Please find below the abstracts of all scheduled short presentations./ Vous trouverez ci-dessous les résumés des courtes présentations inscrites à l’horaire du colloque.
_____________________________________________________
Conversations Worth Starting: Utilizing Art as Connective Tissue in Health Perceptions
Sara Kohrt, Columbia University
Friday April 15 / Vendredi 15 avril
15h00-15h10
Fairmount Queen Elizabeth / Convention Floor/ Matapédia
I would like to share a photography + research project that I’m working on about human bodies and the perception of beauty, flaws and resulting sense of isolation. Without integration, what is self-perceived as flawed becomes spectacular, unacceptable parts of oneself, and remain relegated to either psychological fixation or public shaming. Bodies hold the tendency to blind us. This project opens discussion with the offer to take off part of that blindfold for people, and to share reactions to images which make people feel exposed themselves. This exhibit is not intended to merely point out parts of another, but self as well – by highlighting large scale black and white macro photographs of anonymous models unapologetically in an artistic fashion. A vital aspect of the exhibit was inviting viewers to become an integral part by asking for feedback. Both digital and physical options were offered, and so far, about 230 responses have been included in the project results. The responses definitely change both the meaning and the outcome of the exhibit. The most rewarding observation is that the images are making for better mirrors than photographs or art. What we once saw as embarrassing about ourselves becomes recognized as something beautiful about someone else, and then also becomes part of the perception of ourselves.
Key words: Photography, PechaKucha, Body psychology
Pourquoi enseigner le narratif aux futurs professionnels de la santé?
Sylvie St-Jacques, Columbia University
Friday April 15 / Vendredi 15 avril
15h10-15h20
Fairmount Queen Elizabeth / Convention Floor/ Matapédia
Transportons-nous dans une salle de cours de l’Université Columbia à New York, au mois de septembre 2015. Une vingtaine d’étudiants à la maîtrise en Médecine Narrative, sous la bienveillante direction du professeur Craig Irvine, ont parcouru ensemble une nouvelle de l’auteur irlandais Colm Toibin, premier auteur à l’étude pendant ce semestre où les Toni Morrison, Paul Ricoeur, Judith Butler, Alison Bechdel, Alice Munro ont fait partie des textes au programme du cours Giving and Receiving Accounts of Self.
Certains des étudiants de Craig Irvine étaient d’aspirants candidats à des études en médecine, l’une d’entre eux étaient une praticienne brésilienne, il y avait une professeur d’anglais à la retraite et il y avait même une journaliste montréalaise passionnée de littérature et de toutes questions relatives à l’état des soins de santé. À l’issue de ce semestre chargé en lectures de textes littéraires et philosophiques et en écriture de textes personnels- chaque classe se termine par un exercice d’écriture bref, ou « prompt »- nos compétences narratives ont été bonifiées par le travail exhaustif de « lecture rapprochée » (close reading) des textes au programme. À la fin du semestre, chaque étudiant devait rapporter (dans un format libre, soit une pièce de théâtre, un poème, un essai…) une expérience d’observation au Allen Presbytarian Hospital.
Le Québec, on le dit souvent, possède une tradition littéraire riche, diverse, foisonnante. Et si, on invitait les Monique Proulx, Michel Tremblay, Hubert Aquin, Nancy Huston, Nelly Arcan à l’hôpital ou dans les cours de médecine? Voici quelques exemples d’oeuvre de fiction (théâtre, littérature, cinéma…). Chemin Saint-Paul de Lise Tremblay, pour réfléchir ensemble sur les impacts interpersonnels de la démence et du grand âge dans les famille. Le coeur de la baleine bleue de Jacques Poulin, pour parler des effets psychiques profonds d’une greffe d’organe. Mommy de Xavier Dolan, pour ouvrir une discussion sur les troubles du comportement.
Je souhaite ainsi, par cette participation, mettre l’accent sur la pertinence de créer un pont entre le monde de la fiction et le récit « réel » de la clinique (ou de l’hôpital.)
Humanity Emergency: Poetry of a Medical Student
Dr. Sarah Fraser, Family Medicine Resident at the Northern Ontario School of Medicine.
Friday April 15 / Vendredi 15 avril
15h20-15h30
Fairmount Queen Elizabeth / Convention Floor/ Matapédia
She will give a Pecha Kucha-style presentation about her recently published book, Humanity Emergency. The book is a collection of poetry chronicling her clinical experiences as a medical student. Studies show that medical students lose empathy as they progress through the course of their training. In Dr. Fraser’s experiences, writing helps in preserving humanity while enhancing medical learning. Do we need more humanity in medicine, and in the world
In fact, it is an emergency.
_____________________________________________________
SP-01
Stasis, Changes and Challenges: A Current Portrayal of Humanities’ Contributions to Canadian Medical Education
Bahar Orang (medical student, McMaster University),
Allan Peterkin MD (University of Toronto),
Natalie Beausoleil PHD (Memorial University),
Monica Kidd MD (University of Calgary),
Pamela Brett-Maclean PHD (University of Alberta) and
Hesam Noroozi MD
Friday April 15 / Vendredi 15 avril
09:30-10:00
Fairmount Queen Elizabeth / Convention Floor/ Hochelaga 5-6
In Canada and elsewhere, the field of humanities in medical education is expanding rapidly. This paper reports on our comprehensive review of humanities curricula in all Canadian undergraduate medical schools. This study was inspired by the crucial work of Kidd and Connor (2008) and aims to explore and update the current Canadian landscape of humanities in medical education. Through a combination of online surveys and telephone interviews with key informants from each school, we inquired into the diverse humanities initiatives in medical faculties across the country. This study adopts a reflexive and critical medical humanities framework. We recognize the heterogeneity and fluidity of medical humanities as a field in our country and elsewhere. In this presentation we provide an analysis of the participants’ experiences and assessments of the field in Canada. Participants outlined both the successes and the barriers they have encountered in their involvement with medical humanities. Each of us also shared our own history and insights into medical humanities education initiatives. This exploration of the current Canadian situation aims to provide insights beneficial to medical students, clinicians, health professionals, administrators, teachers and researchers, and hopefully will enable further collaboration and fruitful linkages among proponents of health humanities in the country.
Reference:
Kidd, M. G., & Connor, J. T. (2008). Striving to do good things: Teaching humanities in Canadian medical schools. Journal of Medical Humanities, 29(1), 45-54.
Key words: medical humanities, health humanities, undergraduate medical education curricula, Canada
_________________________________________________________
SP-02
Re-shaping the landscape of medicine for aesthetic and political engagement
Professor Alan Bleakley, Emeritus Professor of Medical Education and Medical Humanities, University of Plymouth Peninsula Medical School, UK
Friday April 15 / Vendredi 15 avril
11:30-12:00
Fairmount Queen Elizabeth / Convention Floor/ Hochelaga 5
Medicine inhabits an historically-shaped landscape that refuses authentic engagement with social justice and accountability. This landscape is shaped by the metaphors of an industrial-military complex where war is waged on disease and the body is a machine. How can this landscape be re-shaped to create the necessary conditions for democratizing medical culture and educating for democratic habits? Properly introduced into the curriculum as core and integrated, a medical/health humanities perspective can reveal the intrinsic beauty of science, and educate for an engaged aesthetics and politics of clinical practice. Doctors should become connoisseurs in diagnostic acumen through education of sensibility, and humane and engaged communicators with patients and colleagues through education of sensitivity. This cannot occur unless three conditions are met: (i) a redistribution of sensibility capital through medical education; (ii) the politicizing and feminizing of medical students and junior doctors (to offer resistance to established authoritarian structures through engagement with collaborative teamwork and patient- and population-centred practices); and (iii) the aestheticizing of students to develop a new landscape of metaphor in medicine that challenges the lingering presence of the industrial-military complex. Drawing on three recent books arguing for the value of the medical/health humanities in re-designing medicine undergraduate curricula, Alan Bleakley (2011, 2014, 205) will set out an agenda for a radical change in healthcare education where practitioners develop connoisseurship and act as political agents of resistance through a re-distribution of sensibility capital and a democratizing of practice, resulting in a re-shaping of the embodied metaphorical landscape of medicine.
References
Bleakley A, Bligh J, & Browne J. (2011). Medical Education for the Future: Identity, Power and Location. Dordrecht: Springer.
Bleakley A. (2014). Patient-Centred Medicine in Transition: The Heart of the Matter. Dordrecht: Springer.
Bleakley A. (2015). Medical Humanities and Medical Education: How the medical humanities can shape better doctors. London: Routledge.
