/pme.1213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 02/19/2024] [Indexed: 03/19/2024]
Abstract
Introduction The arts and humanities (AH) have transformative potential in medical education. Research suggests that AH-based pedagogies may facilitate both personal and professional transformation in medical learners, which may then further enhance the teaching and learning of social advocacy skills. However, the potential for such curricula to advance social advocacy training remains under-explored. Therefore, we sought to identify how AH may facilitate transformative learning of social advocacy in medical education. Methods Building upon previous research, we conducted a critical narrative review seeking examples from the literature on how AH may promote transformative learning of social advocacy in North American medical education. Through a search of seven databases and MedEdPORTAL, we identified 11 articles and conducted both descriptive and interpretative analyses of their relation to key tenets of transformative learning, including: disorientation/dissonance, critical reflection, and discourse/dialogue. Results We found that AH are used in varied ways to foster transformative learning in social advocacy. However, most approaches emphasize their use to elicit disorientation and dissonance; there is less evidence in the literature regarding how they may be of potential utility when applied to disorienting dilemma, critical reflection, and discourse/dialogue. Discussion The tremendous potential of AH to foster transformative learning in social advocacy is constrained due to minimal attention to critical reflection and dialogue. Future research must consider how novel approaches that draw from AH may be used for more robust engagement with transformative learning tenets in medical education.
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Affiliation(s)
- Snow Wangding
- Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Lorelei Lingard
- Department of Medicine, Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Paul Haidet
- Woodward Center for Excellence in Health Sciences Education, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Benjamin Vipler
- Division of Hospital Medicine, University of Colorado Hospital, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Javeed Sukhera
- Departments of Psychiatry, Hartford Hospital and the Institute of Living, Hartford, Connecticut, USA
| | - Tracy Moniz
- Department of Communication Studies, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
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4
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Balhara KS, Regan L, Chopra E, Irvin N. Bringing abstract concepts to life: A health humanities-based approach to teaching social determinants of health. AEM EDUCATION AND TRAINING 2024; 8:e10934. [PMID: 38510731 PMCID: PMC10950014 DOI: 10.1002/aet2.10934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/30/2023] [Accepted: 11/09/2023] [Indexed: 03/22/2024]
Abstract
Background To address health inequities, emergency physicians must understand the structural underpinnings of health disparities, including social determinants of health (SDoH), and must critically reflect on the integration of SDoH into clinical practice. SDoH education should include reflective knowledge acquisition, while incorporating systemic sociohistorical forces and individual factors, such as bias, which propagate inequities but are rarely emphasized in graduate medical education (GME). The health humanities (HH), an inclusive transdisciplinary field combining arts, humanities, and social justice, may represent a novel unexplored approach toward incorporating SDoH in GME. Methods We sought to implement and evaluate a GME HH-based curriculum focused on SDoH. An interprofessional team applied Kern's framework to create a longitudinal HH curriculum integrating narrative medicine and visual thinking strategies with evidence-based practices for addressing SDoH in clinical practice. This curriculum was implemented for 52 residents in an EM program in 2019-2020; sessions were initially held in the classroom and community and then virtually during the COVID-19 pandemic. Objectives included encouraging (1) critical thinking about SDoH, (2) engagement with patients and communities, (3) self-reflection, and (4) translation of SDoH to patient care. Descriptive statistics and a constructivist paradigm were applied to results of a postcurriculum survey and focus group, respectively. Results A curriculum evaluation survey completed by 32/52 residents (61.5%) revealed agreement (75%-90%) that objectives were met. 93.1% of respondents thought humanities were important in residency training. Qualitative analysis of a focus group with 10 participants revealed additional impacts on individual growth, transformation of departmental culture, and transformation of patient care. Curriculum implementation was inexpensive and relied on interprofessional collaboration. Conclusions The HH represent a promising collaborative framework for integrating SDoH in GME and may inspire transformation of learners' attitudes and practices in EM, though clinical impacts still need to be established.
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Affiliation(s)
- Kamna S. Balhara
- Department of Emergency MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Linda Regan
- Department of Emergency MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Eisha Chopra
- Department of Emergency MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
- Present address:
Department of Emergency MedicineThomas Jefferson UniversityPhiladelphiaPennsylvaniaUSA
| | - Nathan Irvin
- Department of Emergency MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
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Tackett S, Eller L, Scharff S, Balhara KS, Stouffer KM, Suchanek M, Clever SL, Yenawine P, Wolffe S, Chisolm MS. Transformative experiences at art museums to support flourishing in medicine. MEDICAL EDUCATION ONLINE 2023; 28:2202914. [PMID: 37074677 PMCID: PMC10120547 DOI: 10.1080/10872981.2023.2202914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 02/13/2023] [Accepted: 04/11/2023] [Indexed: 05/03/2023]
Abstract
PURPOSE We implemented and evaluated a hybrid 4-week arts-based elective for clinical medical students to support flourishing. MATERIALS AND METHODS Five students participated in early 2022. Twelve sessions occurred in-person at art museums and other cultural centers, and five occurred online. Sessions incorporated varied arts-based learning activities, including Visual Thinking Strategies, a jazz seminar, and a mask-making workshop. We evaluated the course via weekly reflective essays, interviews 6 weeks after the course, and pre-post surveys that included four scales with clinical relevance: capacity for wonder (CfW), tolerance for ambiguity (TFA), interpersonal reactivity index, and openness to diversity. RESULTS Qualitatively, the course helped learners: 1) reconnect with individual characteristics and interests that had been neglected during medical education; 2) better appreciate others' perspectives; 3) develop identities as physicians; and 4) engage in quiet reflection, renewing their sense of purpose. Quantitatively, pre-post mean totals increased for the CfW (32.0 [SD 6.8] vs 44.0 [SD 5.7], p=.006) and TFA scales (16.4 [SD 5.2] vs 24.2 [SD 6.9], p=.033). CONCLUSIONS This elective facilitated learners' connecting with themselves, others, and their profession with improvement in clinically-relevant measures. This provides further evidence that arts-based education can foster professional identity formation and be transformative for students.
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Affiliation(s)
- Sean Tackett
- Division of General Internal Medicine, Johns Hopkins Bayview Medical Center and Biostatistics, Epidemiology, and Data Management Core, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Lauren Eller
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Samuel Scharff
- Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kamna S. Balhara
- Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Melissa Suchanek
- Clinical Research Associate, Department of Oncology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Sarah L. Clever
- Department of Medicine and Assistant Dean for Student Affairs, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Suzy Wolffe
- manager of tour experience, Baltimore, MD, USA
| | - Margaret S. Chisolm
- Psychiatry and Behavioral Sciences, and Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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6
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Aluri J, Ker J, Marr B, Kagan H, Stouffer K, Yenawine P, Kelly-Hedrick M, Chisolm MS. The role of arts-based curricula in professional identity formation: results of a qualitative analysis of learner's written reflections. MEDICAL EDUCATION ONLINE 2023; 28:2145105. [PMID: 36373894 PMCID: PMC9668275 DOI: 10.1080/10872981.2022.2145105] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 11/03/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Professional identity formation is an important aspect of medical education that can be difficult to translate into formal curricula. The role of arts and humanities programs in fostering professional identity formation remains understudied. Analyzing learners' written reflections, we explore the relationship between an arts-based course and themes of professional identity formation. MATERIALS AND METHODS Two cohorts of learners participated in a 5-day online course featuring visual arts-based group activities. Both cohorts responded to a prompt with written reflections at the beginning and end of the course. Using a thematic analysis method, we qualitatively analyzed one set of reflections from each cohort. RESULTS Themes included the nature of the good life; fulfilling, purposeful work; entering the physician role; exploration of emotional experience; and personal growth. Reflections written at the end of the course engaged significantly with art - including literature, poetry, lyrics, and film. One student disclosed a mental illness in their reflection. CONCLUSIONS Our qualitative analysis of reflections written during a visual arts-based course found several themes related to professional identity formation. Such arts-based courses can also enrich learners' reflections and provide a space for learners to be vulnerable. PRACTICE POINTS (five short bullets conveying the main points) Arts-based courses can support learners' professional identity formationReflection themes related to professional identity formation included entering the physician role, fulfilling clinical work, and personal growthAt the end of the course, learners' reflections included significant engagement with artReflective writing in small, arts-based learning communities can provide space for learners to be vulnerableThe Role of Arts-Based Curricula in Professional Identity Formation: Results of A Qualitative Analysis of Learner's Written Reflections.
