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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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2
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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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3
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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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4
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Koshy AJ. Art and activism in medical education: a modern necessity. Int Rev Psychiatry 2023; 35:619-622. [PMID: 38461389 DOI: 10.1080/09540261.2023.2260475] [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: 09/14/2023] [Indexed: 03/11/2024]
Abstract
Artivism is the use of visual art to promote activism and foster meaningful action and change. This commentary argues that artivism should be embraced and utilised more consistently in medical education and healthcare advocacy related efforts. A brief history of artivism, rationale for use, and one approach for implementation based on the author's experience is shared.
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Affiliation(s)
- Anson J Koshy
- McGovern Center for Humanities and Ethics, John P. McGovern Medical School, Houston, TX, USA
- Pediatrics, Baylor College of Medicine, Houston, TX, USA
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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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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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Guth T, Medakovich M, Milla SS. Art in medicine: in the classroom, exam room, and Reading room. Int Rev Psychiatry 2023; 35:583-590. [PMID: 38461391 DOI: 10.1080/09540261.2023.2262018] [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: 09/19/2023] [Indexed: 03/11/2024]
Abstract
In this article, the authors discuss the development and current curriculum of the Art in Medicine course at the University of Colorado School of Medicine (CUSOM), developed in collaboration with the Centre for Bioethics and Humanities, and the Denver Art Museum. Examples of art museum-based techniques implemented with medical students are discussed with objectives, methods, and pedagogy highlighted. Translational skillsets for medical professionals, including empathy, tolerance of ambiguity, perspective taking, bias, and communication are emphasised through practice in engagement in visual arts with facilitation by medical faculty and art museum educators. Following the discussion of classroom based activities, two of the co-authors, physician-educators from the CUSOM Departments of Medicine and Radiology, discuss the direct applications and importance of these skillsets in the context of the exam room and the reading room respectively.
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Affiliation(s)
- Todd Guth
- Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | | | - Sarah S Milla
- Department of Radiology, University of Colorado School of Medicine, Aurora, CO, USA
- Department of Radiology, Children's Hospital Colorado, Aurora, CO, USA
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Ballou E, Gaufberg E. Exploring the intersection of psychiatry, art, and medical education through photographic portraits. Int Rev Psychiatry 2023; 35:555-559. [PMID: 38461392 DOI: 10.1080/09540261.2023.2268738] [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: 10/05/2023] [Indexed: 03/11/2024]
Abstract
This paper describes a technique using photographic portraits in medical education to encourage close observation, cultivate empathic curiosity, explore learners' values and beliefs, and to reveal and reflect on fundamental biases. This new and evolving educational method uses the lens of psychotherapy to explore learners' experience of the portrait in a similar way we would discuss a case in psychodynamic supervision. Through close looking and small group engagement, the facilitator creates a space for deeper reflection and collaborative exploration of the therapeutic relationship, with emphasis on countertransference and the role of prior expectations. The exercise strengthens dialectical thinking through perspective-taking, challenging implicit assumptions and fostering cultural humility. Radiologists are taught to look in every corner of the X-ray and to observe each shadow, all while evaluating the entire image. Portraits can be examined in the same way, looking for subtle clues to the personality and history of the subject. Information from other sources confirms, or sometimes profoundly changes, our evaluation. In this example, we use a historical photographic portrait to demonstrate ways of engaging medical learners as they discover common psychotherapeutic approaches. The method has the potential to enhance therapeutic encounters, improve analytical skills and reduce bias.
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Affiliation(s)
- Eloise Ballou
- Instructor in Psychodynamic Psychotherapy, University of Toronto, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Elizabeth Gaufberg
- Center for Professional and Academic Development, Cambridge Health Alliance, Cambridge, MA, USA
- Harvard Medical School, Boston, MA, USA
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Kagan HJ, Yenawine P, Duke L, Stephens MB, Chisolm MS. Visual thinking Strategies and the peril of 'see one, do one, teach one'. Int Rev Psychiatry 2023; 35:663-667. [PMID: 38461393 DOI: 10.1080/09540261.2023.2276377] [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: 06/22/2023] [Accepted: 10/24/2023] [Indexed: 03/11/2024]
Abstract
Visual Thinking Strategies is an arts and humanities pedagogical intervention increasingly incorporated into medical education. As a straightforward method that appears easy to use, its nuances are often overlooked or-less frequently-improperly implemented entirely. Such haphazard use can lead to lessened impact for learners, and result in inconsistent and non-generalizable findings in studies in the nascent field of arts and humanities medical education. Critical and often glossed-over components of Visual Thinking Strategies include choosing the appropriate artwork, adhering to the specific 3-question language of the method, facilitating dialogue with effective paraphrasing, framing and linking of participant comments, intentionally utilizing non-verbal communication, and carefully setting up the environment. These components can be systematically taught by strengthening Visual Thinking Strategies training for faculty and adopting faculty development techniques from the K-12 education realm, namely peer and video feedback, where VTS has been used and fine-tuned for decades. It is an opportune time to begin rigorous faculty coaching for Visual Thinking Strategies facilitation and set the standard for art and humanities interventions in medical education.