Keywords: aesthetics, politics, metaphor
_______________________________________________________
Exploring Student Leadership in Developing the Medicine and Humanities Curriculum
Rayan Delbani, University of Ottawa and Pippa Hall, University of Ottawa
Friday April 15 / Vendredi 15 avril
14:30-15:00
Fairmount Queen Elizabeth / Convention Floor/ Hochelaga 5
Context:
At the University of Ottawa, students are leaders in incorporating humanities into the medical curriculum. Our Medicine and Humanities (M&H) curriculum, available both in French and English, infuses history, philosophy, arts, literature, wellness and mindfulness into our curricular and extracurricular programs.
Intervention:
A dynamic group of motivated students have led innovative initiatives. Representatives from different class promotions and language streams joined faculty to provide ongoing dialogue. Student-selected humanities resources are incorporated into mandatory weekly Case Based Learning scenarios. Students have opportunities to develop their artistic ability, creativity, and personal wellness. These include annual art shows, coffee house performances, a student choir, ethics group discussions, and student-led publications.
Observations:
The perspectives of students who have taken on leadership positions in developing the M&H curriculum are being explored in semi-structured interviews to better understand their roles and motivations. Emerging ideas on their incentives and motivations will be identified. Student’s views on the evolution of the curriculum will be explored and steps they believe should be taken moving forward will be identified.
Discussion:
This study will explore how students identify personal characteristics and motivations that make them passionate about leading components of M&H. We will present their perceptions of the potential impact of the M&H curriculum on their medical experience and on their future as physicians. These students are leaders in our current program, and have a chance to be leaders in creating their own holistic medical experience. This study will help us develop the curriculum and increase student participation.
Key words: leadership, humanities, curriculum
________________________________________________________
How to Understand?: The Radicalization and Diversification of Narrative Medicine
Shane Neilson, BSc MD FCFP MFA MA & PhD Candidate in English and Cultural Studies, McMaster University
Friday April 15 / Vendredi 15 avril
15:00-15:30
Fairmount Queen Elizabeth / Convention Floor/ Hochelaga 5
Scholarship in the discipline of English literary studies has, for over fifty years, diversified to include queer studies, gender studies, race theory, and analysis of social class. Yet for the most part, health humanities initiatives in Canadian universities largely use the lens of narrative medicine as a pedagogical tool. The common theoretical lenses of the English department are absent in the typical instrumentalist medical humanities seminar. The “canon” of Canadian literature has exploded in terms of diversity since the 1960s, but the current deployment of literature in health humanities is insulated from radicalization, from an alterity of knowing. When texts are presented to students to encourage empathy and understanding with suffering/the sufferer, then it is difficult for learners to resist this constructed and endorsed path and instead embark upon a critique of the offered path. In my short presentation, I will argue that the same theoretical tools in the English scholar’s toolkit should be introduced to medical, nursing, physiotherapy, pharmacy, and occupational therapy students in conjunction with the hegemonic narrative medicine model so that: (1) students can be permitted to embrace literature as art, (2) students can analyze literature in complex ways that build upon the insight-based narrative medicine model so as to radicalize that model, and (3) students can become themselves more aware of their own social position, an awareness that is required to encourage the promotion of diversity in the first place.
Keywords: Narrative, literature, diversity
______________________________________________________
Unmasking the Hidden Curriculum: Restoring Health to Undergraduate Education through 1st-Year Narrative Medicine Approaches
Wendy Shilton, PhD (English Department, University of Prince Edward Island)
Jodi Heys (Paramedic; 2nd-Year Psychology Major, University of Prince Edward Island)
Friday April 15 / Vendredi 15 avril
16:00-16:30
Fairmount Queen Elizabeth / Convention Floor/ Hochelaga 5
This joint faculty-student presentation will explore the concept of the “hidden curriculum” as it applies to both healthcare education and studies in writing, rhetoric, and communication. The presenters will argue that the rudiments of narrative medicine can be introduced in first-year undergraduate writing, literature, and writing-intensive courses to provide the best possible foundation for language, interpretive ability, and empathically nuanced communication skills for best practices and outcomes in healthcare training.
The “hidden curriculum” in healthcare education is a phrase that refers to liberal arts areas of study – cultural studies, history, philosophy, the creative and interpretive arts, and so forth – which have critical import for perception, health, and healthcare, but which have been marginalized through decades of scientific positivism and increasingly commodified healthcare systems that suppress cultural difference. In the context of writing and rhetoric studies, “the hidden curriculum” refers to the ever-present but often unseen role of language and rhetorical power in constructing and negotiating meaning in and across all disciplines and cultural contexts both in higher education and in personal and public life. The relatively new field of narrative medicine is a pivotal link between these two “hidden” curricula, with its transformative capacity to build linguistic, analytical, emotional, and cultural competencies essential for providing skillful and caring attention to the presence and impact of stories generated within illness contexts by all involved, regardless of social and cultural position.
The presentation will begin with an overview of the “hidden curriculum” concept and then examine how key capacities identified as “narrative medicine” skills actually are an integral component of rhetorically-informed and well-designed composition and literature courses. It then will examine how such skills can be developed and contemporized innovatively, through relevant cultural content and active-learning pedagogies, to enhance health-explicit topics within a broad range of subjects. Finally, the presentation will shift to a student perspective, examining the impact of returning to university after twenty years of paramedic service and taking a first-year writing and a first-year literature course.
Among the many aha! elements of discovery shared by the latter will be the importance of summary skills; of differentiating rhetorical positions on the subjective-objective continuum; of discerning cultural markers of difference (gender, race, class, religion, etc.) among audiences; of focus and precision in language; of allowing multiple interpretive perspectives; of communicating respect with personal authority; of recognizing “wholeness” when considering the elements of a story, including underlying thoughts and feelings similar to the cognitions and emotions involved in assessing patient conditions; and, perhaps above all, of listening to, being moved by, and responding effectively to the stories of others while holding fast to what matters through skillful communication.
KEY WORDS: Narrative medicine education
______________________________________________________
Lessons from the Field: An analysis of physicians’ and medical learners’ reflective narratives
Tracy Moniz, Department of Communication Studies, Mount Saint Vincent University
Chris Watling, Centre for Education Research and Innovation, Western University
Lorelei Lingard, Centre for Education Research and Innovation, Western University
Friday April 15 / Vendredi 15 avril
16:30-17:00
Fairmount Queen Elizabeth / Convention Floor/ Hochelaga 5
Previous studies of reflective narratives written by physicians, residents and medical students tend to reflect thematic analyses of content in narrative responses to specific, leading questions or writing prompts generated through surveys, interviews, or coursework.
This study explores the stories that these groups spontaneously chose to tell about the practice of medicine in narrative sections of medical journals, focusing on the lessons conveyed through their stories, the narrative strategies used to convey them, and the relationships between the two. Using a narrative analysis approach, we analyzed 50 articles published in the narrative sections of three international medical education journals between May 2011 and July 2013.
Our findings suggest that the stories often involved physicians reflecting meaningfully on their roles in society and on their personal and professional identities. Each of the stories conveyed a lesson for the reader, usually explicitly. Recurring lessons included: (1) Practicing medicine is a privilege, (2) Patients are vulnerable, (3) Physicians are fallible, (4) Humanity matters, and (5) The “system” is flawed. These lessons were told using one of a narrow range of narrative strategies: a lament, a hero story, a quest, an awakening, a rediscovery, and a testimony. The relationships between the lessons and the narrative strategies used to express them are currently being analyzed for patterns, such as the expression of lessons about system flaws told as laments, or the expression of lessons about humanity told as stories of rediscovery. The content and narrative structure of physician stories may offer a window into important internal conversations in the study and practice of medicine.
Key words: narrative analysis, reflective writing, lessons
_____________________________________________________
Taking Care of Ourselves and of Each Other: The Power of Mindfulness Practices, Caring Relationships and Community on Patient Well-Being.
Mary Beattie, Jim Beattie, Sheila Cook, Barb Riley.
Friday April 15 / Vendredi 15 avril
17:00-17:30
Fairmount Queen Elizabeth / Convention Floor/ Hochelaga 5
The paper presents the narratives of two individuals who used mindfulness practices to deal with the challenges of a cancer diagnosis and its treatments—colon cancer and breast cancer—in their lives. These narratives are based on written interviews with individuals who agreed to be co-researchers in the project, in order to better understand their own experiences, and to tell their stories for the benefit of others. They agreed to share their lived realities as they know and understand them from their own unique perspectives, and to explain how their practices of mindfulness/meditation/yoga, and the interactions they experienced within a community of care, helped them to deal with their situations with dignity and composure, and with empathy, compassion, and a sense of humour.
By involving the participants as co-researchers, this research was designed to benefit them in that the act of writing provides another kind of mindfulness exercise that can be used to develop focus and attention, to develop the abilities to reflect on experience from multiple perspectives, to re-connect with oneself, and to promote well-being.
