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This report, produced as part of the UCSF Archives and Special Collections Summer Fellowship program, explores the efficacy of Optical Character Recognition (OCR) technology in processing archival documents. OCR technology, which automates the extraction of text from images, has significantly advanced recently, providing substantial benefits for archival organizations by making vast amounts of previously “hidden” data more accessible. This study specifically examines the disparities in OCR quality between handwritten and typewritten documents, highlighting that OCR’s effectiveness is considerably lower for handwritten texts. This discrepancy results in biases and underrepresentation in datasets, particularly affecting the accessibility and utility of handwritten documents from historical archives.Utilizing a dataset comprising documents related to AIDS/HIV activism from the 1980s and 1990s, this project evaluates the performance of three OCR tools—Tesseract, Google Cloud Document AI, and Amazon Textract—across different document types. The objective is to identify the most effective OCR solution for enhancing the accessibility of handwritten documents within the UCSF Archives and Special Collections. The findings aim to contribute to the broader archival field by addressing the challenges of digitizing and utilizing handwritten archival materials, thus supporting more inclusive and comprehensive historical research.

Welcome to the 25th anniversary edition of PLEXUS, UC Irvine School of Medicine’s annual student-organized Journal of Medical Humanities & Arts. To mark this celebratory milestone, it is with great pleasure that I present to you NAVIGATE. In the ever-evolving landscape of medicine, the ability to navigate through challenges and unforeseen obstacles is paramount. NAVIGATE serves as a timely invitation for our colleagues to reflect on the distances traversed and to envision the new horizons that lie ahead. We sought to highlight the constellation of tools utilized when we feel lost and to acknowledge the beacons that steer our actions. The subsequent pages offer its readers profoundinsights into the extraordinary journeys undertaken by the greater UCI Health community. We hope it delivers a sense of direction, solace, and clarity to all readers.As we celebrate our 25th anniversary, wehonor the visionaries, contributors, and readers that have propelled us forward on this remarkable voyage. Their collective support fuels our efforts to serve as a creative outlet for the community, catalyze meaningful discussions, and apply the tenets of medical humanities to foster a cohort of compassionate healers.We extend our deepest gratitude to our faculty advisors Dr. Juliet McMullin and Dr. TanNguyen for their invaluable guidance and for sharing their expertise within the field. We thank the UCISOM Medical Humanities & Arts Program and the UCI Department of Family Medicine for their unwavering support. I invite you to embark on this exploration with us, and witness the intricate tapestry of our contributors’ lived experiences that defines our shared journey in healthcare.Bon voyage,Christopher SahagianEditor-in-ChiefCreative Review — Caroline GeeCreative Review — Huan NguyenCreative Review — Sana ShahDesign — Nicole ParkerDesign — Britney WengFaculty Advisor — Dr. Juliet McMullinFaculty Advisor — Dr. Tan NguyenStaff Advisor — Leonora Naser-Saravia{Front Cover): NEW HEIGHTS Britney Weng, MS1San Pedro de Atacama, Chile(Inner Cover): TRAVERSING  Britney Weng, MS1Chile Route 23

Background: Medical humanities can contribute positively to clinical practice and medical education. Therefore, in many countries, medical schools have been progressively incorporating medical humanities into their curriculum. In Italy, only a few medical schools offer a variety of medical humanities courses, often as elective. What induces Italian medical students to take a medical humanities course has not yet been explored. The aim of this study is to fill this gap by investigating whether academic performance, sociodemographic and psychological variables may influence student motivation. Methods: We conducted a cross-sectional study in a medical school and collected data from 260 medical students, from the 3rd to the 6th year of the degree course. The students who chose to take a course in Medical Humanities were compared with those who chose not to take such a course, analysing numeric variables (age, grade point average, psychometric scores) and categorical variables (gender, nationality, educational level, living conditions). Motivations were investigated by open-ended questions and categorized prior to analyses. Results: The two subgroups showed no significant differences in sociodemographic characteristics, except for age, which was lower for the students who chose to take a medical humanities course (p < 0.001). Among the psychometric scores, only the anxiety score differed significantly between the groups, being lower for the students who chose a medical humanities course (p < 0.05). Regarding academic performance, the number of examinations passed was similar between the groups, while the average grade was lower for the students taking the course (p < 0.01). Interest in the humanities and their educational potential were the main reasons for choosing to take a course in medical humanities (76.2%). Concurrent commitments and lack of time were the major obstacles to this choice (39%). Conclusions: Age, anxiety levels and academic performance seem to be inversely associated with the choice to take a medical humanities course. Considering the workload due to curricular activities when planning elective courses could increase student participation. [ABSTRACT FROM AUTHOR]

