Impacts of "Diabetes Theater," a participative educational workshop for health care professionals, on participants: a patient empowerment perspective

Introduction

Patient empowerment, as part of patient-centered care, is important in the treatment of diabetes. However, this concept is still not well-understood by healthcare professionals, because it differs substantially from traditional approaches. We developed the "Diabetes Theater" workshop to promote a better understanding of patient empowerment. The present study sought to characterize the learning experience and impact of Diabetes Theater on participants' perceptions regarding patient empowerment.

Methods

We analyzed the data using mixed methods. Quantitative data were collected using a questionnaire with a five-item, 11-point Likert scale derived from the Diabetes Attitude Scale. The qualitative component asked the question "If you had to tell your colleagues at work two things you felt or learned at the Diabetes Theater, what would they be?" Quantitative data were analyzed using t tests, and free-text responses were analyzed using Steps for Coding and Theorization.

Results

We received 131 responses. Nurses were the most numerous respondents, followed by dietitians, physicians, and pharmacists. Scores for the five items after participation increased in the direction of promoting participants' understanding of and attitudes toward patient empowerment compared to pre-participation. Scores for most questions increased significantly, regardless of the participants' occupation. In their answers to the open-ended questions, participants reported that they had learned about patient empowerment.

Discussion

Diabetes Theater appears to be a useful method for healthcare professionals to accurately understand the philosophy of patient empowerment in diabetes.

Aging as Adaptation

In traditional gerontological terms, adaptation is usually understood as the production of physical aids to mitigate the impairment effects caused by age-related disabilities, or as those alterations organizations need to make under the concept of reasonable adjustment to prevent age discrimination (in the UK, e.g., age has been a protected characteristic under the Equality Act since 2010). This article will be the first to examine aging in relation to theories of adaptation within cultural studies and the humanities. It is thus an interdisciplinary intervention within the field of cultural gerontology and cultural theories of adaptation. Adaptation studies in cultural studies and the humanities have moved away from fidelity criticism (the issue of how faithful an adaptation is to its original) toward thinking of adaptation as a creative, improvisational space. We ask if theories of adaptation as understood within cultural studies and the humanities can help us develop a more productive and creative way of conceptualizing the aging process, which reframes aging in terms of transformational and collaborative adaptation. Moreover, for women in particular, this process of adaptation involves engagement with ideas of women's experience that encompass an adaptive, intergenerational understanding of feminism. Our article draws on interviews with the producer and scriptwriter of the Representage theater group's play My Turn Now. The script for the play is adapted from a 1993 coauthored book written by a group of 6 women who were then in their 60s and 70s, who founded a networking group for older women.

Using nominal group technique to determine skills that applied improvisation can teach health profession education learners

Objective

Applied improvisation (AI) is an approach used in health professions (HP) education to teach skills essential for clinical practice such as communication, teamwork, and empathy. Little is known about which skills can be developed using AI, or those which an AI should prioritize. Our research aims to identify skills essential to include in an AI curriculum for HP learners.

Methods

A modified nominal group technique (NGT) was conducted to identify and prioritize specific skills which can be taught using AI. This involved silent generation of ideas, round robin, discussions, 2-rounds of preliminary voting, and a final ranking survey to determine a prioritized list of skills to include in an AI curriculum for HP learners.

Results

Six content experts participated in the NGT meeting. Initially, 83 skills were identified, and through NGT, a final list of 11 skills essential to an AI curriculum were determined including: adaptability, affirmation of others, acceptance, active listening, being present, cooperation, collaboration with other, advancement, compassionate communication, sharpened non-verbal communication, resilience.

Conclusion

Essential skills for an AI curriculum relate to adaptability, attunement, collaboration, affirmation, and advancement.

Innovation

This study is a novel application of NGT as a strategy to organize an approach to curriculum innovations.