These narratives provide insights into how stories of experience told from an individual’s own perspective can help others to navigate the often difficult paths of their lives, to avoid practices that deplete them , and to focus on those practices that nourish and support them. They also show how within caring communities, caring relationships and interactions, and instruction in practical mindfulness strategies, individuals can learn to deal with physical and emotional pain and stress, and develop the resources for self-care and compassion towards themselves and others.
Wellspring is a place where cancer patients and their caregivers have access to a range of mindfulness/meditative techniques, counselling relationships with trained professionals, and the support of a caring community. All of these resources are available to them free of charge and on a daily basis. Individuals can choose the classes, relationships and practices which will help them to develop the abilities to engage in self-care, to restore their well-being, and to show care and compassion for others.
Key Words: Mindfulness, Caring Relationships, A community of Care and Support.
______________________________________________________
Are the Biomedical body and Citizenry incompatible? A Literary Inquiry.
Daniel Laforest, Associate Professor, French & Cultural Studies, University of Alberta.
Friday April 15 / Vendredi 15 avril
11:30-12:00
Fairmount Queen Elizabeth / Convention Floor/ Hochelaga 6
This proposal stems from a larger research that examines Canadian and US literary works in which the responsibility towards personal and public health organizes the models of life-narratives being put forward in multicultural middle-class communities. The biomedical individual is conceived by health-care systems as de facto responsible for her/his own health and sustenance (Fierlbeck & Lahey 2013; Lazar & al. 2013; Reid 2010). But this model of personal responsibility is more congruent with a narrative model of citizenry than with a narrative model of the biological self. Indeed, such a rigid ideal does not intermingle with the heterogeneous rhythms constitutive of the biological body and its processes, of various organs, etc. Thus the biomedical self as a responsible constituent of health-care systems often does not correspond to the dominant narrative representations of the personal self as an agent of everyday life, and therefore as a citizen.
With this talk I want to show 1) how the current state of body visualization technologies in medicine are deeply affecting our traditional image of the narrative self, thus of our very belief in a life-story; 2) how this change of paradigm can concretely affect our relations to citizenry in the very near future. Examples will be drawn from literature and recent popular culture.
______________________________________________________
Interdisciplinarity for Social Justice: Reading Jamaica Kincaid’s Girl
Bahar Orang, first year medical student, McMaster University
Friday April 15 / Vendredi 15 avril
14:30-15:00
Fairmount Queen Elizabeth / Convention Floor/ Hochelaga 6
I have encountered the poem “Girl”, by Jamaica Kincaid, three times in my life: first as an undergraduate English student in a gender studies course, second as an MA student tutoring Humanities students from low-income backgrounds, and third as a first-year medical student. In this personal essay, I attempt to weave together these seemingly disparate threads. I ask: what might happen if these isolated voices are brought together in conversation? What might happen if Humanities experts, people with lived experience, and medical students who will become professionals with power sat ‘round the table to discuss “Girl”? In the Humanities, one important thing we do is study literature that addresses and unpacks interactions between those in power and those who suffer the consequences of that power. But how can we use this knowledge to serve the social welfare of marginalized people, and by extension, humanity as whole? Ultimately, I argue that by connecting academic, experiential, and professional ways of knowing, there can be a possibility for real social justice via poetry, and in this case, with the poem “Girl”.
______________________________________________________
Imprinting Care: An Analysis on the Production of Patient Charts and the Standardization of Medicine
Kacper Niburski, MA at University of Toronto at the Institute of History and Philosophy of Science and Technology
Friday April 15 / Vendredi 15 avril
15:00-15:30
Fairmount Queen Elizabeth / Convention Floor/ Hochelaga 6
The medical record rewrites the body. By shaping illness into spatial and temporal zones, by carving out an anatomy of the ideal form, and by categorizing messy deviations into neat tables, the patient becomes an artifact to be mapped upon (Berg, 1996; Bowker, 1996). Through such isolated representation, the body undergoes a performance. It moves, is moved, and experiences movement in chronicled parts meant to signify the end of a healthy whole.
Such physical compartmentalization is a vestigial trait of 19th century ephemeral printing. The Industrial Age saw rapid evolution of patient charts. There was the segmentation of qualitative comments from measured facts, the slow incorporation of analytical techniques, and the formalization of standard, institutional practices (Andrews, 1999; Warner and Risse, 1999). Yet little has been done to analyze the historical construction of these documents, the deliberations in the process of production, and how these early patient charts displaced patients’ narratives.
Anchored by medical records from the Archives of Ontario, I reproduce these “paper tools” (Klein, 2002). As a Massey Printing Fellow at U of T, I work with and on 19th century presses. In mirroring the process of assembly, I recontextualize the form, rehistorize the diagnostic considerations relevant, and note the continuum of both practical and operational choices that have stretched into current records.
The research is necessarily artistic. It wedges medical paradigms into paper borders. With ink, lead, and ingenuity, a worldview is recreated. I would like to showcase this marriage of medicine and art, to challenge the static interpretations of paper tools, and to use the recreated artifacts to suggest the tradition of reconfiguring the body as a thing dissolving into objectification.
Keywords: Printing, Patient, Charts
Work Cited:
Bowker, G. The multiple bodies of the medical record: Towards a sociology of an artifact. Sociological Quarterly. 1996. 3, 32-60.
Berg, M. Practices of reading and writing: the constitutive role of the patient record in medical work. Sociology of Health and Illness. 1996. 18, 499-524.
Andrews, J. Case notes, case histories, and the patient’s experience of insanity at Gartnavel Royal Asylum, Glasgow, in the nineteenth century. The Society for the Social History of Medicine. 1998. 11, 255-281.
Warner, J. Risse, G. Reconstructing clinical activites: Patient records in medical history. The Society for the Social History of Medicine. 1992.12, 113-136.
Klein, U. Experiments, models, paper tools. Stanford University Press. 2002.
______________________________________________________
Comment travailler ensemble? Travail collectif, partage des tâches et justifications dans un cours de santé communautaire à la faculté de pharmacie
How do pharmacy students work and learn together ? Collective work, task sharing and justifications in an innovative multi-cohort community health course
Pierre-Marie David1,3, Aude Motulsky1,2, Caroline Robitaille1, Daniel Cortès-Vargas1, Marie-France Beauchesne1, Johanne Collin1
1 Faculté de Pharmacie, Université de Montréal, Montréal, Canada
2 Faculté de Médicine, McGill University, Montreal, Canada
3 Laboratoire SPHERE, Université Paris Diderot
Friday April 15 / Vendredi 15 avril
16:30-17:00
Fairmount Queen Elizabeth / Convention Floor/ Hochelaga 6
En 2011, la Faculté de pharmacie de l’Université de Montréal a lancé un cours innovant mettant l’accent sur la promotion de la santé en utilisant une approche d’apprentissage par projet et par équipe. L’objectif général du cours était de développer et mettre en œuvre une intervention vers un problème lié à la santé communautaire, en participant avec les acteurs de la communauté pour la mise en œuvre d’une intervention. L’objectif de cette présentation est de décrire le processus de travail et d’apprentissage en équipe du cours de service à la communauté. Ceci permettra d’éclairer, à partir d’exemples précis, comment les tâches se répartissent, comment le travail collectif prend sens chez des étudiants futurs professionnels de la santé et quels sont les principes et justifications sur lesquels ils peuvent se mettre d’accord.
Pour répondre à ces questions, nous avons réalisé deux groupes de discussion pour explorer l’expérience d’apprentissage avec 14 étudiants en 2015. Les sujets de discussion comprenaient notamment le partage des tâches, leurs représentations de leur rôle en tant que futurs professionnels de la santé et les justifications qui permettaient au groupe de travailler ensemble. À ceci s’ajoute l’analyse des documents encadrant le cours et les réflexions de responsables de formation sur un cours qui reste en évolution.
En plus de rendre compte du travail collectif et de l’apprentissage dans ce cours, ce travail devrait permettre de préciser les enjeux qui intéressent toute formation interdisciplinaire pour les professionnels de la santé, notamment vis-à-vis: i) du mentorat entre les étudiants eux-mêmes, ii) des facteurs limitants ou favorisants de ce type de cours et iii) de la spécificité de la santé communautaire comme matière pour développer un travail d’équipe.