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Affiliation(s)
- James Aluri
- Department of Psychiatry and Behavioral Sciences University School of Medicine, University Mental Health, Baltimore, Maryland, USA
| | - Joyce Ker
- Department of Medicine, Science, Humanities at Johns Hopkins University in Baltimore, Baltimore, Maryland, USA
| | - Bonnie Marr
- Section of Palliative Medicine Division of General Internal Medicine Johns Hopkins University in Baltimore, Baltimore, Maryland, USA
| | - Heather Kagan
- Department of Medicine at Memorial Sloan Kettering Cancer Center with a Secondary Appointment as an Instructor at Weill Cornell College of Medicine Maryland, USA
| | | | - Philip Yenawine
- Visual Thinking Strategies and an Independent Writer and Educator, Baltimore, Maryland, USA
| | | | - Margaret S. Chisolm
- Department of Psychiatry and Behavioral Sciences, Department of Medicine, Johns Hopkins University in Baltimore, Baltimore, Maryland, USA
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Stern EM. Art is Patient: A Museum-Based Experience to Teach Trauma-Sensitive Engagement in Health Care. THE JOURNAL OF MEDICAL HUMANITIES 2023; 44:481-501. [PMID: 37505360 DOI: 10.1007/s10912-023-09810-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/05/2023] [Indexed: 07/29/2023]
Abstract
Psychological trauma is ubiquitous, an often hidden yet influential factor in care across clinical specialties. Interdisciplinary health professions education is mobilizing to address the importance of trauma-sensitive care. Given their attention to complex human realities, the health humanities are well-poised to shape healthcare learners' responses to trauma. Indeed, many such arts and humanities curricula propose narrative exercises to strengthen empathy, self-reflection, and sensitive communication. Trauma, however, is often unwordable, fragmentary, and physically encoded, incompatible with storying methods. This article presents a recent innovation, the Art is Patient seminar series, which focuses on aesthetic exercises to help learners access and share non-verbal, embodied, and relational responses to art. Based in an art museum context, it provides successive experiences of approaching, witnessing, and engaging with visual art as an analogue to developing trauma-sensitive relationships. Reflections on the process locate the seminar vis-à-vis health humanities practices, aesthetics, and trauma-informed approaches.
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Affiliation(s)
- Eva-Marie Stern
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
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8
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Czech H, Hildebrandt S, Reis SP, Chelouche T, Fox M, González-López E, Lepicard E, Ley A, Offer M, Ohry A, Rotzoll M, Sachse C, Siegel SJ, Šimůnek M, Teicher A, Uzarczyk K, von Villiez A, Wald HS, Wynia MK, Roelcke V. The Lancet Commission on medicine, Nazism, and the Holocaust: historical evidence, implications for today, teaching for tomorrow. Lancet 2023; 402:1867-1940. [PMID: 37951225 DOI: 10.1016/s0140-6736(23)01845-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/07/2023] [Accepted: 08/29/2023] [Indexed: 11/13/2023]
Affiliation(s)
- Herwig Czech
- Ethics, Collections, and History of Medicine, Medical University of Vienna, Vienna, Austria
| | - Sabine Hildebrandt
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.
| | - Shmuel P Reis
- Center for Medical Education, Hebrew University Hadassah Medical School, Jerusalem, Israel; Department of Digital Medical Technologies, Holon Institute of Technology, Holon, Israel
| | - Tessa Chelouche
- Rappaport Faculty of Medicine, Technion Institute, Haifa, Israel
| | - Matthew Fox
- Jakobovits Center for Jewish Medical Ethics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Esteban González-López
- Division of Family Medicine and Primary Care, Department of Medicine, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | - Etienne Lepicard
- Center for Medical Education, Hebrew University Hadassah Medical School, Jerusalem, Israel
| | - Astrid Ley
- Memorial and Museum Sachsenhausen, Oranienburg, Germany
| | - Miriam Offer
- Center of the Study of Jewish Medicine during the Holocaust, Western Galilee College, Acre, Israel
| | - Avi Ohry
- Rehabilitation Medicine, School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Maike Rotzoll
- Institute for the History of Pharmacy and Medicine, Marburg University, Marburg, Germany
| | - Carola Sachse
- Institute of Contemporary History, University of Vienna, Vienna, Austria
| | - Sari J Siegel
- Center for Medicine, Holocaust, and Genocide Studies, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Michal Šimůnek
- Institute of Contemporary History of the Academy of Sciences of the Czech Republic, Prague, Czech Republic
| | - Amir Teicher
- Department of History, Tel Aviv University, Tel Aviv, Israel
| | - Kamila Uzarczyk
- Department of Humanities and Social Sciences, Wrocław Medical University, Wrocław, Poland
| | - Anna von Villiez
- Memorial Israelitische Töchterschule, Hamburger Volkshochschule, Hamburg, Germany
| | - Hedy S Wald
- Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Matthew K Wynia
- Center for Bioethics and Humanities, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Volker Roelcke
- Institute for the History, Theory and Ethics of Medicine, Giessen University, Gießen, Germany
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Jung D, Chugh N, Stephens M, Blazek M, Flanagan MP, Chisolm MS. How to design and implement a Group Poem activity. Int Rev Psychiatry 2023; 35:668-671. [PMID: 38461384 DOI: 10.1080/09540261.2023.2271552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 10/12/2023] [Indexed: 03/11/2024]
Abstract
Museum-based learning activities provide interactive and innovative ways to integrate the arts and humanities into medical education. Like other museum-based activities, the Group Poem supports the development of multiple clinically relevant skills and attributes, such as observation, communication, perspective-taking, empathy, and implicit bias awareness. In this paper, we present a step-by-step guide for educators seeking to design and implement a museum-based Group Poem activity for medical learners. The overall 'task' of the activity is for learners to collectively create a poem that they perform for others, a process that participants find to be engaging and meaningful to their formation as physicians. In this paper, we provide specific directions on pre-selecting the works of art, preparing the supplies, dividing into small groups, providing iterative instructions to learners, managing the timing of the session, and debriefing the activity. Although designed to be experienced in an art museum, we note that the Group Poem activity can also be conducted in the classroom or virtually using photographic or digital reproductions of artwork.
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Affiliation(s)
- Diane Jung
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Natasha Chugh
- University of Cambridge, Cambridge, England
- UNTHSC Texas College of Osteopathic Medicine, Fort Worth, TX, USA
| | - Mark Stephens
- Associate Dean for Medical Education, a Professor of Family and Community Medicine, and a Professor of Humanities at the Pennsylvania State University College of Medicine, University Park, PA, USA
| | - Mary Blazek
- Clinical Professor of Psychiatry at The University of Michigan School of Medicine, Ann Arbor, MI, USA
| | - Michael P Flanagan
- Assistant Dean for Student Affairs, a Professor of Family and Community Medicine, and of Humanities, at the Pennsylvania State University College of Medicine, University Park, PA, USA
| | - Margaret S Chisolm
- Professor of Psychiatry and Behavioral Sciences, and of Medicine, at the Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Gaufberg E, Zimmermann C, Wong LM, Williams R, King B, King K, Paradise R. The Harvard Macy Institute Art Museum-based Health Professions Education Fellowship: Transformational faculty development through the arts. Int Rev Psychiatry 2023; 35:645-657. [PMID: 38461394 DOI: 10.1080/09540261.2023.2283596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 11/10/2023] [Indexed: 03/11/2024]
Abstract
Museum-based education for health professionals can lead to a variety of important learning outcomes within the domain of skills development, personal insight, perspective-taking and social advocacy. The Harvard Macy Institute's Art Museum-based Health Professions Education Fellowship was designed to develop faculty expertise in art museum-based practices, encourage scholarship, and cultivate a cohesive and supportive community of educators. The Fellowship was piloted from January to May 2019 with twelve interprofessional Fellows. Two in-person experiential sessions were held at Boston-area museums with intervening virtual learning. Fellows were introduced to a variety of approaches used in art museum-based education and developed a project for implementation at their home institution. A qualitative formative evaluation assessed immediate and 6-month post-Fellowship outcomes. Outcomes are reported in four categories: (1) Fellows' personal and professional development; (2) Institutional projects and curriculum development; (3) Community of practice and scholarly advancement of the field; and (4) Development of Fellowship model. A follow-up survey was performed four years after the conclusion of the pilot year, documenting Fellows' significant accomplishments in museum-based education, reflections on the Fellowship and thoughts on the future of the field.