Connecting improvisational exercises and pharmacy communication skills: A how-to guide

BACKGROUND AND PURPOSE

Medical improvisation (improv) is increasingly being used to teach physicians, nurses, and other caregivers how to better communicate with patients and other members of the healthcare team. This article describes how improvisational activities were incorporated within an existing pharmacy practice lab course and how to implement improv games targeting specific communication skills.

EDUCATIONAL ACTIVITY AND SETTING

Three hours of improvisational activities were incorporated into a semester-long pharmacy practice lab course. Partner games such as "the mirror" and group games such as "out-of-order story" were played and connected to communication skills related to counseling or taking a patient's history. Additional activities were introduced targeting specific areas of weakness identified in a formative assessment.

FINDINGS

A survey was used to assess student perceptions of the improv activities. Students were largely able to connect the skills learned in improv to pharmacy, and some provided examples of how they were already implementing these skills in practice.

SUMMARY

This article provides a user manual so that faculty with little to no improv experience can include these activities in their communications courses.

Evaluation of a pilot, community-led mental illness de-stigmatization theater intervention in rural uganda

BACKGROUND

In rural areas of low- and middle- income countries, mental health care is often unavailable and inaccessible, and stigma is a major barrier to treatment. Destigmatization can increase treatment-seeking attitudes, community support, and acceptance of individuals suffering from mental illness. This study's primary objective was to evaluate the impact of a community-led, theater-based destigmatization campaign for mental illness conducted in the Busoga region of Eastern Uganda.

METHODS

One hundred residents of the Busoga region were randomly selected via cluster sampling to complete a structured questionnaire assessing mental health stigma. Four focus groups were conducted for qualitative data on mental health stigma. Common misconceptions and specific points of stigma were identified from these responses, and local village health team personnel developed and performed a culturally-adapted theatrical performance addressing these points. Changes in perceptions of mental illness were measured among 57 attendees using two measures, the Broad Acceptance Scale (designed to reflect factors that contribute to structural stigma) and Personal Acceptance Scale (designed to reflect factors that contribute to interpersonal, or public stigma), before and after the performance.

RESULTS

There was a significant increase in acceptance according to the Broad Acceptance Scale (p < .001) and Personal Acceptance Scale (p < .001). Qualitative responses from play attendees also indicated a decrease in stigma and an increased sense of the importance of seeking treatment for mentally ill patients.

CONCLUSION

This study shows community-led, theater intervention may be an effective tool for the destigmatization of mental illness in rural areas of Uganda. Larger studies are needed to further test the efficacy of this approach and potential for longer-term scalabilityand sustainability.

Using Forum Theater as a Teaching Tool to Combat Patient Bias Directed Toward Health Care Professionals

INTRODUCTION

Health care professionals who identify as members of underrepresented and racial minority groups may experience bias from patients and patient families. These occurrences disrupt the educational and therapeutic environments, distress the targeted individuals and allies, and create potential legal liability. Yet there are few educational opportunities for individuals to brainstorm and implement strategies for responding professionally during such instances.

METHODS

Presented first as a grand rounds, then an invited workshop, and finally an invited series, this educational activity was developed in a stepwise manner over the course of a year. Each format was sequentially modified based on feedback from participants-more than 200 physicians and other health care professionals-using evaluation forms that were voluntary and anonymous. The educational activity used an adaptation of forum theater, in which participants role-played an instance of oppression with a goal of altering the ultimate outcome. This approach provided participants with the opportunity to develop and rehearse responses to workplace bias in a way that preserved the provider-patient relationship.

RESULTS

Feedback for these educational sessions was overwhelmingly positive. Participants noted the importance of acknowledging and addressing bias in the workplace and encouraged facilitators to expand the sessions in length, frequency, and scope.

DISCUSSION

Forum theater is a methodology that can be employed in health care to teach appropriate and authentic responses to expressed patient bias while maintaining the therapeutic relationship. The positive reception from participants in our preliminary sessions established a strong foundation for future improvements to this work.