Mots clés: travail collectif, justifications, étudiants, pharmacie, santé communautaire
______________________________________________________
Visual representations of atrocities: preparing students for work in an asylum clinic
Caroline Wellbery MD PhD, Georgetown University
Friday April 15 / Vendredi 15 avril
17:00-17:30
Fairmount Queen Elizabeth / Convention Floor/ Hochelaga 6
Incorporating a discussion of physical and emotional trauma in medical education can help prepare students for their encounters with trauma/torture survivors in clinical practice. However, introducing students to the practice and impact of violence can be challenging. Because of the profound emotional suffering trauma can induce in its victims, students themselves must be emotionally and psychologically equipped to tend to their patient’s needs. This presentation focuses on the symbolic and interpretive power of visual images to convey the experience of trauma, outlined in 4 sections:
Purpose of visual representations. Documentary evidence for torture reaches back thousands of years. The purpose of historical or current representations of torture includes rationalizing state-sponsored torture, providing an outlet for critique and protest, and organizing representation of the enemy. The most subtle works of art leave it to the viewer to ponder the right and wrong of state-justified torture.
Ethical concerns of viewing. Images of torture, war, genocide and the like invoke ethical concerns relating to the impact of visual images, where viewing can elicit an ambiguous response, casting the viewer into the role of voyeur. At the same time, indifference or inattention has its own liabilities.
Engaging the viewer’s subjectivity. Recognizing the respective roles of perpetrators, victims and observers offer opportunities for the viewer to engage in self-reflection.
Healing and advocacy. Art also offers opportunities for advocacy on the victim’s behalf, sometimes facilitated by dissemination of visual representations, but also by involving the victim in activities that exploit the healing power of art.
Key Words: Trauma, torture, visual art
Reference: Wellbery C. “Artistic representation of atrocities: a medical pedagogy” Forthcoming in: Journal of Medical Humanities, Special Issue, “Traumatextualities: Trauma in the clinical, arts and humanities contexts.” Guest Editors: Crawford P, Brown B, Baker C, Rodrigues RR.
_____________________________________________________
Art-science collaborations: medical research in the context of social awareness
Caroline Wellbery MD, PhD Georgetown University
Friday April 15 / Vendredi 15 avril
11:30-12:00
Fairmount Queen Elizabeth / Convention Floor/ St-Charles
In previous work, I have explored the nature and benefit of art-science collaborations, particularly in the medical field. The proposed presentation, based on interviews with Deborah Robinson (DR), an artist, and Julian Rayner (JR), a malaria researcher at the Sanger Institute in the United Kingdom, describes one such collaboration and its effects on the scientist’s contextual awareness. Although it can be obvious how an artist’s work might engage critically or analytically with the scientific enterprise, it is not always clear what scientists gain in their collaborations with artists. In a project supported by the Wellcome Trust, DR spent 3 weeks in a malaria lab with the purpose of creating an artwork in response to her experience. Meanwhile, JR and colleagues agreed to mentor DR in the areas of their research, focused on erythrocyte-parasite interactions. DR’s final product was a series of installations that melded the visual translation of data with archival film clips of mid-20th-century DDT-based eradication programs. This presentation discusses DR’s work and the provocations her installations elicited in scientific audiences. Many perceived her art as a direct ethical challenge to their research. Both DR’s and JR’s reflections on this experience highlight the benefit of art-science collaborations as a means of deepening the contextual awareness of scientific and artistic work respectively. In this presentation I suggest that art-science collaborations are a means of articulating awareness of the ethical and social responsibilities that attend the production of both art and scientific research.
Key words: Art-science collaboration; social awareness
References: Wellbery C. Art-science collaboration: A blueprint for medical innovations. Accepted for publication New England Journal of Medicine
Ese, Sian. Art & Science, I.B Taurus Press, London: 2005.
_____________________________________________________
Cancer : démocratiser les résultats de recherche par l’art
Astrid Brousselle, professeure titulaire, Chaire de recherche du Canada en Évaluation et Amélioration du système de santé, Université de Sherbrooke, Centre de recherche de l’hôpital Charles-Le Moyne.
Anouk Sugar, artiste visuelle formée au Goldsmith’s College de Londres et détentrice d’une maîtrise en sociologie de l’UQÀM
Mylaine Breton, professeure adjointe, Université de Sherbrooke, Centre de recherche de l’hôpital Charles-Le Moyne
Lynda Benhadj, candidate au doctorat, Université de Sherbrooke, Centre de recherche de l’hôpital Charles-Le Moyne
Marianne Beaulieu, chercheure post-doctorale, Université de Sherbrooke, Centre de recherche de l’hôpital Charles-Le Moyne
Friday April 15 / Vendredi 15 avril
14:30-15:00
Fairmount Queen Elizabeth / Convention Floor/ St-Charles
L’art, parce qu’il sollicite les émotions et les sensibilités, est un vecteur important pour rejoindre le grand public. Une collaboration étroite entre une artiste visuelle et une équipe de chercheurs a permis de traduire sous forme de collages, les résultats d’une recherche portant sur le diagnostic précoce de cancer.
Contexte : Plus les délais qui précèdent le diagnostic de cancer sont courts, meilleurs sont le pronostic et la qualité de vie. Nos résultats indiquent, entre autres, que les proches peuvent faire une différence au niveau des délais, en encourageant la personne qui s’inquiète à consulter.
Création : Pour illustrer le vécu des personnes atteintes de cancer rencontrées, nous avons amorcé un processus de création artistique. Le collage, une technique artistique malléable et spontanée, a été choisi pour transmettre au mieux l’état d’esprit de la personne traversant les peurs et l’indécision qui précède la première consultation médicale. Les verbatim des patients illustrant ce processus ont été intégrés aux images.
Diffusion : Les images, imprimées en format cartes postales, ont été distribuées à l’heure de pointe à l’entrée du métro Longueuil et diffusées sur le web par le biais des réseaux sociaux.
Pertinence : L’art peut créer un dialogue entre les résultats de recherche et la mobilisation sociale. Cette stratégie innovante de diffusion mérite d’être explorée pour démocratiser les connaissances scientifiques.
____________________________________________________
Memory, Aging & Expressive Arts: Fostering community and knowledge through shared art experiences
Anne Mondro, Associate Professor, University of Michigan Stamps School of Art & Design
Friday April 15 / Vendredi 15 avril
15:00-15:30
Fairmount Queen Elizabeth / Convention Floor/ St-Charles
The presentation will discuss designing a community engagement course to build intergenerational relationships through shared art experiences for persons with memory loss and university students. Using University of Michigan (U-M) Professor Anne Mondro’s course Memory, Aging & Expressive Arts as a model, the presentation will focus on how to design and facilitate reciprocal creative experiences to maintain wellbeing.
Uniquely engaging U-M academic units and the U-M Health System, Memory, Aging & Expressive Arts focuses on developing students’ sensitivity and understanding toward those experiencing changes in memory or thinking through collaborative art experiences. Students from across campus meet with specialists in neurology, public health, social work, and the arts to learn about the scientific basis of memory and dementia, the societal basis of dementia, and institutional projects to support persons with dementia.
Partnering with the U-M Geriatrics Center Silver Club Mild Memory Loss Programs, students are paired one-to-one with persons with dementia to explore and enjoy their creativity through visual art, music, dance, and writing for twelve weeks. Through these sessions, students and persons with dementia explore the potential of the arts to serve as an outlet for expression and joy.
The presentation will cover course objectives and learning paths designed to nurture intergenerational creative experiences including overcoming pre-determined attitudes about aging and dementia, exploring the benefits of creativity, and utilizing the expressive arts to improve one’s quality of life.
Key words: community arts, intergenerational learning, art & dementia
_______________________________________________________
The Art Hive Science Shop: Creating third spaces for informal knowledge creation and exchange
Janis Timm-Bottos, PhD, ATR-BC. PT, Creative Arts Therapies, Concordia University
Rosemary Reilly, PhD, CCFE, Department of Applied Human Sciences, Concordia U
Friday April 15 / Vendredi 15 avril
16:00-16:30
Fairmount Queen Elizabeth / Convention Floor/ St-Charles
Entering the medical system as a patient, academic or medical professional automatically delineates a particular hierarchy of power, making social accountability a limited venture. In this presentation, we offer a new form of citizen engagement, which can level the playing field to foster human-size interactions in large-scale medical institutions. Art Hives are small, sustainable, safe places where individuals remove their patient–physician personas and interact as citizens interested in health and wellbeing, in solidarity with each other. Art Hives, primarily located between institutions and private homes, are also being designed as third spaces within institutions. It is a place where everyone is welcome, and invited to engage in self-guided art making and conversation about what matters. The Science Shop, one emerging program of Art Hives, is a designated time when community members craft questions and concerns revolving around science and health, and researchers provide participatory research support with the intention of implementing change.
Together the presenters have 40+ years of experience working in the intersection of medical delivery, academia, and community. The Art Hive emerged from twenty years of sustained practice research, initially launched as a community art studio with Health Care for the Homeless in Albuquerque. Later iterations, starting with La Ruche d’Art: Community Studio and Science Shop has led to a network of 20 Art Hives in Montreal and 60 across Canada. This talk will offer examples of the ways Art Hives intersect with healthcare through cancer support groups, a geriatric medical centre, and youth mental health services.