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Affiliation(s)
- Elizabeth Gaufberg
- Medicine and Psychiatry, Harvard Medical School and Director of the Center for Professional and Academic Development, The Cambridge Health Alliance, Cambridge, MA, USA
| | - Corinne Zimmermann
- Museum Educator and Consultant, Corinne Zimmermann Consultancy, Watertown, MA, US
| | - Lisa M Wong
- Department of Pediatrics, Harvard Medical School, Boston, MA, US
| | - Ray Williams
- Director of Education and Academic Affairs, The Blanton Museum of Art, Austin, TX, USA
| | - Brandy King
- Health Sciences Librarian, Knowledge Linking, Wilmington, MA, USA
| | - Kristin King
- Research and Evaluation Project Manager, Institute for Community Health, Malden, MA, USA
| | - Ranjani Paradise
- Department of Evaluation, Institute for Community Health, Malden, MA, USA
- School of Medicine, Tufts University, Boston, MA, USA
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11
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Yaden ME, Sawaya RT, Reddy J, Jong KA, White J, Moniz T, Chisolm MS. A systematic review of the arts and humanities in psychiatry education. Int Rev Psychiatry 2023; 35:540-550. [PMID: 38461397 DOI: 10.1080/09540261.2023.2278718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/30/2023] [Indexed: 03/11/2024]
Abstract
This systematic review characterizes the published literature on arts and humanities curricula for psychiatry learners that include any form of program evaluation. Authors searched three databases (Medline ALL, Embase.com, and PsycINFO) to identify articles on arts and humanities in psychiatry education. Criteria for the review included articles reporting outcome measures for arts and humanities learning activities in psychiatry learners. For those articles meeting inclusion criteria, a descriptive analysis was performed as well as an assessment of the level of program evaluation using the Kirkpatrick framework. Of 1,287 articles identified, 35 met inclusion criteria. About half of the programs included medical students (n = 17, 49%). Film and television was the most frequent arts and humanities subject (n = 16, 46%). Most studies incorporated a non-randomized, non-controlled design (n = 30, 86%). Twenty-two (63%) achieved a Kirkpatrick Level 1 designation, 12 achieved Level 2 (34%), and one study achieved Level 3 (3%). Arts and humanities programs have a promising role in psychiatry education. At present, significant heterogeneity in the extant literature makes it difficult to draw general conclusions that could guide future program development. This review underscores the need for rigorous evaluative methods of arts and humanities programs for psychiatry learners.
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Affiliation(s)
- Mary E Yaden
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Rayah T Sawaya
- Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Jessica Reddy
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Katherine A Jong
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA
| | - Jacob White
- Welch Medical Library, Johns Hopkins University, Baltimore, Maryland, USA
| | - Tracy Moniz
- Department of Communication Studies, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Margaret S Chisolm
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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12
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Manohar S, Moniz T, Haidet P, Chisolm MS, Balhara KS. Applying the Prism Model to design arts and humanities medical curricula. Int Rev Psychiatry 2023; 35:576-582. [PMID: 38461395 DOI: 10.1080/09540261.2023.2254384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 08/29/2023] [Indexed: 03/11/2024]
Abstract
The arts and humanities (A&H) play a fundamental role in medical education by supporting medical learners' development of core competencies. Like all medical curricula, those integrating the A&H are more likely to achieve the desired outcomes when the learning domains, goals, objectives, activities, and evaluation strategies are well-aligned. Few faculty development programs focus on helping medical educators design A&H curricula in a scholarly manner. The Prism Model, an evidence-based tool, supports educators developing A&H medical curricula in a rigorous way for maximum impact. The model posits that the A&H can serve four pedagogical functions for medical learners: 1) skill mastery, 2) perspective taking, 3) personal insight, and 4) social advocacy. Although this model has been described in the literature, no practical guidance exists for medical educators seeking to apply it to the development of a specific curriculum. This paper provides a step-by-step demonstration of how to use the Prism Model to design an A&H curriculum. Beginning with the first step of selecting a learning domain through the final step of curriculum evaluation, this paper helps medical educators apply the Prism Model to develop A&H curricula with intentionality and rigour to achieve the desired learning outcomes.
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Affiliation(s)
| | - Tracy Moniz
- Department of Communication Studies, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Paul Haidet
- Woodward Center for Excellence in Health Sciences Education, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | | | - Kamna S Balhara
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Orr A, Hussain F, Tomescu O, DeLisser H, Grundy KM, Niepold S, Rizzo A, Shaw S, Balmer D. Extending Arts-Based Interventions in Graduate Medical Education through the Positive Humanities: the Re-FRAME Workshop. J Gen Intern Med 2023; 38:3252-3256. [PMID: 37407762 PMCID: PMC10651601 DOI: 10.1007/s11606-023-08292-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 06/15/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND Arts-and-humanities-based interventions are commonly implemented in medical education to promote well-being and mitigate the risk of burnout. However, mechanisms for achieving these effects remain uncertain within graduate medical education. The emerging field of the positive humanities offers a lens to examine whether and how arts-based interventions support well-being in internal medicine interns. AIM Through program evaluation of this visual art workshop, we used a positive humanities framework to elucidate potential mechanisms by which arts-based curricula support well-being in internal medicine interns. SETTING We launched the re-FRAME workshop at the Philadelphia Museum of Art in winter 2020. PARTICIPANTS Fifty-six PGY-1 trainees from one internal medicine residency program. PROGRAM DESCRIPTION The 3-h re-FRAME workshop consisted of an introductory session on emotional processing followed by two previously described arts-based interventions. PROGRAM EVALUATION Participants completed an immediate post-workshop survey (91% response rate) assessing attitudes towards the session. Analysis of open-ended survey data demonstrated 4 categories for supporting well-being among participants: becoming emotionally aware/expressive through art, pausing for reflection, practicing nonjudgmental observation, and normalizing experiences through socialization. DISCUSSION Our project substantiated proposed mechanisms from the positive humanities for supporting well-being-including reflectiveness, skill acquisition, socialization, and expressiveness-among medical interns.
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Affiliation(s)
- Andrew Orr
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Farah Hussain
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Oana Tomescu
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Horace DeLisser
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Karen M Grundy
- Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Adam Rizzo
- Philadelphia Museum of Art, Philadelphia, PA, USA
| | - Sarah Shaw
- Philadelphia Museum of Art, Philadelphia, PA, USA
| | - Dorene Balmer
- Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Manohar S, Oloyede O, Kollmer Horton ME. Evaluating an intergenerational art and storytelling program with older adults and medical students. Int Rev Psychiatry 2023; 35:608-618. [PMID: 38461399 DOI: 10.1080/09540261.2023.2278717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/30/2023] [Indexed: 03/11/2024]
Abstract
Older adults in residential communities face loneliness and isolation, challenges exacerbated by COVID-19, leading to adverse physical and mental health outcomes. Intergenerational arts and humanities programs have been successful in addressing these challenges while also enabling medical learners to better understand aging populations. Draw YOUR Story, a program at a Houston residential senior living community, connects premedical and medical student volunteers with older adults through an art and storytelling activity. To evaluate the program, we conducted a focus group with older adults and pre and post-volunteering student surveys with questions about attitudes towards older adults and an Interpersonal Reactivity Index. Student surveys (n = 18) showed increased comfort working with older adults after volunteering (p = 0.02). Students who spent less time volunteering reported a decline in their perceptions of older adult quality of life, when compared to more frequent volunteers (p = 0.02). Older adults shared that the program encouraged learning new skills, offered time for reflection, connected them to medicine, and furthered desire for community. Draw YOUR Story benefitted students and older adults, increasing student comfort with older adults, providing aging adults opportunities to learn new skills and reflect, and building intergenerational connections.