Concussions in Dancers and Other Performing Artists

Dancers and other performing artists are subject to head impacts that result in concussion-like symptoms. In spite of this, performing arts do not have access to the continual, focused emphasis on the diagnosis, management, and prevention of concussions that is commonplace in sports. Performing arts present a unique environment in which concussions occur and must be managed. This article outlines what is known about performing arts concussions, describes mechanisms of head impacts sustained by participants in dance and the related artforms of theater, circus, and film and television stunts, and offers concussion management guidelines for these artistic fields.

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The present contribution analyses the nervousness and neurasthenia discourse in the early Soviet Union. Its focus is on psycho‐hygienic plays staged by the Moscow Theatre for Sanitary Culture. It asks in which images, figures and actions a knowledge about the nervous disorder was presented on stage, which genre traditions and communicative instruments were used and on which changing political implications those performances were based. To obtain this the archive sources, selected texts of neurasthenic dramas, reports and reviews in daily press have been evaluated.

The Immersive Theater Experience for Individuals with Autism Spectrum Disorder

Despite growing public awareness of ASD, many caregivers of children with ASD struggle to find opportunities for participation in community activities with appropriate accommodations. The current study evaluated the experiences of individuals with ASD who attended immersive theater performances specifically designed for individuals with ASD. Parents and teachers of 256 children and adolescents completed questionnaires regarding their pre-show expectations and post-show satisfaction with the performance. Analyses revealed that, on average, parents' and teachers' levels of satisfaction significantly outweighed their pre-show expectations. Based on researcher observations, audience feedback, and past research, a list of best practices for successful theater programming for individuals with ASD was compiled with the goal of widespread dissemination to increase accessibility of theater performances for neurodiverse audiences.

Rise Up, Get Tested, and Live: an Arts-Based Colorectal Cancer Educational Program in a Faith-Based Setting

Engaging community members in efforts to reduce cancer-related health disparities through community mini-grant programs has been shown to have meaningful impact. A predominantly African-American church in South Carolina was awarded a community mini-grant to increase awareness about colorectal cancer (CRC) screening among disproportionally high-risk African-American communities through culturally appropriate arts-based cancer education. The church's pastor, health and wellness ministry, and drama ministry created a theatrical production called Rise Up, Get Tested, and Live. Over 100 attendees viewed the play. A pre/post-test evaluation design assessed the effectiveness of the production in increasing participants' knowledge about CRC and examined their intentions to be screened. Results showed increased knowledge about CRC, increased awareness and understanding about the importance of CRC screening, and favorable intentions about CRC screening. Findings suggest that arts-based cancer education may be an effective tool for the dissemination of information about CRC screening.

The Cosmos in a Cabinet: Performance, Politics, and Mechanical Philosophy in Henry Bridges' 'Microcosm'

How did ordinary people - artisans, laborers, servants, and children - come to know the Newtonian universe? And what effects did this knowledge have on how they contextualized their place in society? When it appeared in 1733, Henry Bridges' "Modern Microcosm" promised to give paying customers a view of the entire universe ingeniously recreated in a ten-foot-tall automaton theater. A hit with audiences, this clockwork wonder was displayed in Britain and the American colonies until disappearing mysteriously in the 1770s. This paper attempts to recover non-elite understandings of public science by examining the career of an astronomical wonder in the rowdy marketplace of ideas that was the London show scene.

Active Learning on Center Stage: Theater as a Tool for Medical Education

INTRODUCTION

Knowledge and skill development related to communication must incorporate both affective and behavioral components, which are often difficult to deliver in a learning activity. Using theater techniques and principles can provide medical educators with tools to teach communication concepts.

METHODS

This 75-minute faculty development workshop presents a variety of techniques from theater and adapts them for use in medical education. Using examples related to diversity and inclusion, this session addresses general educational and theater principles, role-play, sociodrama, applied improvisation, and practical aspects of involving theater partners. The session materials include a PowerPoint presentation with facilitator notes, interactive activities to demonstrate each modality, and an evaluation. The sessions can be extended to longer formats as needed.