There is a paucity of rigorous longitudinal data regarding the relationship between humanities and their effect on multiple psychometrics. Using an observational art course, we assessed pre- and post-course metrics and longitudinal impacts with 120 preclinical medical students taking the "Art of Observation" between 2016 and 2019. Jefferson Scale of Empathy (JSE) and Jeffreys Transcultural Self-Efficacy Tool (TSET) were assessed annually for four years. Budner Tolerance of Ambiguity (TOA) Scale was administered before and after the course. The JSE showed no drop in empathy as students progressed from first to fourth year (p = 0.374). The TSET showed statistically significant increases in cultural self-efficacy (p < 0.001) in the cognitive and practical components but no change in the affective component of the scale. After the art course, TOA significantly improved on two [solubility (p = 0.009) and complexity (p = 0.21)] of the three subscales, but not novelty (p = 0.62). Empathy and cultural self-efficacy remained consistently high throughout medical school and did not decrease during the clinical years in an institution prioritizing the humanities and community engagement. Comfort with cultural competency generally improved throughout training. After taking an art course that emphasizes cognitive flexibility and a multiple perspectival approach, students demonstrated greater tolerance for ambiguity. [ABSTRACT FROM AUTHOR]

Reflective writing (RW) is a popular tool in medical education, but it is being used in ways that fail to maximize its potential. Literature in the field focuses on why RW is used – that is to develop, assess, and remediate learner competencies – but less so on how to use it effectively. The emerging literature on how to integrate RW in medical education is haphazard, scattered and, at times, reductionist. We need a synthesis to translate this literature into cohesive strategies for medical educators using RW in a variety of contexts. These 12 tips offer guidelines for the principles and practices of using RW in medical education. This synthesis aims to support more strategic and meaningful integration of RW in medical education. [ABSTRACT FROM AUTHOR]

With the growing prevalence of health and illness narratives on digital platforms, research examining the social psychological processes involved in these storytelling environments remains scarce. This paper addresses this research gap by conducting a mixed-methods study of digital storytelling within the UK's healthcare context, focusing on online consumer reviews of the medical memoir, Do no harm: stories of life, death and brain surgery (Marsh, 2014). Utilising computer-assisted text analysis methods of LIWC-22 and the Sketch Engine, linguistic cues for cognitive, affective, social and perceptual processes are identified in a corpus of online consumer reviews. A subsequent qualitative analysis, based on 'narrative modulation' (Huang, 2024, 2020), investigates the role of these processes in constructing and developing storylines across the user reviews. Finally, the study explores how consumer reviews in the form of 'small stories' challenge canonical narratives in the UK's healthcare services. This research advances the field of narrative studies by emphasising the role of social psychological processes (Chung and Pennebaker, 2019) in modulating emerging, evolving and counter narratives in digital storytelling. The findings reveal an instrumental role of social psychological processes, as signalled by linguistic cues, in shaping narrative threads in online user reviews. This study not only develops narrative modulation as a valuable concept for narrative analysis, but also underscores its effectiveness when combined with computer-assisted text analysis tools for in-depth examinations of narrative data. Furthermore, it provides critical insights into digital storytelling in healthcare contexts, promoting knowledge transfer across narrative studies, stylistics, social psychology and medical humanities. [ABSTRACT FROM AUTHOR]

Background: Healthcare organizations are under pressure to improve services because of an aging population and increasing healthcare demands. Lean healthcare management focuses on improving service quality and efficiency under the condition of limited resources, but it may overlook patients' emotional needs and experiences, especially in developing countries. This study advocates integrating medical humanities with lean healthcare to develop a patient-centered service model. Methods: The study employs literature review to discuss the critical role of medical humanities in lean healthcare frameworks, both theoretical and practical. Additionally, it conducts a qualitative study through semi-structured interviews to explore strategies for developing a humanistic lean healthcare model. The study conducts semi - structured interviews with eight management staff members and doctors in a tertiary hospital in China that actively adopts this approach. Results: Eight managers and doctors (five female and three male) were interviewed between January and March 2024 at their chosen locations. Firstly, the study identifies key benefits of integrating medical humanities into lean healthcare, which are as follows: (1) Enhancing the personalization and comprehensiveness of services. (2) Building trust in doctor-patient relationships. (3) Boosting the satisfaction of healthcare teams. Secondly, it highlights strategies for a humanistic approach, namely: (1) Conducting comprehensive patient assessments and providing personalized treatments. (2) Enhancing doctor - patient communication for emotional resonance. (3) Optimizing the medical environment for humanized services. (4) Developing humanistic qualities among healthcare professionals. (5) Using information technology effectively. Additionally, the study also addresses potential issues regarding lean healthcare's focus on profitability and proposes preventive measures: (1) Implementing a scientific evaluation and incentive mechanism. (2) Enhancing transparency and oversight in healthcare. (3) Cultivating a patient - centric medical culture. Conclusions: This research proposes a patient-centered lean healthcare model integrating medical humanities, providing a novel framework for improving service quality and efficiency while ensuring compassionate care. This management framework can support the reform of public hospitals in China and also serve as a reference for other countries. [ABSTRACT FROM AUTHOR]