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Affiliation(s)
- Sujal Manohar
- Student Affairs, Baylor College of Medicine, Houston, Texas, USA
| | - Oluwapelumi Oloyede
- Student Affairs, Tilman J. Fertitta Family College of Medicine at the University of Houston, Houston, Texas, USA
| | - Mary E Kollmer Horton
- McGovern Center for Humanities and Ethics at McGovern Medical School, Houston, Texas, USA
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Gaufberg E, DiGiovanni Evans B, Rutberg P, Chisolm MS. What's art got to do with it?-Transfer of learning in museum-based health professions education. Int Rev Psychiatry 2023; 35:672-681. [PMID: 38461382 DOI: 10.1080/09540261.2023.2288299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 11/22/2023] [Indexed: 03/11/2024]
Abstract
Museum-based education for health professionals is a rich and expanding field in which educators engage health professions learners in arts-based activities intentionally designed to support transfer of learning from a museum to a clinical context. Museum-based education for health professionals promotes several key learning outcomes including: mastery of core skills such as observation, interpretation, and communication; cultivating personal insight; fostering appreciation for multiple perspectives; opening avenues to explore social advocacy; and promoting wellness. Following a museum-based activity, translational facilitators guide learners through a debriefing process which supports the discovery of real-world connections to clinical teaching, learning, and care delivery. Translational debriefing involves practices such as attending to psychological safety, using reflective listening and open-ended questions, practicing cultural humility, maintaining neutrality, and modeling curiosity. These translational opportunities can also help participants who are themselves health professions educators gain insights into their own teaching practices and provide new tools to incorporate, including bedside teaching strategies and innovative ways to facilitate small group learning.
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Affiliation(s)
- Elizabeth Gaufberg
- Medicine and Psychiatry, Harvard Medical School/Cambridge Health Alliance, Cambridge, MA, USA
| | | | - Pooja Rutberg
- Pediatrics, Harvard Medical School/Cambridge Health Alliance, Cambridge, MA, USA
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Chisolm MS, Bhugra D. The arts and humanities are fundamental to health professions education. Int Rev Psychiatry 2023; 35:537-539. [PMID: 38461398 DOI: 10.1080/09540261.2023.2321034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/11/2024]
Affiliation(s)
- Margaret S Chisolm
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Dinesh Bhugra
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Kelly-Hedrick M, Louis SR, Chisolm MS. Character and virtue development in medical learners: another role for the arts? Int Rev Psychiatry 2023; 35:631-635. [PMID: 38461381 DOI: 10.1080/09540261.2023.2268211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/04/2023] [Indexed: 03/11/2024]
Abstract
Medical education serves to teach students how to think and act as future physicians. Doing so successfully requires supporting learners' acquisition of clinical skills and knowledge, but also attending to their character education and virtue development. The arts and humanities are widely embraced as a fundamental component of a complete medical education. While not frequently touted as a useful pedagogical tool for teaching character and virtue, we argue the integration of arts-based activities into medical education can promote virtue development. In this article, we use the virtues framework from the Jubilee Centre for Character and Virtues at the University of Birmingham to review existing empirical studies of arts-based programs for each of these virtue domains of intellectual, moral, civic, and performance virtues. Learners may benefit from further exploration-both conceptual and empirical-of how the arts can scaffold character development in medical education.
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Affiliation(s)
| | - Sarah R Louis
- Department of Arts and Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Margaret S Chisolm
- Department of Psychiatry and Behavioral Sciences, and of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Harz D, Begin AS, Alansari R, Esparza R, Zimmermann C, Evans BD, Eisenberg S, Katz JT. The art of empathy: Teaching empathy through art. CLINICAL TEACHER 2023; 20:e13643. [PMID: 37654209 DOI: 10.1111/tct.13643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 08/01/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND The instruction of empathy is challenging. Although several studies have addressed how art-based education can foster empathy, there is a need for more evidence showing its impact and students' perceptions, especially in graduate education. APPROACH We designed and implemented a virtual art-based curriculum focused on fostering empathy-The Art of Empathy. This novel curriculum used diverse art-based education methodologies to promote meticulous and collaborative observation and reflection, building on constructivism. Thirty-six interns at the Brigham and Women's Hospital were invited to participate in the curriculum, while 34 served as control. EVALUATION We used mixed methods to explore interns' perceptions of the curriculum and assess its impact on their empathy. We used two quantitative instruments with known psychometric characteristics: the Toronto Empathy Questionnaire (TEQ) and the Jefferson Scale of Physicians Empathy (JSPE), which were distributed in a survey and completed by 31/99 (31.3%). We collected qualitative data from four interns using semi-structured interviews. Thematic analysis showed how The Art of Empathy promoted interns' reflections and actions toward empathy. This was partially supported by the quantitative data that showed significantly higher scores on the 'Compassionate Care' subscale of the JSPE (p = 0.039) when compared with interns in the control group. The thematic analysis showed that interns appreciated the curriculum and valued its benefits while highlighting the limitations of the virtual delivery approach. IMPLICATIONS Our curriculum was well received by interns and showed the potential of art-based methodology to promote empathic capacities in graduate students.
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Affiliation(s)
- Dominique Harz
- Dental School, Pontificia Universidad Católica de Chile, Santiago, Chile
- Harvard Medical School, Boston, Massachusetts, USA
| | - Arabella Simpkin Begin
- Harvard Medical School, Boston, Massachusetts, USA
- Lincoln College, University of Oxford, Oxford, UK
| | - Reem Alansari
- Harvard Medical School, Boston, Massachusetts, USA
- Arabian Gulf University, Manama, Bahrain
- Massachusetts General Hospital Institute of Health Professions, Boston, Massachusetts, USA
| | - Ramiro Esparza
- Harvard Medical School, Boston, Massachusetts, USA
- University of Guadalajara, Guadalajara, Mexico
| | | | | | | | - Joel T Katz
- Harvard Medical School, Boston, Massachusetts, USA
- Brigham and Women's Hospital, Boston, Massachusetts, USA
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Kelly-Hedrick M, Stouffer KM, Benskin E, Wolffe S, Wilson N, Chisolm MS. A Pilot Study of Art Museum-Based Small Group Learning for Pre-Health Students. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2023; 14:957-960. [PMID: 37693300 PMCID: PMC10492539 DOI: 10.2147/amep.s403723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 08/20/2023] [Indexed: 09/12/2023]
Abstract
Introduction Health professions educators are increasingly recognizing the fundamental role the arts and humanities play in professional identity formation; however, few reports exist of programs designed specifically for pre-health professional students. Methods We designed and delivered four, 2.5-h sessions for pre-health professions students at a local museum in partnership with museum educators. Participants were invited to respond to a follow-up survey asking about their perceived insights from and importance of the session. We used descriptive statistics and thematic content analysis for quantitative and qualitative data, respectively. Results Ten of the participants responded to the survey (n=10/23, response rate=43%) and all supported the integration of such an experience in their pre-health curriculum. The qualitative analysis of responses to the open-ended item about any insights gained from participation in the program revealed three themes: cultivation of the health professional, personal growth, and awareness and appreciation of multiple perspectives. Discussion Participants who responded to our survey drew meaningful connections to the relevance of these sessions to their development as future professionals.
