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通过即兴喜剧和单口喜剧、图文医学以及被压迫者戏剧来传授推进健康公平。

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

作者信息

Chin Marshall H, Orlov Nicola M, Callender Brian C, Dolan James A, Miller Doriane C, Peek Monica E, Rusiecki Jennifer M, Vela Monica B

机构信息

M.H. Chin is the Richard Parrillo Family Distinguished Service Professor of Healthcare Ethics, Department of Medicine, and senior faculty scholar, Bucksbaum Institute for Clinical Excellence, University of Chicago, as well as codirector, Robert Wood Johnson Foundation Advancing Health Equity: Leading Care, Payment, and Systems Transformation National Program Office, and codirector, Merck Foundation Bridging the Gap: Reducing Disparities in Diabetes Care National Program Office, Chicago, Illinois; ORCID: https://orcid.org/0000-0003-1924-5641 .

N.M. Orlov is assistant professor of pediatrics, Department of Pediatrics, associate program director, Pediatric Residency Training Program, and junior faculty scholar, Bucksbaum Institute for Clinical Excellence, University of Chicago, as well as clerkship director for pediatrics, University of Chicago Pritzker School of Medicine, Chicago, Illinois.

出版信息

Acad Med. 2022 Dec 1;97(12):1732-1737. doi: 10.1097/ACM.0000000000004905. Epub 2022 Nov 23.

Abstract

Ninety-minute virtual workshops that used improvisational comedy, standup comedy, graphic medicine, and Theatre of the Oppressed were implemented in 2020 within a required health equity course at the University of Chicago Pritzker School of Medicine to train 90 first-year medical students in advancing health equity. Learning objectives were to (1) deepen understanding of diverse human experiences by developing relationship skills, such as empathy, active listening, engagement, and observation; (2) recognize how diverse patients perceive students and how students perceive them to gain insight into one's identity and how intersectional systems of oppression can stigmatize and marginalize different identities; and (3) engage in free, frank, fearless, and safe conversations about structural racism, colonialism, White and other social privileges, and systemic factors that lead to health inequities. With a 61% (109/180 [90 students × 2 workshops per student]) survey response rate, 72% of respondents thought workshops were very good or excellent, and 83% agreed or strongly agreed they would recommend workshops to others. Key recommendations are to (1) incorporate experiential storytelling and discussion; (2) define clear learning goals for each workshop, map exercises to these goals, and explain their relevance to students; and (3) create a safe, courageous, brave space for exploration and discussion. For health equity, transformation happens as students share their perspectives of curriculum content from their intersectional identities, experiences, and varied privileges; are challenged by others' perspectives; and attempt to understand how others can experience the same content differently. The arts create a powerful form of sharing beyond routine conversations or discussions, which is critical for honest dialogue on difficult topics, such as racism, homophobia, and White privilege and other social privileges. Educators should enable students to have the space, time, and courage to share their true perspectives and engage in authentic discussions that may be uncomfortable but transformative.

摘要

2020年,芝加哥大学普利兹克医学院在一门必修的健康公平课程中开展了时长90分钟的虚拟工作坊,运用了即兴喜剧、单口喜剧、图像医学和被压迫者戏剧等形式,对90名一年级医学生进行健康公平推进方面的培训。学习目标包括:(1)通过培养共情、积极倾听、参与和观察等关系技能,加深对不同人类经历的理解;(2)认识不同患者如何看待学生以及学生如何看待患者,以洞察自身身份,以及压迫的交叉系统如何给不同身份贴上耻辱标签并使其边缘化;(3)就结构性种族主义、殖民主义、白人及其他社会特权,以及导致健康不平等的系统性因素展开自由、坦诚、无畏且安全的对话。调查回复率为61%(109/180 [90名学生×每名学生2个工作坊]),72%的受访者认为工作坊非常好或优秀,83%的受访者同意或强烈同意会向他人推荐该工作坊。关键建议包括:(1)纳入体验式故事讲述和讨论;(2)为每个工作坊明确学习目标,将练习与这些目标对应,并向学生解释其相关性;(3)营造一个安全、勇敢、无畏的探索和讨论空间。对于健康公平而言,当学生从其交叉身份、经历和不同特权出发分享他们对课程内容的看法,受到他人观点的挑战,并试图理解他人如何以不同方式体验相同内容时,转变就会发生。艺术创造了一种超越常规对话或讨论的强大分享形式,这对于就种族主义、恐同症、白人特权及其他社会特权等困难话题进行诚实对话至关重要。教育工作者应让学生有空间、时间和勇气分享他们的真实观点,并参与可能令人不适但具有变革性的真实讨论。

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