Keywords: Art Hives, Science Shop, Third Space
________________________________________________________
Faculty Reflections on our Role in the Student-led Arts & Literary Journal “Murmurs: East Meets West”: A Collaboration between Medical Students from the University of Ottawa and Jiao Tong School of Medicine.
Pippa Hall1; Lynn Bloom2; Daozhen (Jane) Wang3; Suping Wang4; Yizhi (Catherine) Zhang1; Yuwei (Jay) Wang1; Talia Chung5; Jean Roy
1. Faculty of Medicine, University of Ottawa; 2. Department of Innovation in Medical Education, University of Ottawa; 3. Clinical Medical School, Shanghai Jiao Tong University; 4. Shanghai Jiao Tong University; 5. Interim Director, Health Sciences Library, University of Ottawa
Friday April 15 / Vendredi 15 avril
17:00-17:30
Fairmount Queen Elizabeth / Convention Floor/ St-Charles
Background: In 2014, the University of Ottawa’s Faculty of Medicine entered into a partnership with the Shanghai Jiao Tong School of Medicine in China. A number of joint initiatives are underway. One of these is the trilingual student-led and student-directed literary and arts journal publication, Murmurs. Started by Marlon Danilewitz and Jonathan Blankenstein, both medical students at the University of Ottawa, Murmurs was published in 2013 & 2014, receiving contributions from students across Canada. This year’s editorial team is composed of students from both the Shanghai and Ottawa medical schools. The goal is to produce a joint publication of Murmurs entitled ‘East Meets West’. This humanities based publication celebrates students’ creative writing, poetry and art and allows students to reflect on their experiences as they interact with each other, their cultures and their communities.
Faculty Reflections: As faculty working on this project with our students, we will share our felt experiences as this project developed. We will reflect on the questions, dilemmas and communication challenges that arose during the process and how these issues reflect our own cultural and societal perspectives. We will discuss the different ways we explored these questions and challenges, how the experiences have affected our own professional development and the relationships that result from collaborating on a project based in the humanities. We will share what we have learned of our communities, and of our roles as health care educators in our different societies through the perspectives of our students.
Key Words: culture; reflections, faculty
________________________________________________________
Quelle place pour l’anthropologie dans le domaine de la formation des professionnels de la santé? Entre théorie et application. Pertinence, enjeux et limites.
Patrick Cloos, M.D., M.SC., Ph.D. Professseur, École de service social, Université de Montréal.
Friday April 15 / Vendredi 15 avril
11:30-12:00
Fairmount Queen Elizabeth / Convention Floor/ Matapédia
Cette communication a pour objectif de discuter la pertinence de l’approche anthropologique dans le domaine de la santé. Après avoir pratiqué la médecine hospitalière en Belgique et humanitaire dans plusieurs pays notamment l’Afghanistan, les Philippines, le Liberia et le Laos, j’ai réalisé un doctorat en sciences humaines et sociales.
À partir de données de recherche en cours portant sur la situation de la “communauté haïtienne au Québec” et de la littérature, je propose de discuter l’importance de considérer, dans le domaine de la pratique médicale, la question de la diversité des significations données à la maladie, aux symptômes, à la recherche d’aide et aux choix thérapeutiques, et l’importance de la prise en compte du contexte social des personnes et des groupes qui entourent l’émergeance des maladies, infectieuses ou chroniques, et des rapports de pouvoir dans lesquels s’inscrivent les soins et le processus clinique.
L’orientation culturaliste des théories anthropologiques ont plutôt tendance à établir un lien entre les conduites humaines et les représentations, les croyances et les valeurs qui seraient partagées par un groupe culturel. Ainsi, appliqué à la pratique médicale, il s’agirait de discipliner les corps en vue de l’adoption de comportements sains ou encore de prendre en compte des ‘facteurs de risque’ qui concerneraient certaines communautés plus que d’autres. Mais cette perspective a déjà montrer toutes ses limites.
Une autre approche, plus structurelle, passe plutôt par le contexte politique, social et économique pour comprendre les maladies, sans toutefois nier sa composante culturelle. Ce regard critique tend à voir la maladie comme l’expression de facteurs structurels. Il en va ainsi de l’approche des déterminants sociaux de la santé pointant du doigt les politiques sociales, la position sociale et les conditions de vie des personnes pour expliquer leurs comportements de santé et en finalité la variation des états de santé. Mais comment prendre cette perspective en ligne de compte dans l’éducation est un questionnement qui sera notamment discuté lors de cette présentation.
Mots-clés: pratique médicale, anthropologie, critique
________________________________________________________
Heart in Darkness: Revisting the Pain of Others
Dr. Russell Cobb, Associate Professor of Spanish and Latin American Studies, Department of Modern Languages and Cultural Studies, University of Alberta
Friday April 15 / Vendredi 15 avril
14:30-15:00
Fairmount Queen Elizabeth / Convention Floor/ Matapédia
My intervention in the Creating Space VI 2016 symposium, Health Humanities: Social Accountability in Action, will reflect on the ethics of writing memoir and/or personal journalism about a disease in one’s family. I am both a practicing writer who has written a book and an essay of literary non-fiction about heart disease in my family, and a scholar of contemporary literary non-fiction. Therefore, I approach the question of “How can patient-produced material (i.e. written and audio narratives, online blogs, memoirs, film documentaries, stage plays, comic books, etc.) be used in healtcare education,” as both a patient and an author. In my short presentation, I will read from my own work while also reflecting on some of the debates about the ethics of truth and authenticity in the field of life-writing. I am interested in exploring the ethical ramifications of writing not only about one’s own illness, but in writing about the illness of others. My presentation will interweave my own literary production with reflections about writing and illness in some important works of contemporary literary non-fiction (Sontag, Didion, Guwande, et al.) I hope to generate a lively discussion about how writers and health care professionals choose to represent—in Sontag’s words—the pain of others.
_______________________________________________________
Quels types de patients pour quelles situations d’enseignement?
Vincent Dumez, co-directeur, Direction Collaboration et Partenariat Patient (DCPP), Faculté de médecine de l’Université de Montréal
Alexandre Berkesse, conseiller sénior, Direction Collaboration et Partenariat Patient (DCPP), Faculté de médecine de l’Université de Montréal
Saturday April 16 / Samedi 16 avril
10:30-11:00
Fairmount Queen Elizabeth / Convention Floor/ Hochelaga 5
Proposition : depuis 2010, les membres de l’équipe de la DCPP, composée de patients, cliniciens, gestionnaires et chercheurs élaborent et déploient des innovations pédagogiques mobilisant des patients formateurs au sein du programme de médecine (doctorat de premier cycle et résidence) et des 13 autres disciplines des sciences de la santé. Après avoir formé plus de 10 000 étudiants au partenariat avec les patients et leur avoir fait expérimenter, au sein de leur formation initiale, le partenariat avec plus de 150 patients formateurs, nous amorçons aujourd’hui avec les responsables pédagogiques de la formation en médecine une réflexion systémique sur la caractérisation des différents types de patients (patient simulé, patient standardisé, patient témoin, patient formateur, etc.) afin de pouvoir identifier, parmi ces différents profils (auxquels sont associés des critères de recrutement et des activités de préparation différentes), lesquels sont les plus pertinents selon les différentes situations d’enseignement qui composent la formation initiale en médecine. Dans une perspective d’approche par compétences (APC), nous aimerions présenter aux participants une proposition de catégorisation des patients en fonction des compétences que nous désirons développer chez les étudiants en médecine. Cette catégorisation servira de base à l’identification des futures innovations pédagogiques en matière de partenariat avec les patients à la faculté de médecine de l’Université de Montréal.
Mots clés : patients, approche par compétences, situations d’enseignement
_____________________________________________________
Can the patient speak? Applying postcolonial theory to patient involvement in medical education
Malika Sharma, MD FRCPC, Research Fellow, Wilson Centre for Research in Education, University of Toronto
Saturday April 16 / Samedi 16 avril
14:00-14:30
Fairmount Queen Elizabeth / Convention Floor/ Hochelaga 5
There is a growing recognition of the role of lived experience in the production of knowledge. People with chronic diseases are increasingly seen as experts about their bodies and medical experiences. As such, patients are increasingly being engaged in the training of healthcare professionals. This involvement disrupts the traditionally asymmetrical doctor-patient relationship in significant ways that have not been theorized in the medical literature.