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Affiliation(s)
| | | | - Elizabeth Benskin
- Department of Education, The Baltimore Museum of Art, Baltimore, MD, USA
| | - Suzy Wolffe
- Department of Education, The Baltimore Museum of Art, Baltimore, MD, USA
| | - Norah Wilson
- Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Margaret S Chisolm
- Department of Psychiatry and Behavioral Services, and of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Anil J, Cunningham P, Dine CJ, Swain A, DeLisser HM. The medical humanities at United States medical schools: a mixed method analysis of publicly assessable information on 31 schools. BMC MEDICAL EDUCATION 2023; 23:620. [PMID: 37658394 PMCID: PMC10472551 DOI: 10.1186/s12909-023-04564-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 08/01/2023] [Indexed: 09/03/2023]
Abstract
INTRODUCTION There have been increasing efforts to integrate the arts and humanities into medical education, particularly during undergraduate medical education (UME). Previous studies, however, have focused on courses and curricular programming without rigorous characterization of the associated paracurricular environment or infrastructure enabling or facilitating these offerings. METHODS To assess opportunities for students to engage the arts and humanities during their medical education as well as the institutional resources to support those opportunities, we developed the Humanities and Arts Programming Scale (HARPS): an 18-point scale involving eight sub-domains (Infrastructure, Curricular Opportunities, Extracurricular Engagement, Opportunities for Immersion, Faculty Engagement, Staff Support, Student Groups, and Scholarship). This scale was used to evaluate the top-31 ranked United States medical schools as determined by US News and World Report's (USWNR) Medical School Research Rankings using information derived from public-facing, online information. RESULTS Mean cumulative HARPS score was 11.26, with a median score of 12, a standard deviation of 4.32 and a score range of 3-17. Neither USWNR ranking nor private/public institution status were associated with the cumulative score (p = 0.121, p = 0.739). 52% of institutions surveyed had a humanities-focused center/division with more than 70% of the schools having significant (> 5) faculty engaged in the medical humanities. 65% of schools offered 10 or more paracurricular medical humanities events annually, while 68% of the institutions had more than 5 medical humanities student organizations. While elective, non-credit courses are available, only 3 schools required instruction in the arts and humanities, and comprehensive immersive experiences in the medical humanities were present in only 29% of the schools. CONCLUSIONS Although there is a significant presence of the medical humanities in UME, there is a need for integration of the arts and humanities into required UME curricula and into immersive pathways for engaging the medical humanities.
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Affiliation(s)
- Joshua Anil
- Academic Programs Office, Perelman School of Medicine, Jordan Medical Education Center, University of Pennsylvania, 6th Floor, Building 421 3400 Civic Center Blvd, Philadelphia, PA, 19104-5162, USA
| | - Phoebe Cunningham
- Academic Programs Office, Perelman School of Medicine, Jordan Medical Education Center, University of Pennsylvania, 6th Floor, Building 421 3400 Civic Center Blvd, Philadelphia, PA, 19104-5162, USA
| | - C Jessica Dine
- Academic Programs Office, Perelman School of Medicine, Jordan Medical Education Center, University of Pennsylvania, 6th Floor, Building 421 3400 Civic Center Blvd, Philadelphia, PA, 19104-5162, USA
| | - Amanda Swain
- Academic Programs Office, Perelman School of Medicine, Jordan Medical Education Center, University of Pennsylvania, 6th Floor, Building 421 3400 Civic Center Blvd, Philadelphia, PA, 19104-5162, USA
| | - Horace M DeLisser
- Academic Programs Office, Perelman School of Medicine, Jordan Medical Education Center, University of Pennsylvania, 6th Floor, Building 421 3400 Civic Center Blvd, Philadelphia, PA, 19104-5162, USA.
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Noyen M, Sanghera R, Kung JY, Schindel TJ. Pharmacy Students' Perceptions of the Pharmacist Role: An Arts-Informed Approach to Professional Identity Formation. PHARMACY 2023; 11:136. [PMID: 37736908 PMCID: PMC10514856 DOI: 10.3390/pharmacy11050136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/07/2023] [Accepted: 08/24/2023] [Indexed: 09/23/2023] Open
Abstract
Elements of professional identity are closely intertwined with professional roles, and individuals perceive themselves in relation to their roles. How pharmacists perceive their professional identity influences how they enact their roles in practice. For pharmacy students, understanding the pharmacist role and envisioning themselves in that role supports the formation of their professional identity. This study explores students' perceptions of the pharmacist role. First-year pharmacy students enrolled in the Doctor of Pharmacy program at the University of Alberta were invited to participate in this study. Using an adapted version of the draw-and-write technique, participants were asked to express their understanding of the pharmacist role visually. An analysis of the results was guided by established discourses related to pharmacist identity derived from pharmacy education literature. In total, 100 pharmacy students participated in this study. The findings indicate that pharmacy students have a comprehensive understanding of the pharmacist role, especially the dispenser and health care provider aspects of a pharmacist's professional identity. Additionally, students acknowledged the involvement of pharmacists in health care teams, in public health, and primary health care services. A discourse related to professional identity, the multi-faceted professional, emerged to describe the coexistence of multiple roles in modern pharmacy practice. An arts-based activity successfully facilitated the exploration of pharmacy students' perceptions of the professional role of pharmacists. This approach has potential in supporting instruction regarding professional identity formation within the curriculum.
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Affiliation(s)
- Meghan Noyen
- College of Health Sciences, Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, AB T6G 2H7, Canada
| | - Ravina Sanghera
- College of Health Sciences, Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, AB T6G 2H7, Canada
- Office of the Dean of Students, University of Alberta, Edmonton, AB T6G 2H7, Canada
| | - Janice Y. Kung
- John W. Scott Health Sciences Library, University of Alberta, Edmonton, AB T6G 2R7, Canada
| | - Theresa J. Schindel
- College of Health Sciences, Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, AB T6G 2H7, Canada
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Landry-Wegener BA, Kaniecki T, Gips J, Lebo R, Levine RB. Drama Training as a Tool to Teach Medical Trainees Communication Skills: A Scoping Review. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2023; 98:851-860. [PMID: 36538658 DOI: 10.1097/acm.0000000000005121] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
PURPOSE Recognizing the similarities between the skills an actor needs and those required of a physician in clinical communication, medical educators have begun to create drama-based interventions to teach communication skills. The purpose of this scoping review was to summarize existing educational interventions that use drama training to teach medical trainees communication skills. METHOD The authors searched PubMed, CINAHL Plus, Embase, ERIC, and Web of Science Core Collection multiple times beginning in March 2020 through March 2022. Articles were included if they (1) described components of an educational intervention, (2) used an active intervention based on drama training, (3) stated a curricular goal of improving learners' communication skills, and (4) included medical trainee learners. Data extracted included the details of the targeted learners and educational interventions, assessment tools, and outcomes. The quality of each study was assessed. RESULTS Thirty articles met the inclusion criteria. Twenty-five (83%) articles included acting and improvisation exercises, 9 (30%) used some or all of the conventions of forum theater, and 3 (10%) used dramatic performance. The interventions included undergraduate, graduate, and continuing medical education learners. Most were elective and involved a member of the theatrical community. Although low overall study quality (average MERSQI score was 8.5) limited the strength of the evidence, of the 8 articles that evaluated learners' knowledge, skills, and/or behaviors, the majority showed an initial improvement in communication skills post-intervention. CONCLUSIONS This review is the first, to the authors' knowledge, to focus on the curricular goal of improving communication skills and to include a broader scope (beyond medical improv) of drama trainings. While the included articles represent a diverse group of interventions, generally they reported an outcome of improved communication skills in their learners. More high-quality studies are needed to determine best practices and the generalizability of drama-based initiatives.
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Affiliation(s)
- Bernard A Landry-Wegener
- B.A. Landry-Wegener is assistant professor, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Timothy Kaniecki
- T. Kaniecki is a rheumatology fellow, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Julia Gips
- J. Gips is a resident physician, Osler Medical Residency, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Rachael Lebo
- R. Lebo is clinical services librarian, Wegner Health Sciences Library, University of South Dakota, Sioux Falls, South Dakota
| | - Rachel B Levine
- R.B. Levine is professor and associate dean for faculty educational development, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Nash W, Erondu M, Childress A. Expanding Narrative Medicine through the Collaborative Construction and Compelling Performance of Stories. THE JOURNAL OF MEDICAL HUMANITIES 2023; 44:207-225. [PMID: 36690776 PMCID: PMC9870772 DOI: 10.1007/s10912-022-09779-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/07/2022] [Indexed: 05/07/2023]
Abstract
This essay proposes an expansion of the concept of narrative competence, beyond close reading, to include two more skills: the collaborative construction and compelling performance of stories. To show how this enhanced form of narrative competence can be attained, the essay describes Off Script, a cocurricular medical storytelling program with three phases: 1) creative writing workshop, 2) dress rehearsal, and 3) public performance of stories. In these phases, Off Script combines literary studies, creative writing, reflective practice, collegial feedback, and drama. With increased narrative competence, Off Script participants are likely better equipped to engage in more impactful health advocacy and partner with patients more effectively.
