Arts-based interventions in healthcare education

Effects of Arts-Based Pedagogy on Competence Development in Nursing: A Critical Systematic Review

The integration of arts-based methods into nursing education is a topic of growing interest in nursing practice. While there is an emerging body of research on this subject, evidence on competence development remains vague, largely due to methodological weaknesses. The purpose of this review is to evaluate the effectiveness of arts-based pedagogy in nursing, specifically in terms of students' changes in knowledge, skills, and attitudes. It explores which arts-based approaches to nursing education qualify as evidence-based practice in terms of nursing competence. A systematic critical review of research on arts-based pedagogy in nursing was conducted, identifying 43 relevant studies. These studies were assessed for methodological quality based on the CEC Standards for evidence-based practice, and 13 high-quality comparative studies representing a variety of arts-based approaches were selected. Creative drama was identified as the only evidence-based practice in the field, positively affecting empathy. The findings highlight a research gap in nursing education and emphasize the need for measurement and appraisal tools suitable for the peculiarities of arts-based pedagogy.

Story-Sharing Facilitation Guide: An Educational Strategy to Develop Strengths-Based Nursing and Healthcare Leaders

BACKGROUND

A reflective praxis process has been developed to facilitate story-sharing, an educational strategy grounded in narrative pedagogy.

METHOD

This article describes this strategy, the Story-Sharing Facilitation Guide (SSFG). The guide allows educators to facilitate the telling of a story that often triggers a memory of similar or contrasting experiences. Sharing stories helps learners find personal and professional meaning, develop new insights, and revise actions. The SSFG is underpinned by Dreyfus and Taylor's Contact Theory of how human beings learn and come to know and understand their different life-worlds.

RESULTS

The SSFG was developed and used by faculty in a leadership training program. Evaluation results of the program found this to be an effective educational method.

CONCLUSION

The guide provides educators with an intentional process of reflection that deepens learning and allows for labeling the experience and linking it with the concepts being taught. [J Nurs Educ. 2024;63(X):XXX-XXX.].

From skillful to empathic: evaluating shifts in medical students' perceptions of surgeons through a combined patient as teacher and arts-based reflection program

Introduction

The purpose of this study was to identify whether the incorporation of a combined Patient as teacher (PAT) and arts-based reflection (ABR) program during a surgical clerkship rotation could influence more humanistic perceptions of surgeons, using an innovative evaluation approach.

Methods

A novel, single question evaluation tool was created. Third year medical-students were asked to "list the top 5 attributes of a surgeon, in order of perceived importance" both before and after their surgical clerkship rotations and participation in the PAT/ABR program. Attributes identified by students were coded as either "humanistic" or "non-humanistic," which were then analyzed using generalized linear regression models under a Bayesian framework.

Results

After participation in the PAT/ABR program, the predicted probability of students ranking a humanistic characteristic as the most important attribute of a surgeon had increased by 17%, and the predicted probability of students ranking a humanistic characteristic amongst their top three attributes for a surgeon had increased by 21%.

Conclusion

This innovative evaluative method suggested the success of a combined PAT/ABR program in encouraging a humanistic perspective of surgery and this approach could potentially be explored to evaluate other humanistic education initiatives.

Quantitative metrics and psychometric scales in the visual art and medical education literature: a narrative review

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.

How Are the Arts and Humanities Used in Medical Education? Results of a Scoping Review

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.

Teaching and discussing mental health among university students: a pilot arts-based study

Purpose

Interdisciplinary approaches to health education are becoming increasingly common. Here, the authors describe an arts-based approach designed by academics and artists to both supplement the study of mental illness and support the individual mental health of undergraduate and postgraduate university students, by raising the visibility of mental illness in an innovative way.

Design/methodology/approach

Through workshops, university students were guided in a sensory and physical way to discuss psychological health and vulnerability. This was followed by the creation of physical representations of mental distress through art pieces.

Findings

Students were able to design their own art pieces and discuss mental health issues in an open and creative way. Students reported that the arts-based initiative was beneficial to their practice as future professionals and provided a holistic learning experience. At the same time, artists were able to generate powerful images which facilitated further discussions within the faculty.