Storytelling events in medical education settings are a powerful way to share stories, build community, promote resilience, and foster well-being, but many educators are unsure how to go about creating an event. This paper outlines practical tips to empower readers to plan and carry out a successful, impactful storytelling event. [ABSTRACT FROM AUTHOR]

The document from the Clinical Teacher journal discusses various workshops and sessions aimed at enhancing medical education, addressing issues such as inequity, bioethics education, mental health assessment, and innovative teaching methods. The workshops cover topics like clinical entrepreneurship, bioethics education, game-based learning, mindfulness, and inclusive pedagogies. The sessions aim to equip educators with skills and knowledge to improve teaching practices, promote student engagement, and address challenges in medical education. The document emphasizes the importance of supporting educators at all career stages and fostering a collaborative and inclusive learning environment. [Extracted from the article]

Contributing to the emerging field of critical sleep studies, and developing an intervention situated at the intersection of the environmental and the medical humanities, this article considers a range of contemporary texts: Jenny Offill's realist novel Weather (2020), Karen Russell's Sleep Donation (2014), Cherie Dimaline's The Marrow Thieves (2017) and Hunting by Stars (2021) – three examples of the 'sleep-apocalypse' genre – Finegan Kruckemeyer's play Hibernation (2021), and the Perfect Sleep app by Tega Brain and Sam Lavigne (2021). I show how these texts do not just simply reflect the negative effects that climate change has on sleep health, which are manifold, as scientific research evidences. Rather, cultural production arguably draws attention to structural parallels between the climate crisis and the so-called sleep crisis, namely, contemporary society's presumed widespread sleep deprivation and rise in sleep disorders. Both crises are the product of a capitalist system geared towards continuous extraction – and exhaustion – of resources, from the Earth and human bodies. Thus, in the texts considered, sleep is explored, on the one hand, as a casualty of the climate crisis and, on the other hand, as something whose value we need to reassess as part of our ongoing work to avert climate collapse. [ABSTRACT FROM AUTHOR]

Narrative structures, though invisible to the naked eye, guide our understanding of pandemics. Like curves and graphs, we can plot them, identify their patterns and organizing principles. These structures act upon our understanding of social and biological events just as much as the rhythms of viral replication and mutation. They order not only themselves but also social and health outcomes. This essay uses narrative precision to expand beyond Charles Rosenberg's influential dramaturgic model and develops new pandemic forms, scaled from the level of an individual line break to the multi-part series: Arc, a form of sequence. Cycle, a form of repetition. Sequel, a form of elongation. Caesura, a form of break. It investigates the potentialities and limitations of these forms, how they intersect, collide, and contradict, and how analysis of these interactions contributes to a deeper understanding of pandemics, their effects, and the diverse perspectives defining their structures. In doing so, it prototypes how literary methods offer conceptual frameworks for pandemic historiography and how a transdisciplinary, medical humanities analysis produces novel understandings at the intersection of health, culture, and society. [ABSTRACT FROM AUTHOR]

Appropriate use of medical terminology is one of the core conditions for successful communication in monolingual and multilingual healthcare communities. The modern scientific language is based on the descriptive terminology. However, it is often the case that the advantages of descriptive terminology are at odds with the ability to express complex concepts in just a few words. To solve this practicality problem it is customary to coin abbreviations and acronyms preferred to traditional eponyms. Today eponyms are considered ambiguous and non-descriptive, linked to the terminology of the past. The overview of this study demonstrates that the current habit of using acronyms can increase the scientific descriptive capacity compared to eponyms. On the other hand, acronyms remain ambiguous and more ephemeral than eponyms. Furthermore, eponyms are not as descriptive as acronyms, but they still carry important information for a medical student. If you truly believe in the importance of Medical Humanities in the medical curriculum, two aspects cannot be overlooked. First, eponyms bring students closer in an almost subliminal way to the history of medicine and the non-strictly technical-scientific field of medicine. Second, medicine is a complex science applied to humans and must strive to keep the patient at the center of its interests. Patients and their families preferably ask us to use eponyms. Which terminology to choose for medical students? The teachers have the last word. [ABSTRACT FROM AUTHOR]