RESULTS

Forty-five participants at Learn Serve Lead 2016: The AAMC Annual Meeting attended the 75-minute session. We emailed 32 participants 5 months after the conference, and eight responded. Participants reported that their confidence level in using theater techniques as a tool for medical education increased from low-to-medium confidence presession to high confidence postsession. All survey respondents who were actively teaching said they had made changes to their teaching based on the workshop. All commented that they appreciated the active learning in the session. Many indicated they would appreciate video or other follow-up resources.

DISCUSSION

Principles and techniques from theater are effective tools to convey difficult-to-teach concepts related to communication. This workshop presents tools to implement activities in teaching these difficult concepts.

Examining the Impact of This Is My Brave on Mental Illness Stigma and Willingness to Seek Help: A Pilot Study

This Is My Brave (TIMB) is a contact-based mental illness stigma reduction program, set in theaters, meant to reduce stigma, increase beliefs about empowerment and recovery, and improve attitudes towards treatment seeking for mental health concerns. The authors conducted the first empirical evaluation of TIMB using a pre-post survey design. Approximately 481 audience members of TIMB performances were invited to complete a survey of stigmatizing attitudes towards mental illness, beliefs about recovery and empowerment, and willingness to seek treatment at pre-and post-performance. Analyses of responses from 372 participants using paired samples t-tests revealed changes in the desired direction on all variables from pre-test to post-test. Audience members experienced a decrease in stigma, improvements in beliefs about recovery and empowerment, and greater willingness to seek treatment. TIMB is a promising stigma-reduction program and there is a need for a more detailed investigation of the program's impact using more rigorous methodology.

Pilot assessment of two disordered eating prevention programs. Preliminary findings on maladaptive beliefs related to eating disorders

AIMS

As eating disorders have severe consequences, they require prevention. We aimed to compare maladaptive beliefs related to eating disorders by following two programs based on media literacy in adolescents at post-test intervention, and after 6 and 12month-follow-ups. The Male and Female Nutrition and Media Literacy Model preventive program (NUT+MEF+MEM+ML in Spanish) and the Theater Alive program are both based on the same contents, the former being presented in a multimedia and interactive format and the latter in a drama format. Both were compared to a control group without intervention, whose participants received usual classes before the assessments.

METHOD

Participants were 178 adolescents in the second year of compulsory secondary education from fours schools of Terrassa (Catalonia, Spain). All participants in each school were assigned to the same group, depending on school schedules. A mixed 3 (group: Theater Alive, NUT+MEF+MEM+ML, control)×3 (time: post-test, 6-month-follow-up, 12-month-follow-up) factorial design was used to evaluate the effect on maladaptive beliefs measured using a CE-TCA tool.

RESULTS

When compared to the control group, both Theater Alive (d=0.88) and NUT+MEM+MEF+ML (d=0.60) obtained lower scores over time, the latter being not statistically significant.

DISCUSSION

The Theater Alive program may produce an effect of cognitive dissonance that might eliminate the discrepancy between the contents of the play and those that are internalized, thus modifying maladaptive beliefs. Participants in the Theater Alive program, as actors in front of an audience, had to defend certain content that was rehearsed over and over again to the point until it became internalized.

The Cultural Value of Older People's Experiences of Theater-making: A Review

Purpose of the Study

Although a number of existing reviews document the health and social benefits of arts participation by older people, there are none which focus specifically on theater and drama. This article presents the findings of a study conducted as part of the UK's Arts and Humanities Research Council "Cultural Value Project." The 2-year (2013-2015) "Cultural Value Project" sought to make a major contribution to how we think about the value of arts and culture to individuals and to society. It made 72 awards: 19 critical reviews of existing bodies of research, 46 research development awards to carry out new research, and 7 expert workshop awards to facilitate discussions among academics and practitioners. Together, these awards explored the components of cultural value and the ways in which cultural value is evidenced and evaluated.