Practical implications

This project provides an innovative model for workshops which could be employed to raise the visibility of common mental health disorders among university students while providing a safe space to discuss and support wellbeing. Additionally, variations could be implemented to enhance the teaching of affective disorders within a university curriculum.

Originality/value

This paper presents the results of collaboration between academics and artists, who together generated an innovative way to both support students' mental health and provide an alternative way to supplement experiential learning about common mental health conditions such as anxiety and depression.

Photodentistry - an innovative approach to improving students' empathy and learning experiences in comprehensive patient care

OBJECTIVES

Preparing future dental school graduates to provide comprehensive patient care with empathy requires the completion of adequate training in such practice. This study was undertaken to investigate the effectiveness of the Photodentistry learning activity, which uses visual arts, in improving dental students' empathy and learning experience in comprehensive patient care.

METHODS

All fourth-year undergraduate dental students (n = 69, response rate = 100%) participated in the Photodentistry learning activity developed by specialists from the areas of dentistry, arts, education, and psychology. A survey using the Toronto Empathy Questionnaire (TEQ) was conducted both pretest and posttest, followed by an open-ended written survey of their reflection towards the learning activity. Quantitative data were analyzed via paired t-test (P < 0.05), while qualitative data were analyzed using thematic analysis.

RESULTS

There was a significant increase in both students' total mean empathy score and the individual scores for 8 (out of 16) items of the TEQ after the learning activity. Students stated that they had an improved understanding of managing patients in a comprehensive manner (e.g., managing medically compromised patients, performing treatment planning, communication with patients who have special health care needs). Students also reported the development of skills (e.g., observation, critical thinking) and positive attitudes (e.g., empathy, responsibility) towards patients.

CONCLUSION

Photodentistry is an effective learning approach for improving dental students' empathy and learning experience in comprehensive patient care.

Reflecting Art in Nursing Practice: Developing Visual Arts Programs to Transform and Strengthen Practice

Despite evidence of its positive impact on observation, description, empathy, and self-care, few arts-related professional development opportunities exist for nurses in practice settings. This academic medical center launched a 4-part visual arts-humanities professional development workshop for RNs to enhance their clinical skills through reflective activities and guided conversations of art. Participating RNs provided written feedback of their impressions and reflections on course content and potential personal growth. Participants reported profound changes in their self-awareness in multiple areas, and 3 consistent themes emerged: 1) seeing as enhanced observation; 2) attunement, and 3) thinking shifts. The workshop also provided respite from patient care demands for professional development and opportunities to cultivate collegial relationships among nurses from different areas and units. These findings underscore the value of the Quadruple Aim, which focuses on workplace practices that promote a sense of well-being and meaning at work. Consistent support from the chief nursing officer and nursing leadership was essential to the success of the program.

The TRANScending Love Arts-Based Workshop to Address Self-Acceptance and Intersectional Stigma Among Transgender Women of Color in Toronto, Canada: Findings from a Qualitative Implementation Science Study

Purpose: Transgender (trans) women of color's HIV vulnerabilities are shaped by social exclusion and intersectional stigma. There is a dearth of tailored HIV prevention interventions with trans women of color in Canada. The objective of the study was to explore trans women of color's HIV prevention priorities and to pilot test an intervention developed from these priorities.

Methods: We conducted a qualitative implementation science study to develop HIV intervention strategies with trans women of color in Toronto, Canada. First, we conducted a focus group with trans women of color (n=8) to explore HIV prevention priorities. Second, we held a consultation with trans women of color community leaders (n=2). Findings informed the development of the TRANScending Love (T-Love) arts-based workshop that we pilot tested with three groups of trans women of color (n=18). Workshops were directly followed by focus groups to examine T-Love products and processes.

Results: Focus group participants called for researchers to shift the focus away from trans women's bodies and HIV risks to address low self-acceptance produced by intersecting forms of stigma. The community leader consultation articulated the potential for strengths-focused arts-based approaches to address self-worth. T-Love participants described how workshops fostered self-acceptance and built connections between trans women of color.

Conclusions: Findings demonstrate the feasibility and acceptability of an arts-based strategy with trans women of color to elicit group-based sharing of journeys to self-acceptance, fostering feelings of solidarity and connection. Providing opportunities for dialogue and reflection about individual and collective strengths may reduce internalized stigma among trans women of color.