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Affiliation(s)
- Woods Nash
- Department of Behavioral and Social Sciences, University of Houston Fertitta Family College of Medicine in Houston, Houston, TX, USA.
| | | | - Andrew Childress
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA
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De Souza D, Adams GC. Practical Pedagogical Tips for Using Movies in Medical Education. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2023; 47:90-94. [PMID: 36547770 DOI: 10.1007/s40596-022-01740-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023]
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Ryznar E, Kelly-Hedrick M, Yenawine P, Chisolm MS. Relevance of Visual Thinking Strategies for Psychiatry Training. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2023; 47:78-81. [PMID: 35075589 PMCID: PMC8786370 DOI: 10.1007/s40596-022-01590-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 01/07/2022] [Indexed: 06/14/2023]
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Rajagopalan A, Chew QH, Sim K. Medical Humanities in Undergraduate Psychiatry Teaching: Learner Assessment and Mediators of Better Learning Outcomes. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2023; 10:23821205231214393. [PMID: 38025022 PMCID: PMC10644729 DOI: 10.1177/23821205231214393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVES Previous studies have found that the inclusion of medical humanities in medical education was associated with improvements in learner reflectivity and empathy. There is less data, however, on the impact of medical humanities on perceived patient care and mediators of learner outcomes. Our study aimed to determine the impact of medical humanities on perceived learner well-being and patient care, and the mediators of these outcomes in medical undergraduates undergoing psychiatric training. METHODS This cross-sectional study was conducted from August 2021 to December 2022 within undergraduate medical students undergoing psychiatry rotations and who attended sessions entitled "Humanities in Psychiatry." Both quantitative and qualitative data were obtained through anonymized online feedback forms. Path analysis was performed to examine the relationship between learners' perception of the medical humanities writing activity and its potential to improve their well-being, patient care, as well as mediators of these outcomes. RESULTS Overall, 97 medical undergraduates (response rate 67.4%) participated in the study and more than four-fifths reported improvements in listening, reflection, empathy, personal well-being, and perceived patient care. Males showed more interest in additional medical humanities sessions (mean rank 57.9 vs 42.5, P = .005) and greater improvements in personal well-being (mean rank 55.1 vs 44.5, P = .044). Path analysis showed that reflective capacity of learners mediated the relationship between reflective writing and perceived improvements in learner well-being (β = 0.596, 95% CI = 0.409-0.737) and patient care (β = 0.557, 95% CI = 0.379-0.702). CONCLUSIONS Our study found that the majority of learners responded positively to the medical humanities sessions, which suggests that its use could be beneficial in fostering empathy, reflection, learner well-being, and improved patient care. Using the PRISM model, we present practical implications for educators to consider when using medical humanities in relation to psychiatry training.
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Affiliation(s)
| | - Qian Hui Chew
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Kang Sim
- West Region, Institute of Mental Health, Singapore, Singapore
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Nguyen A, Duong D, O’Sullivan P. Overlapping worlds of art and plastic surgery: developing a concept model and its implications in surgical education. GLOBAL SURGICAL EDUCATION : JOURNAL OF THE ASSOCIATION FOR SURGICAL EDUCATION 2022; 2:9. [PMID: 38013859 PMCID: PMC9734446 DOI: 10.1007/s44186-022-00089-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 11/23/2022] [Accepted: 11/27/2022] [Indexed: 12/14/2022]
Abstract
Purpose Editorials speculate on the relationship between art and plastic surgery, and studies of limited art education in surgical training show intriguing benefits. Identifying the shared concepts and skills in art and plastic surgery could advance incorporating artistic skills and concepts into plastic surgery training and curriculum. Methods Using a grounded theory approach, we interviewed plastic surgeons and formally trained or self-identified artists and then analyzed the transcripts. During the process, we used a constant comparison approach while coding along with data collection. The team developed the codebook from initial transcripts; 2 members coded each transcript. We reconciled codes and summarized codes into themes based on discussion among the team. Results 15 plastic surgeons aged 36-80 years and 16 artists aged 19-62 years were interviewed. We then developed a concept model, "Ways of Making," to illustrate the shared aspects of the artistic and surgical process through their ways of doing, knowing, seeing, and thinking. Both plastic surgeons and artists recognized that strong technical foundational skills are key to developing competency. Both groups spoke about the Elements of Art and Principles of Design, though artists know this formally. Artists and plastic surgeons shared that awareness to one's surroundings or to human features facilitates identifying problems or ideas. They described how technical skills, manual dexterity, and three-dimensional thinking can be taught and nurtured. Both groups also recognized that creativity played a major role in their work. While creativity was seen as innate, participants can learn to be innovative through critical thinking. Conclusion This study provides a model for how plastic surgery and art overlap using data from interviews. Though there are differences between the two fields, the ways of doing, knowing, seeing, and thinking are key components of the artistic and surgical processes. Identifying the shared concepts and skills in art and plastic surgery could help enhance curricula seeking to incorporate artistic skills and concepts into plastic surgery training.
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Affiliation(s)
- Audrey Nguyen
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of California San Francisco (UCSF), 505 Parnassus Ave, Suite M-593, San Francisco, CA 94143 USA
| | - Dawn Duong
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of California San Francisco (UCSF), 505 Parnassus Ave, Suite M-593, San Francisco, CA 94143 USA
| | - Patricia O’Sullivan
- School of Medicine, Departments of Medicine and Surgery, University of California San Francisco, San Francisco, USA
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Ike JD, Howell J. Quantitative metrics and psychometric scales in the visual art and medical education literature: a narrative review. MEDICAL EDUCATION ONLINE 2022; 27:2010299. [PMID: 34866545 PMCID: PMC8648010 DOI: 10.1080/10872981.2021.2010299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/27/2021] [Accepted: 11/20/2021] [Indexed: 06/13/2023]
Abstract
The authors conduct a narrative review of the quantitative observation metrics and psychometric scales utilized in the visual arts and medical education literature in order to provide medical educators with a 'toolkit' of quantitative metrics with which to design and evaluate novel visual arts-based pedagogies. These efforts are intended to support the AAMC and National Academy of Sciences, Engineering, and Medicine's aims to formally evaluate and integrate arts and humanities curricula into traditional scientific educational programming. The scales reviewed examine a variety of domains including tolerance for ambiguity, bias, burnout, communication, empathy, grit, and mindfulness/reflection. Observation skill, given the heterogeneity of quantitative metrics, is reviewed separately.
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Affiliation(s)
- John David Ike
- Clinical Scholar, National Clinician Scholars Program, Clinical Instructor, Division of Hospital Medicine, Hospitalist, Ann Arbor Va Healthcare System, University of Michigan, Ann Arbor
| | - Joel Howell
- Elizabeth Farrand Collegiate Professor of the History of Medicine, Professor, Departments of Medicine and History, University of Michigan, Ann Arbor
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Yan L, Hu H, Zheng Y, Zhou Y, Li L. The development path of the medical profession in China's engineering universities from the perspective of the 'four new' disciplines. Ann Med 2022; 54:3030-3038. [PMID: 36308419 PMCID: PMC9629106 DOI: 10.1080/07853890.2022.2139409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
In recent years, China has actively promoted the construction of first-class universities and disciplines of the world ('Double First-Class'), and built a new model of university development to solve Chinese problems and support high-quality economic and social development. In the context of China's efforts to promote the construction of new engineering, new medicine, new agriculture, and new liberal arts (referred to as the 'four new' disciplines), these disciplines are developing rapidly. As a specialty dealing with major life issues, medical education has become increasingly prominent. To enhance the comprehensive strength of universities, corresponding to the 'four new' disciplines strategy, engineering universities are building and developing medical specialties one after another. At present, the greatest problem in the medical specialty of engineering universities is the tendency to blindly follow trends and integrate new concepts with traditional methods. However, to date, the integration of medical and nonmedical specialties has been superficial and thus has not been successful. To address this problem, this paper, guided by the policies aimed at developing the 'four new' disciplines, analyses the current situation of traditional medicine education and professional development in engineering universities and proposes measures to enhance the competitiveness of new medicine in engineering universities, thereby promoting the development of universities.KEY MESSAGESThe implementation of the 'four new' disciplines is a strategic choice for higher education.Engineering technology is an efficient path and hands-on approach to solving medical problems.Interdisciplinary and comprehensive educational approaches play an important role in the development of medical science.