Viewing patient involvement in the development and delivery of medical education through a post-colonial lens can nurture the growing trend of patient engagement while potentially safeguarding against tokenism and exploitation. I will briefly review the literature on patient engagement in medical education, and then define and explore key concepts from postcolonial theory. Subsequently, I will highlight how post-colonial frameworks have been applied to medical education to date, and further apply a post-colonial lens to the area of patient involvement (1). Given the rich history of activism leading to the greater and meaningful involvement of people living with HIV/AIDS (PHAs) in research and program development, the PHA experience will be used as an exemplar (2).
Finally, the notion of patient as subaltern, or as an individual socio-politically marginalized from hegemonic power structures within the medical institution, will be explored (3). Applying this concept of subalternity may prove instructive as the medical community seeks to meaningfully engage and listen to patients. Lastly, I will suggest methodological approaches that can be applied to understanding the patient as subaltern and recovering their voice in medical education.
Key words: Patient engagement, post-colonial theory, social science
Citations:
Said, E. W. 1993. Culture and Imperialism. New York, N.Y.: Random House LLC.
The greater involvement of people living with HIV (GIPA): Policy brief. UNAIDS: Geneva, Switzerland. 2007.
Spivak, G. 1988. » Can the Subaltern Speak? » In Marxism and the Interpretation of Culture, edited by C. Nelson and L. Grossberg, 271-313. Urbana-Champaign: University of Illinois Press.
___________________________________________________
Separating What from Who: Discursive Constructions of the Patient Role
Brett Schrewe MDCM, MA, FRCP(C), Clinical Asst Professor, Department of Pediatrics, The University of British Columbia
Joanna Bates MDCM, CCFP, FCFP, Scientist, Centre for Health Education Scholarship, The University of British Columbia
Saturday April 16 / Samedi 16 avril
14:30-15:00
Fairmount Queen Elizabeth / Convention Floor/ Hochelaga 5
Butler1 suggests that through discourse and actions, individuals create roles, which are influenced by social, cultural, historical, and philosophical forces. While there is a clear difference between the broader patient role and the unique person inhabiting it, health care perspectives often consider these two entities as identical. The patient role is an indispensable component of the health care system, yet defining what it might be is a largely uncharted landscape at a time when social accountability is increasingly important.
To understand discursive constructions of the patient role, we applied a Butlerian lens to an archive of texts assembled from two sources. The first considered how patient role has been historically understood in the formation of the clinical teaching unit (CTU), while the second involved transcripts produced from a contemporary ethnography of medical student CTU-based learning.
Initial results suggest at least three operative discourses shape the patient role, including: sick person-as-patient, patient-as-educational commodity, and patient-as-disease category.
These discourses may all be operating simultaneously in the same training context, which may lead to learner confusion and unintentional misrecognition and denigration of sick persons in the patient role. To respond to these discourses effectively, we need train our learners to mindfully tack back and forth across them. To do so optimally, we must cultivate this reflective positioning in ourselves. In turn, this reflective positioning may be rendered significantly more robust by medical professionals’ consciously developing reflexive insight about how their own social, cultural, historical and philosophical traditions have positioned their understanding of patients.
Keywords: Patients, Discourses, Undergraduate Learning
References
Butler J. Gender Trouble: Feminism and the Subversion of Identity, New York: Routledge Classics 2006.
_______________________________________________________
What Does it Really Mean to “Create Space” for Humanities in Undergraduate Medical School Admissions? Autoethnography as a Method for Generating Critical Reflection and Practical Recommendations
Andrea Charise PhD, Assistant Professor of Health Studies, University of Toronto Scarborough
Mark D. Hanson MD, Director, MD Admissions and Student Finances, University of Toronto
Saturday April 16 / Samedi 16 avril
09:30-10:00
Fairmount Queen Elizabeth / Convention Floor/ Hochelaga 6
Increased emphasis on humanities-based clinical skills like communication, interpretation, and observation (Hall et al 2014) present a new question for medical educators: given the humanistic aspects of the new MCAT and cognate UME curriculum initiatives (e.g., medical humanities, portfolio writing), how can admissions committees more thoroughly evaluate—and create space for—humanities during the admissions process? We present a critical reflection on our collaborative experience launching a new admissions initiative at the University of Toronto—the Reflection Mini-Personal-Interview (R-MPI)—which aims to enhance the assessment of reflective capacity in medical school candidates at the admissions interview stage. This initiative required developing strong partnerships with colleagues in the humanities to develop and deliver a multi-step training module for faculty and medical trainees tasked with evaluating reflective capacity in applicants on interview day. However, in the course of launching this humanities-focused initiative, what became evident was our need to navigate profoundly divergent disciplinary perspectives and practices regarding the integration of humanities into the medical school admissions process, and develop practical strategies for realizing our shared research and education objectives.
This presentation has two interlinking parts—a critical autoethnographic reflection and practical recommendations—that underscore the opportunities and challenges of actually “creating space” for the humanities at the admissions gateway. Following a brief outline of the R-MPI initiative, we pivot into a critical, autoethnographic reflection (Ellis et al 2010) on how this project underscored the difficulties—and creative workarounds—entailed by this interdisciplinary collaboration. As representatives of the disciplinary cultures of medicine (Hanson) and humanities (Charise), we reflexively explore our collaboration experience as a transformative means of bridging our autobiographical research story to wider practices of integrating humanities into medicine (Farrell et al 2015). We take this deliberately qualitative, autoethnographic approach to propose several concrete recommendations for stakeholders in medicine looking to meaningfully create space for the humanities: lessons learned, opportunities for honouring divergent disciplinary cultures, attitudes toward time constraints, and tolerance for rubrics. Our layered account thus tells a practical yet ethically- and methodologically-situated story of what’s involved in effecting culture change when creating space for humanities: a task that administrators and educators (in both medicine and humanities) should make space to think more clearly—and creatively—about.
This presentation will be of special interest to Scholars, Educators and Stakeholders (6); Healthcare Professionals (5).
Keywords: humanities, admissions, autoethnography
_____________________________________________________
An Interdisciplinary Approach to Teaching and Addressing the Challenges of Aging and Dying in Healthcare Education
Catherine Dhavernas, Associate Professor and Head, Department of French Studies, Queen’s University; Course Instructor, Graduate Program in Aging and Health, Queen’s University
Saturday April 16 / Samedi 16 avril
14:30-15:00
Fairmount Queen Elizabeth / Convention Floor/ Hochelaga 6
I propose to discuss the experiences and challenges of teaching an interdisciplinary Arts and Humanities course called Approaching the Challenges of Aging and Dying to graduate students from a variety of backgrounds in healthcare that is part of a new Aging and Health program at Queen’s University. The course learning outcomes include an interdisciplinary understanding of aging and dying, social accountability in relation to diversity of patient knowledge and experience, and a comprehensive view of humanistic patient-centered care. I will explain how and why the course draws from a variety of sources including Atul Gawande’s Being Mortal; Susan Jacoby’s Never Say Die; Philippe Aries’ The Hour of Our Death; works by artists Carravaggio, Artemisia Gentileschi and Jusepe de Ribera; Helen Humphrey’s Nocturne; Jean-Luc Nancy’s The Intruder; Annie Ernaux’s In Other Words; Sarah Polley’s Away from Her; Denys Arcand’s Barbarian Invasions; Alejandro Amenábar’s The Sea Inside; Elizabeth Strout’s Olive Kitteridge; Tamara Jenkins’ The Savages; Nathalie Sarraute’s The Use of Speech and Robert Antelme’s The Human Race, to explore such issues as Western perceptions of death; the patient’s experience; medicalization of illness, aging and death; physician assisted death; evaluating the risks and needs of independence, autonomy and institutionalized care; effects of Alzheimer’s disease and/or dementia; and verbal and/or non-verbal communication. How the course unfolded, how students evaluated its organization and content, how students achieved the learning outcomes, and how I assessed their engagement with the course materials will comprise my summative findings and will provide material for discussion and feedback from the audience.
Key words: aging, dying, humanities
________________________________________________________
SP-27
Ways of being and knowing: narratives of arts, selves, creativity and advocacy among faculty teaching in medical schools
Natalie Beausoleil PhD, Memorial University
Saturday April 16 / Samedi 16 avril
13:30-14:00
Fairmount Queen Elizabeth / Convention Floor/ Hochelaga 5
This presentation is based on in-depth interviews I have conducted with colleagues from my Faculty and some medical schools in the UK for my research The power to heal: promoting artistic activities and exploring the possibility of integrating an arts program in our medical school. Entrenched in critical health humanities and social science scholarship, this talk will address issues of identity and creativity among seventeen colleagues who teach in medicine. I will also explore their narratives for what they view as possibilities for community engagement provided through the arts and humanities in current medical education. There will be an autoethnographic component to this presentation as the interviews were very much two-way conversations with participants, integrating my own perspective as a visual artist and a long time feminist researcher on representations of healthy and unhealthy bodies in contemporary western society. This talk contributes to current discussions on the nature of medical education in times of curriculum renewal and calls for further accountability and community engagement from medical teaching institutions.
