Improvisational and Standup Comedy, Graphic Medicine, and Theatre of the Oppressed to Teach Advancing Health Equity

Development and delivery of justice, equity, diversity, inclusion, and anti-oppression concepts in entry-level health professional education: A scoping review: BEME Guide No. 88

PURPOSE

Justice, equity, diversity, inclusion (JEDI), and anti-oppression (AO) concepts are necessary in healthcare settings to promote culturally safe and high-quality care; however, entry-level healthcare program curricula (EHPPC) may lack adequate integration and/or delivery of these concepts. The primary aim of this scoping review is to identify what guidelines, frameworks, and models (GFMs) are used, and how they are used, to develop and deliver JEDI, and AO concepts in mandatory EHPPC.

METHODS

A search of Ovid MEDLINE, Ovid EMBASE, and CINAHL was conducted for studies published in English from 2015 onwards that discuss what GFMs are included in mandatory EHPPC and how they guide the development and/or delivery of JEDI and/or AO concepts. Data from the included studies was collated into themes which were presented in tables and figures and described in narrative summaries.

RESULTS

Sixty-one studies from various healthcare programs including medicine, nursing, pharmacy, dentistry, and dietetics were included in this review. Data from the studies were organized into eight categories: GFMs, concepts, methods of evaluation, length and frequency of sessions, modes of delivery, learning activities, and training of curricular developers and facilitators.

CONCLUSIONS

GFMs are used in a variety of ways to integrate JEDI and/or AO concepts into health professional curriculum. Variability in the training of developers and facilitators of curricular concepts also exists. Future research is needed to determine if consistent or variable GFMs, as well as JEDI and/or AO developer and facilitator training, would be more effective for students' learning of these concepts.

Medicine at theatre: a tool for well-being and health-care education

Effective communication plays a crucial role in healthcare settings, as it enhances patient outcomes and improves the overall quality of care and well-being. The rationale for this study was to use theater as a communicative tool by playing stories related to some important healthcare issues. The specific goal was to study the effectiveness of a specially designed theater intervention in enhancing psychological well-being and awareness of some aspects such as the doctor-patient relationships, communication skills, pro-social behavior, and empathy. A pre- and post-experience questionnaire was used to track the audience's response. The results indicate that theater can efficiently promote well-being and spread crucial awareness about healthcare-related issues. Furthermore, the study underscores the varying perceptions and evaluations of health-related topics among individuals based on their age. Finally, we would like to underlie that theatre can also be a valuable tool for health communication. Clinical trial numberNot applicable.

Theatre of the Oppressed to Teach Medical Students About Power, Lived Experience, and Health Equity

BACKGROUND

A difficult challenge in health equity training is conducting honest and safe discussions about differences in lived experience based on social identity, and how racism and other systems of oppression impact health care.

OBJECTIVE

To evaluate a Theatre of the Oppressed workshop for medical students that examines systems of oppression as related to lived health care experiences.

DESIGN

Mixed-methods cross-sectional survey and interviews.

PARTICIPANTS

Forty randomly assigned early first-year medical students.

INTERVENTIONS

A 90-min virtual workshop with three clinical scenes created by students where a character is being discriminated against or oppressed. During performance, students can stop scene, replace oppressed character, and role play how they would address harm, marginalization, and power imbalance. Participants discuss what they have witnessed and experienced.

MAIN MEASURES/APPROACH

Likert-scale questions assessing workshop's impact. Open-ended survey questions and interviews about workshop.

KEY RESULTS

Thirty-one (78%) of 40 participants completed the survey. Fifty-three percent were female. Thirty-seven percent were White, 33% Asian American, 15% Black, 11% Latinx, and 4% multiracial. Ninety percent thought this training could help them take better care of patients with lived experiences different from their own. Most agreed or strongly agreed the workshop helped them develop listening (23, 77%) and observation (26, 84%) skills. Twelve (39%) students felt stressed, while 29 (94%) felt safe. Twenty-five (81%) students agreed or strongly agreed there were meaningful discussions about systemic inequities. Students reported the workshop helped them step into others' shoes, understand intersectional experiences of multiple identities, and discuss navigating and addressing bias, discrimination, social drivers of health, hierarchy, power structures, and systems of oppression. Some thought it was difficult to have open discussions because of fear of being poorly perceived by peers.

CONCLUSIONS

Theatre of the Oppressed enabled medical students to engage in meaningful discussions about racism and other systems of oppression.

Exploring the Scope of Theater of the Oppressed in Medical Education

Theater of the oppressed has been regarded as a dynamic tool to bring about social change and empowerment of the audience. This theatrical exposure to medical students plays a significant role in the delivery of comprehensive training to medical students, which is not only restricted to clinical knowledge but extends to cultural and interpersonal skills to ensure the delivery of comprehensive patient care. In conclusion, the theater of the oppressed has the potential to prepare empathetic and compassionate medical practitioners. To augment the quality of healthcare delivery, this kind of exposure can help medical students in bridging the gap between theory and clinical practice.

Applied Improvisation: Putting Behavioral Skills Center Stage in Simulation-Based Team Training

SUMMARY STATEMENT

Behavioral skills, sometimes referred to as nontechnical skills or team-based skills, are fundamental to simulation-based team training. These skills should be afforded the same deliberate practice and development as clinical knowledge and procedural skills in health care education. Applied improvisation, the use of theater games designed to improve individual and team performance, is gaining traction in health care education to train behavioral skills. Simulation educators are experts in experiential learning with debriefing and therefore well poised to incorporate applied improvisational exercises into team training activities.