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Affiliation(s)
- Li Yan
- Institute of Medical Research, Northwestern Polytechnical University, Xi'an, China
| | - Huijing Hu
- Institute of Medical Research, Northwestern Polytechnical University, Xi'an, China
| | - Yu Zheng
- Department of Ultrasonography, Xían Central Hospital, Xi'an, China
| | - Yin Zhou
- Institute of Medical Research, Northwestern Polytechnical University, Xi'an, China
| | - Le Li
- Institute of Medical Research, Northwestern Polytechnical University, Xi'an, China
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30
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Kagan HJ, Kelly-Hedrick M, Benskin E, Wolffe S, Suchanek M, Chisolm MS. Understanding the role of the art museum in teaching clinical-level medical students. MEDICAL EDUCATION ONLINE 2022; 27:2010513. [PMID: 34866552 PMCID: PMC8648011 DOI: 10.1080/10872981.2021.2010513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/26/2021] [Accepted: 11/22/2021] [Indexed: 05/19/2023]
Abstract
INTRODUCTION The role of the visual arts in medical education has been understudied, especially with regard to program evaluation and learner assessment of complex competencies such as professional identity, team building, and tolerance for ambiguity. We designed a study to explore how an integrative art museum-based program might benefit 3rd and 4th year medical students. METHODS We piloted 6 sessions with 18 participants. Evaluation methods included post-session surveys and semi-structured focus groups, which we qualitatively analyzed using an open-coding method. RESULTS Seven themes emerged from the analysis related to the overarching realms of 'form' and 'function.' 'Form' themes included structural elements of the sessions that enabled engagement: (1) group format, (2) methods (e.g., discussion prompts, activities), (3) setting (e.g., physical space of the museum, temporal space), and (4) objects (e.g., paintings, sculptures). 'Function' themes included the personal and professional value and meaning derived from the sessions: (1) appreciation of others, (2) critical skills, and (3) personal inquiry. DISCUSSION Our results expand what is known about the role of the visual arts in medical education by suggesting that the visual arts may facilitate clinically relevant learning across a range of competencies via specific formal aspects (group format, method, setting, objects) of art museum-based pedagogical methods.
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Affiliation(s)
- Heather J. Kagan
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Elizabeth Benskin
- Department of Teaching and Learning, Baltimore Museum of Art, Baltimore, MD, USA
| | | | - Melissa Suchanek
- Department of Hematology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Margaret S. Chisolm
- Department of Psychiatry and Behavioral Sciences, and Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- CONTACT Margaret S. Chisolm Johns Hopkins University School of Medicine, 5300 Alpha Commons Drive, 446B, Baltimore, MD21224, USA
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31
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Balhara KS, Irvin N, Zink KL, Mohan S, Olson AS, Tackett S, Regan L. "A sorely neglected field": A multisite study of self-reported humanities exposure among emergency medicine residents. AEM EDUCATION AND TRAINING 2022; 6:e10772. [PMID: 35784381 PMCID: PMC9242415 DOI: 10.1002/aet2.10772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The Association of American Medical Colleges has identified the humanities as fundamental to medical education across all specialties. Evidence from undergraduate medical education (UME) demonstrates the humanities' positive impacts on outcomes that could be relevant to patient care and trainee well-being in emergency medicine (EM) residency training. However, less is known about the humanities' role in graduate medical education (GME). OBJECTIVES The objectives were to describe EM residents' self-reported exposure to the humanities and its relationship with their empathy, tolerance of ambiguity, and patient-centeredness, and to assess their attitudes toward the humanities in GME. METHODS This cross-sectional survey-based study was conducted at six U.S. EM residency programs in 2018-2019. Quantitative analyses included linear regressions testing for trends between humanities exposures and outcomes, adjusted for sex, year in training, and clustering within programs; adjunct analysis of free-text responses was performed using an exploratory constructivist approach to identify themes about views on the humanities' role in medicine. RESULTS Response rate was 54.8% (153/279). A total of 65% of respondents were male and 28.1% of respondents had a preceding humanities degree. Preceding humanities degree and current self-reported humanities exposure were positively associated with performance on empathy subscales (p = 0.02). Seventy-five percent (n = 114) of respondents agreed humanities are important in GME; free-text responses revealed perceived positive impacts of humanities on generating well-rounded clinicians and enhancing patient care. CONCLUSIONS Engagement with the humanities may be associated with empathy among EM residents. Although the magnitude of associations was smaller than that seen in UME, this study demonstrates resident interest in humanities and suggests that extracurricular engagement with the humanities may be insufficient to prolong positive impacts seen in UME. Further research is needed to explore how to sustain these benefits through integration or addition of the humanities in existing GME curricula.
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Affiliation(s)
- Kamna S. Balhara
- Department of Emergency MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Nathan Irvin
- Department of Emergency MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Korie L. Zink
- Department of Emergency MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Sanjay Mohan
- Division of Medical Toxicology, Ronald O. Perelman Department of Emergency MedicineNYU Grossman School of MedicineNew YorkNew YorkUSA
| | - Adriana S. Olson
- Section of Emergency Medicine, Department of MedicineUniversity of ChicagoChicagoIllinoisUSA
| | - Sean Tackett
- Division of General Internal MedicineJohns Hopkins Bayview Medical CenterBaltimoreMarylandUSA
- Biostatistics Epidemiology and Data Management CoreJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | | | - Linda Regan
- Department of Emergency MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
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Balhara KS, Ehmann MR, Irvin N. Antiracism in Health Professions Education Through the Lens of the Health Humanities. Anesthesiol Clin 2022; 40:287-299. [PMID: 35659401 DOI: 10.1016/j.anclin.2021.12.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Racism represents a public health crisis, adversely impacting patient outcomes and health care workplace inclusivity. Dismantling racism requires transforming both racist systems and individual and collective consciousness. Focusing on antiracism in health professions education through the transdisciplinary lens of the health humanities can spur self-reflection, critical thinking, and collaboration among health professions educators and trainees to create more equitable structures of care. This article describes how the health humanities provide a powerful framework for antiracist health professions education. The authors conclude with a snapshot of an existing humanities-based antiracist curriculum, with suggestions to facilitate implementation in other settings.
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Affiliation(s)
- Kamna S Balhara
- Emergency Medicine Residency Program, Johns Hopkins University School of Medicine, Johns Hopkins Department of Emergency Medicine, 1830 E Monument Street, Suite 6-100, Baltimore, MD 21287, USA.
| | - Michael R Ehmann
- Emergency Medicine Residency Program, Johns Hopkins University School of Medicine, Johns Hopkins Department of Emergency Medicine, 1830 E Monument Street, Suite 6-100, Baltimore, MD 21287, USA. https://twitter.com/MichaelEhmannMD
| | - Nathan Irvin
- Johns Hopkins University School of Medicine, Johns Hopkins Department of Emergency Medicine, 1830 E Monument Street, Suite 6-100, Baltimore, MD 21287, USA. https://twitter.com/swervinnirvin
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Waidyaratne GR, Kim S, Howell JD, Ike JD. Design, implementation, and reflections on a two-week virtual visual arts and medicine course for third- and fourth-year medical students. BMC MEDICAL EDUCATION 2022; 22:302. [PMID: 35449075 PMCID: PMC9022161 DOI: 10.1186/s12909-022-03374-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 04/13/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Medical humanities courses that incorporate the visual arts traditionally require in-person instruction and visits to museums. The COVID-19 pandemic afforded medical educators a unique opportunity to implement and evaluate virtual visual arts programming. METHODS A two-week, 7-module visual arts and medicine elective course for third and fourth-year medical students was conducted virtually in the Spring of 2021. The course included traditional didactic components as well as a range of hands-on creative art activities including painting, graphic medicine, photovoice, and Kintsugi (Japanese craft). Digital tools including Canvas, Google Jamboard, and Zoom facilitated student engagement. Student feedback was collected through anonymous post-course surveys. RESULTS We successfully conducted a virtual visual arts and medicine elective which integrated hands-on creative art activities. Most students "strongly agreed" that remote instruction was sufficient to meet course objectives. However, all students also "agreed" that in-person instruction may promote more in-depth engagement with the visual arts. The hands-on creative art activities were appreciated by all students. CONCLUSION Visual arts-based medical humanities courses can be delivered virtually and can include hands-on creative art activities such as painting. Future visual arts and medicine courses may benefit from incorporating a range of pedagogical methodologies, digital tools, control groups, and pre-/post-course assessments.