Background: The Polish educational system for nurses has undergone a substantial transformation over the past two decades, with the introduction of a mandatory university education that encompasses humanization in medicine. Consequently, nurses who had been licensed to practice before the implementation of the reform returned to universities to pursue master's degrees alongside their younger colleagues who had only recently obtained bachelor's degrees. This distinctive learning environment, in which nurses of varying ages and years of practice study together, offers an opportunity to gain insight into their perspectives on the educational process. Accordingly, the present study aims to examine the opinions of Polish postgraduate nursing students at one university regarding medical humanization courses, focusing on the extent to which these opinions are shaped by age, years of service, and specialty of nursing care. Methods: From February to June 2023, an anonymous survey was conducted on the university's online platform, involving 89 out of 169 participants in the master's degree nursing program. The newly designed questionnaire comprised 15 primary questions and 11 metric questions. Results: The study population consisted of registered nurses with a mean age of 35 years (ranging from 22 to 54 years). The majority of participants were women (97.8%). The analysis revealed that older students (Spearman's rho 0.480, p < 0.001) and those with more years of professional experience (Spearman's rho 0.377, p < 0.001) perceived humanizing classes as a vital component of nurse training and work. Younger and less experienced students did not share this perspective. Specialization status was also identified as a differentiating factor (Chi² = 10.830, p < 0.05). However, other characteristics, including the number of positions held during the survey, the type of position, the primary employer, and the nature of work (shift or non-shift), did not exhibit statistically significant differentiation among participants. Conclusions: This study found age- and work-experience-related differences in nursing students' opinions toward courses teaching humanization in health care. The results suggest that changing the teaching format and involving older and more experienced students in sharing experiences with younger and less experienced students could potentially improve the implementation of learned skills in clinical practice. [ABSTRACT FROM AUTHOR]

Purpose This study aimed to implement and evaluate the outcomes, perceptions, and satisfaction of the Capstone Program developed at the Catholic University of Korea, which integrates career exploration and medical humanities. Methods This study was conducted with fourth-year medical students from 2017 to 2019. First, the study analyzed the trends in the results of Capstone Projects conducted by students as part of their career exploration, where they independently explored areas of interest and selected topics. Second, it qualitatively analyzed the content of individual reports in which students reflected on their experiences from a “medical humanities perspective” through the Capstone Program. Third, it examined students’ perceptions and satisfaction with the Capstone Program. Results The analysis revealed that students chose research topics from a wide range of fields, including basic medicine, clinical medicine, global healthcare, and integrated healthcare systems and innovation. The students reported positive perceptions of their career exploration and research experiences through the Capstone Program, particularly valuing sessions like “Meetings with Seniors” within the conference framework. Students indicated that the Capstone Program enhanced their ability to think introspectively from a humanities perspective, deepening their understanding of their roles and responsibilities as medical professionals. Conclusion The Capstone Program provides a significant opportunity for medical students to explore their career paths and engage in introspective reflection from the viewpoint of medical humanities and social sciences. Thus, the integration of programs like capstone into the broader medical curriculum, focusing on career guidance and the reinforcement of medical humanities education, is imperative. [ABSTRACT FROM AUTHOR]

The Justice, Equity, Diversity, Inclusion, and Belonging (JEDIB) committee formed in 2022 in order to support diversity and inclusion in the Health Humanities Consortium and to advance best practices for equity and inclusion in the field of medical and health humanities. This Forum Essay describes our first year of work, including participant-led commitment statement crafting and strategic planning. Health humanities-specific JEDIB work is described in detail in essays about disability justice; gender, sex, sexuality, and reproductive justice; and Indigeneity from a decolonial standpoint. The authors offer transferable techniques for other organizations and institutions with particular attention to heath care and health professions education. Another essay analyzes US institutional and demographic data to show that as an academic program, health humanities gives robust indicators of contributing significantly to student diversity and inclusive success in higher education and medical education. The Forum closes with a reflection on joining the work of equity and inclusion and what new priorities and awareness can emerge to inform health equity scholarship and epistemic justice. [ABSTRACT FROM AUTHOR]