Design and Methods

Following an extensive search of academic databases and E-mail requests via relevant organizations and networks, 77 publications formed the basis for our own critical review.

Results

Our findings highlight the benefits and value of older people's theater and drama participation on health and well-being, group relationships, learning and creativity, and draw attention to the importance of the esthetic value and quality of older people's drama.

Implications

Despite the recent surge of interest in this field (a third of the reviewed literature was published between 2010 and 2014), we suggest that there are multiple areas for further research.

Using a community theatre as a self-directed introductory pharmacy practice experience (SD IPPE) site

OBJECTIVE

To describe a novel setting and method for self-directed introductory pharmacy practice experiences (SD IPPE).

METHODS

Students presented health care information relative to the plot of a production at a local community theater throughout the season. Students developed a poster and handout that were presented in the theater lobby prior to each production.

ASSESSMENT

A six-question survey was provided to students after each presentation that identified their perceived benefit to play patrons and their overall experience using a 5-point Likert scale.

IMPLICATIONS

Completing SD IPPE in a theater is a novel and innovative concept. Data suggest that students prefer presenting information in non-traditional settings. Students felt their work enhanced the theatrical experience of patrons. Results demonstrate that the theater is a viable setting for future presentations that benefit both students and public.

"There's No Correspondence Between Me and My Age": Old Age in Theresia Walser's King Kong's Daughters

PURPOSE OF THE STUDY

Against the context of a rapidly aging population, the theme of senescence has been figuring increasingly prominently in contemporary German theater. This paper discusses the depiction of old age in one notable example, Theresia Walser's King Kong's Daughters, a hugely successful black comedy set in a nursing home.

DESIGN AND METHODS

This paper takes an interdisciplinary approach in its analysis of Walser's play, drawing not just on drama and theater studies, but also on performance, film, and cultural studies as well as the sociology and psychology of aging.

RESULTS

King Kong's Daughters might seem to be pervaded with negative ageist stereotypes. It is argued here, however, that Walser skillfully exploits the special formal qualities of theatrical performance--in particular, its liveness, corporeality, and communality--to illuminate both what it is like to be old and what it is like to care for the elderly in today's world.

IMPLICATIONS

Given demographic developments, senescence seems set to increasingly inform the themes, motifs, and characters of theater in Germany and beyond. Paying closer attention to how old age is invoked on the contemporary stage can generate insights that are not only of interest to theater scholars, but are also of value to gerontologists and age scholars more generally.

Bühnen des Kapitalismus: Der Getreidehandel als Wissensobjekt zwischen den Weltkriegen

Capitalism on Stage: Grain Trade as Objects of Knowledge During the Interwar Period. Between 1900 and 1930 the worldwide grain markets attained considerable attention in literature (Frank Norris' novel The Pit of 1903), cinema (D. W. Griffith's A Corner in Wheat of 1909), theatre (Bertolt Brecht's unfinished play fragment Jae Fleischhacker in Chikago, 1924-1926), politics (e. g. Report of the Federal Trade Commission on the Grain Trade, 1920-1926) and economics (e. g. Wheat Studies by the Food Research Institute at Stanford University, 1924-1944). The paper discusses grain trade as objects of knowledge in paradoxical situations and entails a parallel reading of these texts by analyzing their epistemic practices and narrative techniques. Bertolt Brecht's comprehensive plan to depict the laws of the allocation and distribution of grain markets on stage failed in 1926 and he turned to Marxism. In the meantime economic research focused on the aggregation of statistics relating to world grain supplies and prices. Studies about the relation between changes in the volumes of stocks and phases of trade cycles served furthermore as material for John Maynard Keynes' abolition of the classical theory around 1930.