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Affiliation(s)
| | - Sangri Kim
- Neurology Residency Program, McGaw Medical Center at Northwestern University, Chicago, IL, USA
| | - Joel D Howell
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
- Department of History, University of Michigan, Ann Arbor, MI, USA
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
| | - John David Ike
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA.
- Medicine Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.
- National Clinician Scholars Program at the Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA.
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van Kessel R, Hrzic R, O'Nuallain E, Weir E, Wong BLH, Anderson M, Baron-Cohen S, Mossialos E. Digital Health Paradox: International Policy Perspectives to Address Increased Health Inequalities for People Living With Disabilities. J Med Internet Res 2022; 24:e33819. [PMID: 35191848 PMCID: PMC8905475 DOI: 10.2196/33819] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/26/2021] [Accepted: 11/15/2021] [Indexed: 02/06/2023] Open
Abstract
The COVID-19 pandemic accelerated the uptake of digital health worldwide and highlighted many benefits of these innovations. However, it also stressed the magnitude of inequalities regarding accessing digital health. Using a scoping review, this article explores the potential benefits of digital technologies for the global population, with particular reference to people living with disabilities, using the autism community as a case study. We ultimately explore policies in Sweden, Australia, Canada, Estonia, the United Kingdom, and the United States to learn how policies can lay an inclusive foundation for digital health systems. We conclude that digital health ecosystems should be designed with health equity at the forefront to avoid deepening existing health inequalities. We call for a more sophisticated understanding of digital health literacy to better assess the readiness to adopt digital health innovations. Finally, people living with disabilities should be positioned at the center of digital health policy and innovations to ensure they are not left behind.
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Affiliation(s)
- Robin van Kessel
- Department of International Health, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands.,Studio Europa, Maastricht University, Maastricht, Netherlands.,Global Health Workforce Network Youth Hub, World Health Organization, Geneva, Switzerland
| | - Rok Hrzic
- Department of International Health, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Ella O'Nuallain
- Public Sector Strategy Team, Deloitte Consulting Pty Ltd, Sydney, Australia
| | - Elizabeth Weir
- Autism Research Center, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Brian Li Han Wong
- Global Health Workforce Network Youth Hub, World Health Organization, Geneva, Switzerland.,The Lancet and Financial Times Commission on Governing Health Futures 2030: Growing up in a digital world, Global Health Centre, The Graduate Institute, Geneva, Switzerland.,Steering Committee, European Public Health Association Digital Health Section, Utrecht, Netherlands
| | - Michael Anderson
- Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Simon Baron-Cohen
- Autism Research Center, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Elias Mossialos
- Department of Health Policy, London School of Economics and Political Science, London, United Kingdom.,Institute of Global Health Innovation, Imperial College London, London, United Kingdom
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35
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Morse KA, Balhara KS, Irvin NA, Levy MJ. The Health Humanities and Emergency Medical Services (EMS): A Call to Action. Prehosp Disaster Med 2022; 37:1-2. [PMID: 35172914 DOI: 10.1017/s1049023x22000243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
In the context of an on-going global pandemic that has demanded increasingly more of our Emergency Medical Services (EMS) clinicians, the health humanities can function to aid in educational training, promoting resilience and wellness, and allowing opportunity for self-expression to help prevent vicarious trauma.As the social, cultural, and political landscape of the United States continues to require an expanded scope of practice from our EMS clinicians, it is critical that the health humanities are implemented as not only part of EMS training, but also as part of continued practice in order to ensure the highest quality patient-centered care while protecting the longevity and resilience of EMS clinicians.
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Affiliation(s)
- Kiriana A Morse
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MarylandUSA
| | - Kamna S Balhara
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MarylandUSA
| | - Nathan A Irvin
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MarylandUSA
| | - Matthew J Levy
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MarylandUSA
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36
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Moniz T, Golafshani M, Gaspar CM, Adams NE, Haidet P, Sukhera J, Volpe RL, de Boer C, Lingard L. How Are the Arts and Humanities Used in Medical Education? Results of a Scoping Review. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:1213-1222. [PMID: 33830951 DOI: 10.1097/acm.0000000000004118] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
PURPOSE Although focused reviews have characterized subsets of the literature on the arts and humanities in medical education, a large-scale overview of the field is needed to inform efforts to strengthen these approaches in medicine. METHOD The authors conducted a scoping review in 2019 to identify how the arts and humanities are used to educate physicians and interprofessional learners across the medical education continuum in Canada and the United States. A search strategy involving 7 databases identified 21,985 citations. Five reviewers independently screened the titles and abstracts. Full-text screening followed (n = 4,649). Of these, 769 records met the inclusion criteria. The authors performed descriptive and statistical analyses and conducted semistructured interviews with 15 stakeholders. RESULTS The literature is dominated by conceptual works (n = 294) that critically engaged with arts and humanities approaches or generally called for their use in medical education, followed by program descriptions (n = 255). The literary arts (n = 197) were most common. Less than a third of records explicitly engaged theory as a strong component (n = 230). Of descriptive and empirical records (n = 424), more than half concerned undergraduate medical education (n = 245). There were gaps in the literature on interprofessional education, program evaluation, and learner assessment. Programming was most often taught by medical faculty who published their initiatives (n = 236). Absent were voices of contributing artists, docents, and other arts and humanities practitioners from outside medicine. Stakeholders confirmed that these findings resonated with their experiences. CONCLUSIONS This literature is characterized by brief, episodic installments, privileging a biomedical orientation and largely lacking a theoretical frame to weave the installments into a larger story that accumulates over time and across subfields. These findings should inform efforts to promote, integrate, and study uses of the arts and humanities in medical education.
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Affiliation(s)
- Tracy Moniz
- T. Moniz is associate professor, Department of Communication Studies, Mount Saint Vincent University, Halifax, Nova Scotia, Canada; ORCID: https://orcid.org/0000-0002-5078-4611
| | - Maryam Golafshani
- M. Golafshani is a second-year medical student, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Carolyn M Gaspar
- C.M. Gaspar is a PhD candidate, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada; ORCID: https://orcid.org/0000-0003-0412-5495
| | - Nancy E Adams
- N.E. Adams is associate librarian and assistant dean of foundational sciences, Penn State College of Medicine, Hershey, Pennsylvania; ORCID: https://orcid.org/0000-0003-0534-6716
| | - Paul Haidet
- P. Haidet is director of medical education research, Woodward Center for Excellence in Health Sciences Education, Penn State College of Medicine, Hershey, Pennsylvania
| | - Javeed Sukhera
- J. Sukhera is associate professor, Departments of Psychiatry and Paediatrics, and scientist, Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; ORCID: https://orcid.org/0000-0001-8146-4947
| | - Rebecca L Volpe
- R.L. Volpe is associate professor and vice chair for education, Department of Humanities, Penn State College of Medicine, and director, Clinical Ethics Consultation Service, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania; ORCID: https://orcid.org/0000-0003-3406-9498
| | - Claire de Boer
- C. de Boer is director, The Doctors Kienle Center for Humanistic Medicine, and founding director, Center Stage Arts in Health, Penn State College of Medicine and Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania. She is president, National Organization for Arts in Health, San Diego, California
| | - Lorelei Lingard
- L. Lingard is professor, Department of Medicine, and scientist, Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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