Despite the ubiquity of healthcare simulation and the humanities in medical education, the two domains of learning remain unintegrated. The stories suffused within healthcare simulation have thus remained unshaped by the developments of narrative medicine and the health humanities. Healthcare simulation, in turn, has yet to utilize concepts like co-construction and narrative competence to enrich learners' understanding of patient experience alongside their clinical competencies. To create a conceptual bridge between these two fields (including narrative-based inquiry more broadly), we redescribe narrative competence via Ronald Heifetz's distinction of "technical" and "adaptive" challenges outlined in his adaptive leadership model. Heifetz, we argue, enriches learners' self-understanding of the unique demands of cultivating narrative competence, which can be both elucidated on the page and tested within the charged yet supportive simulation environment. We introduce Co-constructive Patient Simulation (CCPS) to demonstrate how working with simulated patients can support narrative work by drawing on the clinical vicissitudes of learners in the formulation and enactment of case studies. The three movements of CCPS—resensing, retelling, and retooling—told through learner experiences, describe the affinities and divergences between narrative medicine's sequence of attention, representation, and affiliation; Montello's three forms of narrative competence (departure, performance, change), and Heifetz's three steps (observe, interpret, and intervene) of adaptive leadership. [ABSTRACT FROM AUTHOR]

This paper examines the efficacy of incorporating spiritual practices, such as prayer and pilgrimages, into patient-centered care to enhance the healing journey of individuals experiencing illness. Using Lisa Ray's cancer memoir, Close to the Bone (2019), we seek to investigate the impact of spirituality, sacred spaces, and faith on maintaining an individual's religiosity during times of ailment. Our analysis of the potential salubrious effects of incorporating practices like prayer and pilgrimages, as well as the ameliorative influence of storytelling and community, aims to shed light on the utility of these practices in healthcare. Furthermore, we aim to situate prayer as a healing modality and examine the pertinence of Hindu pilgrimage sites in India to the case study. By evaluating the spiritual practices and sacred spaces that facilitated Lisa's healing journey, we hope to contribute to the understanding of the importance of including spiritual practices and beliefs in patient care within the interdisciplinary framework of medical humanities, which encompasses a wide array of disciplines concerned with the human pursuit of health and well-being. [ABSTRACT FROM AUTHOR]

Abstract Background Medical humanities can contribute positively to clinical practice and medical education. Therefore, in many countries, medical schools have been progressively incorporating medical humanities into their curriculum. In Italy, only a few medical schools offer a variety of medical humanities courses, often as elective. What induces Italian medical students to take a medical humanities course has not yet been explored. The aim of this study is to fill this gap by investigating whether academic performance, sociodemographic and psychological variables may influence student motivation. Methods We conducted a cross-sectional study in a medical school and collected data from 260 medical students, from the 3rd to the 6th year of the degree course. The students who chose to take a course in Medical Humanities were compared with those who chose not to take such a course, analysing numeric variables (age, grade point average, psychometric scores) and categorical variables (gender, nationality, educational level, living conditions). Motivations were investigated by open-ended questions and categorized prior to analyses. Results The two subgroups showed no significant differences in sociodemographic characteristics, except for age, which was lower for the students who chose to take a medical humanities course (p

Abstract There is a paucity of rigorous longitudinal data regarding the relationship between humanities and their effect on multiple psychometrics. Using an observational art course, we assessed pre- and post-course metrics and longitudinal impacts with 120 preclinical medical students taking the “Art of Observation” between 2016 and 2019. Jefferson Scale of Empathy (JSE) and Jeffreys Transcultural Self-Efficacy Tool (TSET) were assessed annually for four years. Budner Tolerance of Ambiguity (TOA) Scale was administered before and after the course. The JSE showed no drop in empathy as students progressed from first to fourth year (p = 0.374). The TSET showed statistically significant increases in cultural self-efficacy (p

Abstract Background Healthcare organizations are under pressure to improve services because of an aging population and increasing healthcare demands. Lean healthcare management focuses on improving service quality and efficiency under the condition of limited resources, but it may overlook patients’ emotional needs and experiences, especially in developing countries. This study advocates integrating medical humanities with lean healthcare to develop a patient-centered service model. Methods The study employs literature review to discuss the critical role of medical humanities in lean healthcare frameworks, both theoretical and practical. Additionally, it conducts a qualitative study through semi-structured interviews to explore strategies for developing a humanistic lean healthcare model. The study conducts semi - structured interviews with eight management staff members and doctors in a tertiary hospital in China that actively adopts this approach. Results Eight managers and doctors (five female and three male) were interviewed between January and March 2024 at their chosen locations. Firstly, the study identifies key benefits of integrating medical humanities into lean healthcare, which are as follows: (1) Enhancing the personalization and comprehensiveness of services. (2) Building trust in doctor-patient relationships. (3) Boosting the satisfaction of healthcare teams. Secondly, it highlights strategies for a humanistic approach, namely: (1) Conducting comprehensive patient assessments and providing personalized treatments. (2) Enhancing doctor - patient communication for emotional resonance. (3) Optimizing the medical environment for humanized services. (4) Developing humanistic qualities among healthcare professionals. (5) Using information technology effectively. Additionally, the study also addresses potential issues regarding lean healthcare’s focus on profitability and proposes preventive measures: (1) Implementing a scientific evaluation and incentive mechanism. (2) Enhancing transparency and oversight in healthcare. (3) Cultivating a patient - centric medical culture. Conclusions This research proposes a patient-centered lean healthcare model integrating medical humanities, providing a novel framework for improving service quality and efficiency while ensuring compassionate care. This management framework can support the reform of public hospitals in China and also serve as a reference for other countries.