Key words: medical humanities, health humanities, undergraduate medical education curricula, arts, teaching faculty, identities, community engagement
____________________________________________________________
Cyberbullying Physicians and the Impact on Empathy
Veronique Dorais Ram, MD/PhD Student, Faculty of Medicine/Department of English, University of Calgary
Saturday April 16 / Samedi 16 avril
09:00-09:30
Fairmount Queen Elizabeth / Convention Floor/ Matapédia
Introduction: With the increase in technology, information has become harder to monitor and control. The line between what constitutes constructive criticism and intimidating reproaches remains skewed. What happens when patients employ social media to do more than evaluate their experience with health care providers? For instance, a rural town of northern Alberta (<10,000) has a Facebook page employed to report which physicians to avoid, who easily prescribes pain killers, and to vent about dissatisfaction with decisions made in complex care situations. What is the impact of such forums on the patient-physician relationship? Can such sites impact physician empathy, welfare and autonomy?
Methods: This project is divided into two parts:
- a literature review and systematic analysis of studies on physician rating sites and other forms of social media;
- a series of interviews with physicians on their experiences with social media and its impact on their sense of empathy.
Results:12 peer-reviewed articles met the inclusion criteria and demonstrate the growing number of publications on the benefits and harms of social media with regards to patient evaluations of physicians; however, direct evidence remains limited. Moreover, the studies are from Europe or the US; there are no Canadian studies to date. Lastly, the studies focus on the potential of transparency in health care and recommend physicians ignore or learn from rating websites, rather than consider their professional and personal impacts.
Conclusions: The second part of this project has begun and results from the interviews with physicians will be summarized for the conference. I intend to examine the impact of inflammatory commentaries on physician empathy and wellness. The aim is to employ the results to offer strategies for quality standards and regulation of physician-related websites to maintain the transparency of the health care system without stripping both patients and physicians of their humanity.
Key words: cyberbulling, physicians, empathy
____________________________________________________
Lire les journaux pour comprendre ses patients : analyse sociologique des débats publics sur l’aide médicale à mourir au Québec et l’assistance au suicide en Suisse
Samuel Blouin, Doctorant en cotutelle, Département de sociologie, Université de Montréal
Saturday April 16 / Samedi 16 avril
09:00-09:30
Fairmount Queen Elizabeth / Convention Floor/ St-Charles
Les conversations publiques sur l’assistance à mourir sont révélatrices du sens que revêt pour le public l’institutionnalisation de l’aide médicale à mourir au Québec (2014) et de l’assistance au suicide dans le canton de Vaud en Suisse (2012). En « lisant les journaux » en sociologue, je suggère qu’il est possible de dégager les attentes du public au-delà des positions très clivées du « pour » ou du « contre ».
À partir d’une analyse de la trame narrative se déployant dans les articles publiés dans des quotidiens au Québec et dans le canton de Vaud (1990-2015), je dépeindrai la trajectoire et les termes employés dans chacun des contextes. Je fais l’hypothèse que les controverses suisses ont pour effet de tenir à distance des acteurs concernés la possibilité de l’euthanasie, tandis que les débats québécois visent à éloigner les citoyens d’une position potentiellement inconfortable, que ce soit comme personne souffrante ou comme personne devant aider un proche à mettre fin à ses jours. Ces deux perspectives correspondent à des attentes différentes de la part du public. Elles convoquent des conceptions tout aussi variées des responsabilités des professionnels de la santé dans le contexte de la mise en œuvre de l’assistance à mourir. Le sociologue peut aider les soignants à « lire les journaux » pour comprendre les destinataires de la médecine. Prenant appui à un autre niveau que celui des interactions dans la clinique, cette analyse peut outiller les soignants dans leurs rapports aux usagers par une meilleure compréhension réciproque.
Mots clés: Aide médicale à mourir ; assistance au suicide ; sociologie
____________________________________________________
Comment faire bouger les attitudes et les connaissances vis-à-vis du suicide chez les étudiants en pharmacie?
Evaluation d’un cours de sensibilisation à la prévention du suicide à la Faculté de Pharmacie de l’Université de Montréal
Pierre-Marie David1,3, Philippe Vincent1,2
1 Faculté de Pharmacie, Université de Montréal, Montréal, Canada
2 Department de pharmacie clinique, Institut universitaire en sante´ mentale de Montréal, Montreal, Canada
3 Laboratoire SPHERE, Université Paris Diderot, France
Saturday April 16 / Samedi 16 avril
09:30-10:00
Fairmount Queen Elizabeth / Convention Floor/ St-Charles
Depuis 2011 nous avons créé un enseignement à la Faculté de Pharmacie de l’Université de Montréal sur la prévention du suicide. Ainsi, une session de formation a été développée pour les étudiants en pharmacie de troisième année qui comprend i) des statistiques de base, ii) les arguments pour l’implication des pharmaciens dans la prévention du suicide, iii) des outils pour évaluer le risque de suicide. En 5 ans, près de 1 150 étudiants ont participé à ce cours, dont environ 950 pratiquent maintenant comme pharmaciens. L’objectif de cette présentation est de montrer l’évaluation de l’impact de ce cours sur les attitudes et connaissances des étudiants.
Pour ce faire, nous avons évalué (au cours de l’année 2014-2015) l’attitude vis-à-vis du suicide en nous appuyant sur un questionnaire standardisé[1] regroupant 20 questions, proposées aux étudiants avant et après la formation. Tous les étudiants ont répondu avant le cours (196), et 170 ont répondu un mois après l’examen final, montrant un véritable engagement sur la question du suicide. Au terme de cette évaluation, les réponses après-cours ont montré une évolution statistiquement significative (test t) vers de meilleures attitudes dans la plupart des questions. Cette présentation montrera les résultats précis en spécifiant les points particuliers sur lesquels les attitudes et les connaissances vis-à-vis du suicide ont le plus pu changé chez nos étudiants.
Mots clés: Suicide, prévention, pharmacie, attitudes, connaissances, professionnels de la santé
[1] Renberg ES, Jacobsson L. Development of a questionnaire on attitudes towards suicide (ATTS) and its application in a Swedish population. Suicide Life Threat Behav. 2003;33(1):52-64. DOI: 10. 1521/suli.33.1.52.22784.
____________________________________________________
Naming Not Blaming: a Narrative of a Surgery Gone Wrong
Cammy Lee, MA, PhD Student, Ontario Institute for Studies in Education at the University of Toronto
Saturday April 16 / Samedi 16 avril
10:30-11:00
Fairmount Queen Elizabeth / Convention Floor/ St-Charles
I will present a narrative outlining my month-long stay in hospital in 2013 due to a surgical error that was near fatal (perforated bowel). I do this as a former patient who needs to tell my story; I do this as a writer and researcher because I can articulate my experience; and finally I do this as a teacher, because I can see beyond the incident so as to frame it as an opportunity for learning.
Telling my story is significant because the medical community needs to hear it: not in order to blame, but in order to name, that is, to ‘story’ it.
As the medical community looks towards the humanities to bridge a more humanist view of healthcare education, I aim to show how it is by paying attention to patient narratives that future medical professionals can better relate to and understand the multi-faceted experience of patients. By knowing patient narratives, medical professionals can ensure the optimal level of health care by providing a more integrative approach that includes the whole person, and not just readings of blood pressure, or white blood cell counts.
In telling my story, I will outline 3 key points:
- How narrative provides the « autobiographical gap » beneficial to healing.
- How mindfulness-based practices promote self-care.
- How « Narrative Medicine » (Charon) involves not only patient-centred care but also looks at doctor narratives improving the doctor/patient relationship; by connecting in their suffering, ultimately they connect in their healing.
The purpose of the ideas put forth in this talk is not to blame but to name, not to settle nor confirm, but to illuminate and provoke. Going forward, I hope to create enough interest using narrative as a means of improving doctor/patient communication.
Key Words: Narrative, Mindfulness Practices, Self-care
Citations: Charon, R. (2006). Narrative: Honoring the Stories of Illness. New York: Oxford University Press.
____________________________________________________
Music Man: a Narrative of Accountability to Self, to Others and to Community
Mary Beattie, Professor Emeritus, Ontario Institute for Studies in Education at the University of Toronto.
Saturday April 16 / Samedi 16 avril
14:30-15:00
Fairmount Queen Elizabeth / Convention Floor/ Matapédia
The paper presents one of the narratives from a forthcoming book entitled, Choosing The Story: The Practices that Form and Transform Us. The book is based on a five year study of the effects of longstanding arts and mindfulness practices on eight artist/educators’ lives. Their narratives show how their chosen practices provided a context for them to reflect on the stories they were telling in the personal and professional aspects of their lives, to hear and respond to the stories others were telling from their own unique perspectives, and to transform their ways of knowing and being.