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Affiliation(s)
- Heather J Kagan
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
- Weill Cornell College of Medicine, New York, USA
| | | | - Linda Duke
- Marianna Kistler Beach Museum of Art, Kansas State University, Manhattan, KS, USA
| | - Mark B Stephens
- Pennsylvania State College of Medicine, University Park, Pennsylvania
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Rezaei S, Childress A, Kaul B, Rosales KM, Newell A, Rose S. Using Visual Arts Education and Reflective Practice to Increase Empathy and Perspective Taking in Medical Students. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2023; 19:11346. [PMID: 37745278 PMCID: PMC10514245 DOI: 10.15766/mep_2374-8265.11346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 06/13/2023] [Indexed: 09/26/2023]
Abstract
Introduction Empathy is a critical competency for health care providers. However, empathy levels in medical students and residents have been shown to paradoxically decrease during training. Arts and humanities education and reflective practice may reduce burnout and promote empathy during medical school. Methods We developed and implemented an art education elective for medical students focusing on observation and reflective practice and measured its impact on empathy. Between 2017 and 2022, first-year medical students were offered an annual, 4-week elective led by art educators that featured visualization exercises and discussions on the role of bias and perspective in art interpretation. Curriculum effectiveness and impact on empathy were measured using the validated Interpersonal Reactivity Index (IRI) and self-assessments. Results One hundred twenty-eight students participated in the elective over a 5-year period; 89 (70%) completed assessments. Students reported improvements in empathic communication, recognition of bias, and observation skills. IRI data demonstrated a significant increase in perspective taking (19.0 vs. 20.2; p < .0125). Discussion Participation in the elective was associated with self-reported improvements in visual observation, awareness of bias, and empathetic communication. IRI results showed that participants also demonstrated improved perspective taking. Since perspective taking is a cognitive component of empathy, we have provided some empirical evidence that arts education in medical school can promote empathic attitudes and skills.
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Affiliation(s)
- Sina Rezaei
- Fourth-Year Resident, Department of Ophthalmology, Henry Ford Hospital
| | - Andrew Childress
- Assistant Professor, Center for Medical Ethics and Health Policy, Baylor College of Medicine
| | - Bhavika Kaul
- Assistant Professor, Department of Medicine, University of California, San Francisco, School of Medicine
| | | | - Alana Newell
- Assistant Professor, Center for Educational Outreach, Baylor College of Medicine
| | - Stacey Rose
- Associate Professor, Department of Internal Medicine, and Associate Director, Center for Professionalism, Baylor College of Medicine
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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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Brand G, Wise S, Bedi G, Kickett R. Embedding Indigenous knowledges and voices in planetary health education. Lancet Planet Health 2023; 7:e97-e102. [PMID: 36608956 DOI: 10.1016/s2542-5196(22)00308-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 11/01/2022] [Accepted: 11/10/2022] [Indexed: 06/17/2023]
Abstract
Internationally, the health-care sector has been slower than many other sectors in reducing its carbon emissions and broader environmental footprint. Incrementally, tertiary education institutions are changing their focus to integrate environmental and social objectives, including planetary health, into teaching, research, and how the campus is operated. Planetary health and sustainable health-care are emerging topics in the education of health professionals. However, they have largely been limited to specific knowledge rooted in western epistemology with ad hoc curricula that do not consider the complex interdependence of ecosystems and human health. Because of the need to prepare the current and future health-care workforce for planetary consciousness and related practices, in this Personal View we provide an innovative case study that uses Indigenist health humanities (eg, narrative portraiture) and arts-based education strategies to offer a different way of seeing, knowing, and understanding planetary health. Embedding Indigenous knowledges and voices into planetary health education is an important first step in decolonising learning in health professional education.
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Affiliation(s)
- Gabrielle Brand
- Monash Nursing and Midwifery, Monash University, Frankston, VIC, Australia; Monash Centre for Scholarship in Health Education, Monash University, Frankston, VIC, Australia.
| | - Steve Wise
- 27Creative Photography Design, Perth, WA, Australia; Medical Multimedia Design Department, Royal Perth Hospital, Perth, WA, Australia; Australian Institute of Medical and Biological Illustration, Melbourne, VIC, Australia
| | - Gitanjali Bedi
- Monash Sustainable Development Institute, Monash University, Frankston, VIC, Australia
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