Abstract Storytelling events in medical education settings are a powerful way to share stories, build community, promote resilience, and foster well-being, but many educators are unsure how to go about creating an event. This paper outlines practical tips to empower readers to plan and carry out a successful, impactful storytelling event.

This article brings Catherine Malabou's explorations of bodily mutation and metamorphosis at the intersections of philosophy and biomedical science into contact with film. In particular, it explores dialogues between Malabou's work on biomedical understandings of bodily plasticity and filmic representations of medical interventions in the body. This article specifically explores Malabou in relation to Katell Quillévéré's film Heal the Living (Réparer les vivants, 2016), an adaptation of Maylis de Kerangal's novel The Heart (Réparer les vivants, 2014). The film tells the story of Simon Limbres, who is taken to a hospital following a road accent and pronounced brain dead. The film then explores how Simon undergoes organ donation, following his organs on their journey to other bodies in need. I argue that Heal the Living allows us to challenge and extend Malabou's central thinking of (neuro)plasticity, precisely by emphasising the plasticity of the body beyond and in the wake of the brain. Further, the film's emphasis on transplantation allows for an exploration of interpersonal plasticity, developing an ethics of transplanted plasticity in testing and extending conceptions of otherness and alterity central to Malabou's thinking.

OBJECTIVES: Medical humanities has evolved to encompass a multidisciplinary approach, integrating humanities, social sciences, and arts into medical education and practice. Despite its flourishing development, the definition of medical humanities still requires refinement to be inclusive of various cultures and regions. This study aimed to explore perceptions among students, physicians, and nurses, with a focus on the definition, learning, and implementation of medical humanities. MATERIALS AND METHODS: We conducted four heterogeneous focus groups, comprising 4th-year and 6th-year medical students, physicians (including three medical humanities educators), and nurses. Data collection utilized semi-structured guiding questions, followed by thematic analysis. The transcripts were manually analyzed in their original Mandarin, and participant names were anonymized to ensure that the authors remained unaware of the participants’ identities throughout the study. Results: The analysis identified three themes and 16 subthemes. Theme 1, “Medical Humanities Properties,” included four subthemes: variety, evolvement, clinical relevancy, and the value of humaneness. Theme 2, “Medical Humanities Contents,” comprised seven subthemes: self-cultivation, communication, empathy, cultural competence, medical ethics and law, embodiment, and one subtheme open for interpretation in varying circumstances. Theme 3, “Medical Humanities Cultivation,” included five subthemes: personal growth, curriculum, multimedia, clinical experience, and metacognition. Conclusion: Our study introduces a three-layered framework of medical humanities, emphasizing the field’s dynamic nature and the critical role of experiential learning in developing key competencies such as empathy, awareness, and communication. This framework incorporates the concept of “self-cultivation” from Eastern philosophy, accentuating the significance of well-being for health-care professionals. The research not only enriches medical humanities education and practice by incorporating Eastern perspectives but also deepens the overall understanding of humanity in health care.

Abstract Background The Polish educational system for nurses has undergone a substantial transformation over the past two decades, with the introduction of a mandatory university education that encompasses humanization in medicine. Consequently, nurses who had been licensed to practice before the implementation of the reform returned to universities to pursue master’s degrees alongside their younger colleagues who had only recently obtained bachelor’s degrees. This distinctive learning environment, in which nurses of varying ages and years of practice study together, offers an opportunity to gain insight into their perspectives on the educational process. Accordingly, the present study aims to examine the opinions of Polish postgraduate nursing students at one university regarding medical humanization courses, focusing on the extent to which these opinions are shaped by age, years of service, and specialty of nursing care. Methods From February to June 2023, an anonymous survey was conducted on the university’s online platform, involving 89 out of 169 participants in the master’s degree nursing program. The newly designed questionnaire comprised 15 primary questions and 11 metric questions. Results The study population consisted of registered nurses with a mean age of 35 years (ranging from 22 to 54 years). The majority of participants were women (97.8%). The analysis revealed that older students (Spearman’s rho 0.480, p