Narrative and story has moved from the margins of research to the mainstream where it is now gaining prominence across the disciplines and in health care and other professions as a way of studying the lived realities of peoples’ lives, and the ways in which they are experiencing their learning, unlearning and relearning, their health, ill-health and well-being, and (in some cases) their transformation.
The narrative of Music Man has three significant themes:
- Transformative Teaching: Teaching Music as a Way of Helping Others to Become Fully Actualized Human Beings.
- Developing Self Knowledge and Knowledge of Others: The Centrality of Music and Mindfulness Practices
- Contexts for Creativity and Mindfulness: Creating and Re-Creating a New Story for Self, Others and Community.
The narrative of Music Man, provides insights into how his chosen practices allowed him to become more aware of his inner landscape, his emotional state and well-being. It also shows how they helped him to make significant connections between the details and routines of his daily life and his long-term goals, and to make deliberate choices about the direction of his life. The details of the narrative show how his chosen practices allowed him to develop the abilities to become increasingly more accountable to himself and to his own well-being, become more response-able to others, and to provide creative, aesthetic and spiritual leadership to the communities to which he belongs.
Key Words: Well-Being and Transformation; Arts and Mindfulness Practices.
____________________________________________________
Verbatim theatre in healthcare education: understanding patient partnership through the patient voice
Shara Nauth, Medical Student, Faculty of Medicine, University of Toronto
Vibhuti Jethava, Speech Language Pathology Student, University of Toronto
Amy Derochie, Occupational Therapy Student, University of Toronto
Scott Molley, Occupational Therapy Student, University of Toronto
Jessica Teicher, Medical Student, Faculty of Medicine, University of Toronto
Sylvia Langlois, Faculty Lead IPE Curriculum and Scholarship, Centre for Interprofessional Education and Assistant Profesor, University of Toronto
Saturday April 16 / Samedi 16 avril
09:30-10:00
Fairmount Queen Elizabeth / Convention Floor/ Hochelaga 5
Introduction: Patient partnership with health care providers has come to the forefront of practice. As an emerging and complex concept, it necessitates innovative healthcare education with opportunities for learning, reflection, and discussion. Reader’s Theatre provides an interactive teaching method involving an unrehearsed performance and debrief surrounding a healthcare-themed script. Verbatim Theatre, which uses scripts derived entirely from qualitative interviews, is a powerful method of incorporating patient and provider voices into this pedagogy.
Methods: A student team in consultation with an interprofessional education (IPE) faculty member conducted semi-structured interviews with five patients and three health care providers to explore the topic of patient partnership in care. Interviews addressed the perceived role of the patient in their healthcare team and the potential for patient-partnership in health care management. Health care providers were asked for their perspective of the nature of partnership. The transcribed interviews were coded for key themes, and then used to prepare a Verbatim Theatre script delivered in a Reader’s Theatre format for an IPE workshop. Informants and student participants in the workshop discussed their experiences in focus groups.
Results: Emergent themes and understanding of patient-partnership will be discussed from the perspectives of patients, health care providers and participating students.
Conclusions: Verbatim Theatre and Reader’s Theatre are impactful strategies that facilitate direct engagement with lived experiences. Through these experiences, students develop an increased understanding of the patient’s experiences and needs.
Key words: Verbatim Theatre, Patient Partnership, Interprofessional Education
___________________________________________________
Maladjusted: An Interactive Play about Human Centered Care
Leichner, Pierre
Saturday April 16 / Samedi 16 avril
10:30-11:00
Fairmount Queen Elizabeth / Convention Floor/ Matapédia
Ongoing economic constraints, administrative restructuring of corporate-like health care systems and the singular reliance on the Diagnostic and Statistical Manual of Mental Disorders to organize services has resulted in criticism that the mental health care system in Canada has become mechanized.
Participatory theatre, such as Forum Theatre, is an approach that supports systemic change by exploring multiple behavioural options in response to social, cultural and political issues in this case, the realm of policy making for mental health system in Canada.
In this presentation, the creation, performance and policy outcomes of maladjusted, a Forum Theatre play, is explored to address the question of how Forum Theatre can bring improvements to the mental health system. The play was performed 18 times in 2013 at the Firehall Theatre in Vancouver. It then went on tour in 2015 in 26 communities in BC and Alberta. Over 4500 audience members from a wide diversity of cultures and occupations generated authentic reactions and responses to the play, which addressed a number of issues. Over 15,000 people saw it on community television and the global webcasts. A segment of the play and the audience engagement will be played. This presentation will include a summary of the policy recommendations that were reported to the health care regions in 2015.
maladjusted showed us that we are all interconnected; there is no “us and them”. We all play a part in our cultures’ addiction to mechanistic perspectives and behaviours and we all can make a change.
Key words: mental health care services, participatory theater, community involvement
______________________________________________________
I Eat; Therefore I Am: Constructing Identities Through Food
Cammy Lee, MA, PhD Student, Ontario Institute for Studies in Education at the University of Toronto
Friday April 15 / Vendredi 15 avril
16:00-16:30
Fairmount Queen Elizabeth / Convention Floor/ Hochelaga 6
I will present a summary of my MA thesis titled: « I Eat; Therefore I Am: Constructing Identities Through Food ». My thesis is an autoethnographic account that uses narratives, based on my lived experiences growing up as a visible minority in a small town in Ontario, to show the important role food played in my identity formation.
As the medical community looks towards the humanities to bridge a more humanist view of healthcare education, I aim to show how it is by paying attention to the identities of patients, such as the food they eat, and how it informs their cultural, personal, and physical selves, that future medical professionals can better understand those they treat.
In presenting my research, I will outline 3 key areas, divided up into the 3 ‘meal times’, of how food played a pivotal role in my identity formation:
- For ‘Breakfast’, I refer to a narrative I wrote called, « 7 Days Cereal » based on a childhood incident which highlights issues of self-loathing through the psychoanalytic lens of Julia Kristeva’s work on the abjected self. This section also considers food and our foodways as a form of community bonding.
- In ‘Lunch’, the narrative used here outlines the beginnings of appetite and a curiosity about the culinary ‘other’, which is grounded in cultural studies. This section also considers food as a form of self-care
- Over ‘Dinner’, I discuss the gendered food identities of my parents and grandmother, and how theirs impacted and shaped mine.
The narratives provide insight into the importance food plays in creating our identities. And therefore, by improving cultural awareness, and how this gets expressed, it can contribute to the building of better relationships between healthcare professionals and society.
Key Words: Narrative, Food, Identity
SP-37
The Art of Clinical Decision Making
Mark Gilbert PhD Post Doctoral Fellow, Division of Medical Education: Humanities, Faculty of Medicine, Dalhousie University, Halifax, NS.
William M. Lydiatt, M.D. Director, Head & Neck Surgical Oncology Section Professor and Vice Chair, Department of Otolaryngology University of Nebraska Medical Center, Omaha, NE, USA.
Regina Emily Robbins, PhD, RYT Faculty/Program Developer College of Education Health Education Northern New Mexico College Teacher Education Center, Espanola, NM, USA.
Friday April 15 / Vendredi 15 avril
16:30-17:00
Fairmount Queen Elizabeth / Convention Floor/ St-Charles
This paper reports on the use of the visual arts in a unique pre-med program, designed by the University of Nebraska Medical Center (UNMC) in collaboration with public schools. The High School Alliance (HSA) introduces students from varying educational and socioeconomic backgrounds to health professions through a humanistic approach to medical education that includes college courses covering a range of health care topics (e.g., human anatomy, biomedical research, and medical decision-making). HSA students observe, shadow, and work alongside world-renowned health care professionals and researchers. As part of the Art and Science of (Medical) Decision Making curriculum, the HSA students were invited to view and discuss examples of artistic portraits of patients and caregivers and participate in a practical workshop in which a professional artist facilitated a series of observational drawing exercises using a live model as subject matter. This course engaged students in observation, reflection, and dialogue while creating their own visual statements. Students were asked to consider how key aspects of the artistic process could be attributable to clinical decision-making and the doctor patient relationship. Students’ written reflections on class activities demonstrated that they deepened their appreciation for aesthetic statements and reportedly developed observation skills as well as more focused awareness, tolerance for ambiguity, and empathy. Programs like the HSA can complement medical students’ scientific and technical knowledge by augmenting their understanding of the critical and holistic aspects of clinical decision-making.
Key words: Clinical decision-making, drawing, reflection.
Creating Space VI , April 15-16 2016, Montréal 