Extending Arts-Based Interventions in Graduate Medical Education through the Positive Humanities: the Re-FRAME Workshop

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.

Validation of the Perceived Phubbing Scale to the Argentine Context

In recent years, the increased use of mobile devices has changed social dynamics. One such change is the rise of phubbing, described as the behavior of ignoring someone in order to pay attention to one's cell phone. The purpose of this research was to validate the Perceived Phubbing Scale (PPS) and examine its relationship with other psychological variables. An Argentine sample was composed of 1608 participants aged between 18 and 65 (M = 45.59; SD 14.03), with 51.6% identifying as female. They were provided with a phubbing scale, along with scales to measure emotional disconnection, fear of missing out (FoMO) and social exclusion, and a sociodemographic questionnaire. The results indicated that the PPS showed an adequate fit to the data, based on a structure of one factor (X²₍₂₀₎ = 259.353, p < 0.001; CFI = 0.958; IFI = 0.958; RMSEA = 0.089) and the internal consistency (α = 0.93), resulting in a nine-item scale. Participants with high or medium levels of phubbing showed a tendency to suffer FoMO or feel socially excluded or socially isolated. We did not find differences in the levels of phubbing related to the participant's age, gender, or socioeconomic level. It is possible to conclude that PPS can be used as a reliable measure to evaluate perceived phubbing in Argentina. Implications of the variables studied are discussed as possible predictors of phubbing and are to be considered in its approach.

Examining the Flourishing Impacts of Repeated Visits to a Virtual Art Museum and the Role of Immersion

Visiting art museums has been associated with a range of flourishing outcomes. However, there have been recent shifts towards increasing digital engagement with art, leading to a radical change in how people experience visual art. Given the now expansive virtual art viewing options, it is important to understand whether digital engagement can also lead to greater flourishing, and, if so, under what conditions. We examined the flourishing effects of viewing art in a virtual gallery in a pre-registered experiment comprising four sessions over four weeks, with varying viewing instructions designed to increase immersion. Participants were recruited from a USA representative sample on Prolific, resulting in a final sample of 687 participants. People were randomly assigned to one of nine experimental conditions. Eight art viewing conditions involved four 15 min virtual gallery visits with viewing instructions varying on two factors: slow-looking and immersive mindset framing. An active control condition involved reading about (but not viewing) art. Participants completed a battery of baseline flourishing measures in week 1, completed experimental art engagement sessions during weeks 1-4, and completed the battery again in week 5. While immersion levels were greater in the viewing conditions than the reading condition, growth in flourishing did not differ across condition. Exploratory analyses, however, showed that immersion during the gallery visits did predict some changes in specific facets of flourishing (e.g., engagement, meaning, autonomy satisfaction). We suggest a number of possible explanations for these null results and point to what is needed in future research.

The Analgesic Museum

This manuscript uses the perspectives and insights that emerged from the Analgesic Museum conference held virtually on March 11, 2022 as a mechanism for considering the role museums and artists can play in the public health effort to reduce the burden of persistent pain. One hundred and fifty-seven individuals from 22 countries registered for the Analgesic Museum conference. The event explored the intersection of art and pain management practices with presentations centered on three domains of interest: exhibition development, arts experiences and practices, and research and creative scholarship.

The Transition from In-Person to Virtual Museum Programming for Individuals Living with Chronic Pain – A Formative Evaluation

Museum engagement may be an effective approach for decreasing social disconnection and pain among individuals living with chronic pain. In October 2019, we launched a randomized controlled trial to assess the feasibility of museum engagement for individuals living with chronic pain; the study was halted in March, 2020 due to Covid-19-related safety concerns. This paper describes the process of transitioning from in-person to virtual museum programing in order to continue the study. Virtual museum programing is a feasible option for individuals living with chronic pain that is amenable to research and which may improve accessibility, inclusivity, and scalability relative to in-person programing.

Developing a framework for arts in health programs targeting individuals with chronic pain: a mixed-methods study of practitioners

OBJECTIVES

Chronic pain is a leading cause of morbidity and disability across the world. Cultural engagement may be a valuable tool in addressing the social disconnection that often accompanies chronic pain. This study sought to develop a framework for arts in health programs targeting individuals with chronic pain.

STUDY DESIGN

Sequential explanatory mixed-methods study.

METHODS

Web-based, cross-sectional survey sent to arts and cultural professionals to assess their experience with arts in health programming. Semi-structured interviews conducted with a sample of survey respondents to explore their perspectives on targeted arts in health programming for individuals with chronic pain.

RESULTS

Between October 2019 and January 2020, 208 surveys were completed by arts and cultural professionals. One hundred and twenty (58%) of the respondents indicated that they currently run an arts in health or museums in health program. Among these 120 respondents, 52 (43%) targeted older adults, 50 (42%) targeted individuals with mental health concerns, and 18 (15%) targeted individuals living with pain. Improving well-being (101 [84%]) and reducing social isolation (90 [75%]) were the most common intended program outcomes, while improving pain was the least common outcome (26 [22%]). Fifteen survey respondents were interviewed. Interviewees identified four interdependent themes regarding best practices for arts in health programs pertaining to (1) program content and structure, (2) program facilitation, (3) partnerships, and (4) programs for individuals with chronic pain.

CONCLUSIONS

The cultural sector can support chronic pain prevention and treatment efforts through the development of specialized programs. This study provides a framework for developing arts in health programs that support individuals living with chronic pain.

Experiences of patient-led chronic pain peer support groups after pain management programmes: A qualitative study

OBJECTIVE

A qualitative study of patients' experiences and the impacts of peer support groups that patients maintained after UK NHS group pain management programmes (PMPs).

DESIGN

Long-term impacts of group PMPs remain unclear, with indications that positive effects can fade. We evaluated a model of continued peer support, co-produced by patients and clinicians, to maintain the therapeutic impact of PMP groups. A protocol was implemented that encouraged patients to continue to meet in their established PMP group for patient-led peer support (without clinical input) after PMPs finished. Peer support aimed to consolidate self-management, and advance social life recovery. We examined the impacts that groups had on attendees, and why some dropped out.

METHODS

Semi-structured interviews with 38 patients and 7 clinicians, analysed thematically.

RESULTS

Friendship bonds and mutual understandings of effective ways of coping with pain encouraged participants to maintain recovery following PMPs. After PMP professional involvement has ended, these meetings enabled patients to develop greater agency from the shared sense of helping bring about new achievements or averting setbacks. Peer support extended the understanding of what is possible when living with pain. However, continuing meetings were not right for all. Reasons for not attending included lack of connection with peers.

CONCLUSIONS

Co-produced peer support groups after PMPs can be a low-cost, effective social intervention, providing emotional, practical and social benefits, with improved self-management skills, stronger social connections and some reduced use of health services. Project resources for developing peer support meetings after PMPs are freely available online.