Editor's NotePLEXUS is a student-organized journal of the arts and humanities that showcases creative work by medical students, physicians, faculty, and others in the UC Irvine medical community. Through the universal language of art, the journal aspires to connect those who seek to heal and be healed.We hope that PLEXUS will always serve as a creative and welcoming space in which we can all reflect and express our various emotional journeys in medicine and in life. Medicine, especially in recent years, may feel like a solitary endeavor. Now, more than ever, we hope PLEXUS provides solace and community to all who contribute to and view its pages.Identity is the fact of being or knowing what and who we are – an intrinsic property of ourselves and our world that can be challenged, taken for granted, and ultimately shaped by how we choose to live. This year's 24th edition of PLEXUS, Identity, focuses on the experiences and reflections that make us who are. We are moved by forces and convictions that define our individual identities, our motivations in healthcare, and our society. Let us celebrate the triumphs and mourn the losses that carry us to the present and remember the hopes and ambitions we have for the future.We are incredibly grateful to our amazing community for their support in sustaining PLEXUS. We would like to give special thanks to our faculty advisors Drs. Juliet McMullin, Tan Nguyen, and Frank Meyskens. As well as the Endowed Program in Medical Humanities & Arts and the Department of Family Medicine. This journal would not have been possible without their continuous support and guidance.We hope you enjoy PLEXUS 2023: Identity.Kenneth Schmitt (MS4), Celina Yang (GR1), Ashley Hope (MS4)Editors in Chief(Front cover) Tower, Clifford Danza, MS1(Background image) Salt of the Earth. Ashley Hope, MS4

Studio Art Therapy is a unique learning ecology with border crossings between visual arts therapies and art studio practice, education, and health. The increased fluidity between research and practice spaces, art therapy, and arts health are elaborated as a concept, theorized with the western Deleuzoguattarian philosophy. Connections and differentiations between art making and art as therapy are revealed in a discussion of an empirical research project Art, Visual Narrative, and Wellbeing Project (AVNAW). Studio art therapy focuses on body, meaning, and healing. It speaks to the value of people making art, reflecting and talking about their making processes alone and together through an autoethnographic visual narrative approach to artmaking. The paper asks how studio visual artmaking can activate individual productive desire to adapt toward becoming well through artmaking. Care, community, belonging, and resilience are core to a studio art therapy learning ecology that responds to real-life experiences in the support of personal care and wellbeing.

Kain Kim,1 Elizabeth Hornor,2 Ali-John Zarrabi3 1Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA; 2Michael C. Carlos Museum, Emory University, Atlanta, GA, USA; 3Division of Palliative Medicine, Department of Family and Preventive Medicine, Emory University, Atlanta, GA, USACorrespondence: Kain Kim, Emory University School of Medicine, 2015 Uppergate Dr, Atlanta, 30307, Tel +1 201 820 5533, GA, Email kaikim0213@gmail.comIntroduction: Despite the growing evidence favoring use of context-based interdisciplinary pedagogies in medical education, museum learning remains underutilized as a low-cost, replicable tool for introducing such constructs. We describe a novel approach to museum-based education building off the existing pedagogy of Visual Thinking Strategies that heightens the role of context.Methods: Outside the Frame, an optional elective at Emory University School of Medicine, was piloted in two iterations for a total of 7 second-year medical students who voluntarily enrolled in the course for the fall 2022 and 2023 semesters. Participating students were transitioning from the preclinical classroom environment to clinical clerkships, a period associated with feelings of personal and professional instability that may particularly benefit from critical reflection. The course included didactic components, hands-on crafting activities, presentations, and discussion groups. Student feedback was collected through anonymous pre- and post-course surveys, as well as written narrative reflections.Results: All post-course responses ranked their experience of the course as being “valuable” or “very valuable”. Narrative reflections were overall positive and highlighted the role of context and cross-disciplinary input in shaping metacognitive awareness and cultivating comfort with uncertainty.Discussion: This pilot innovation demonstrates that a methodical framework to arts-based learning can elevate the role of context in a standardized museum education curriculum. Future visual arts and medicine courses may incorporate this framework to chart more active collaborations with museum educators and humanities faculty, as well as engage a broader range of communities and professional disciplines beyond medicine.Keywords: medical humanities, visual arts, undergraduate medical education, pedagogy, curriculum evaluation

Art therapy fosters emotional healing and growth. This process can offer healthcare professionals (HCPs) novel insights into patients' medication experiences. We developed a Metaverse Art Gallery of Image Chronicles (MAGIC), which depicted patients' medication experiences symbolically as hero–villain portrayals. This gallery aimed to enhance healthcare students' learning through relatable insights into patients' medication therapies. A character sheet was used to craft patients' personifications of their medication experiences through an art-based narrative therapy approach. ChatGPT, NightCafe, Canva, HeyGen, and Camtasia were used to generate hero–villain portraits based on the character traits and mounted in MAGIC, which consisted of three virtual realms, each with a unique theme. Alpha-testing among sixteen Generation Z healthcare learners indicated that the content in MAGIC enabled them to understand the concepts of medication adherence (93.7%), art therapy (87.5%), and how patients related to their medications (81.3%). Perceived playfulness (rs = 0.925, p < 0.001), perceived compatibility (rs = 0.890, p < 0.001), and social norm (rs = 0.862, p < 0.001) were strongly associated with their behavioral intention to adopt MAGIC as an educational platform. The learners enjoyed their experience (6.31 ± 0.70), felt that MAGIC was interactive and engaging (6.25 ± 0.78), and had the potential to be more effective than traditional learning methods (5.94 ± 0.93). Furthermore, they would recommend it to others for their education (5.94 ± 0.85). [ABSTRACT FROM AUTHOR]

Studio Art Therapy is a unique learning ecology with border crossings between visual arts therapies and art studio practice, education, and health. The increased fluidity between research and practice spaces, art therapy, and arts health are elaborated as a concept, theorized with the western Deleuzoguattarian philosophy. Connections and differentiations between art making and art as therapy are revealed in a discussion of an empirical research project Art, Visual Narrative, and Wellbeing Project (AVNAW). Studio art therapy focuses on body, meaning, and healing. It speaks to the value of people making art, reflecting and talking about their making processes alone and together through an autoethnographic visual narrative approach to artmaking. The paper asks how studio visual artmaking can activate individual productive desire to adapt toward becoming well through artmaking. Care, community, belonging, and resilience are core to a studio art therapy learning ecology that responds to real-life experiences in the support of personal care and wellbeing. [ABSTRACT FROM AUTHOR]

Historical fiction can be understood as a hybrid space: it represents the past and simultaneously allows a consideration of the culture it is written in. Under the assumption that novels help address cultural shifts and attitudes, this paper aims to investigate how, why, and with what implications medical discourses surrounding women are depicted in fiction. This paper explores the manifold conceptualizations of hysteria in An Inconvenient Wife written by Megan Chance in 1998, arguing that the novel presents a complex view of discourses of medicalization. Its central claim is that the novel constructs hysteria not only as a tool of oppression but also as a tool with which to escape social constraints and patriarchal control. Through understanding historical fiction as not merely commenting on the past, but as addressing contemporary issues, the text adds to discussions centering on intersections of medicine and literature. [ABSTRACT FROM AUTHOR]

Background Objectives Methods Results Conclusions The history of studies in the field of infertility represents a chapter of great interest in gender issues.This paper aims to delve deep into the historical roots of the aspect of gender inequality related to couple infertility, with a journey back in time, from classical antiquity to the contemporary age, reporting junctions and metaphors linked to particular historical moments as well as to cultural and religious constructs.This is a narrative review based on an extensive literature search of publications regarding the role of women in couple infertility over the centuries.Rarely in the ancient world, male infertility was taken into consideration, and the sources deal with it mainly indirectly. This attitude of “blaming” the woman for the lack of children had, in fact, strong social implications, which only the scientific research of recent years has managed to bring back into the context of a more egalitarian approach.In the “journey” narrated in this article, the reader starts from the responsibility of couple infertility attributed exclusively to women in some ancient societies, whose central role was determined by their ability to procreate, going up to the medicalization of infertility in the contemporary age, which contributed to sharing with men this participation in the impossibility of having children. [ABSTRACT FROM AUTHOR]

In Ill Feelings (2021), Alice Hattrick shares their experience and history of ME/CFS, a chronic illness that not only dictates their own life but also their mother’s. Drawing on their own diary entries, medical documents, and literary and artistic material, Hattrick blends the voices of women whose illnesses cannot be cured in a standardized medical fashion, because their origins remain unknown. Hattrick’s narrative echoes the reactions of disbelief individuals dealing with Long COVID and other forms of post-viral fatigue have experienced. It is a defiant account of illness that resists the gendered nature of medical diagnosis and seeks to undo the structures that continue to question and condemn women patients to a life in hiding. In this article, I explore the ways in which Hattrick re-establishes truth to the illness narratives of women. Building on knowledge that has shaped the medical humanities, I argue that Hattrick redefines what doctors have termed their hysterical language, one they share with their mother, to create a network of support for women that encourages them to speak their language of ill feelings, find understanding, and thereby oppose institutional medicine. [ABSTRACT FROM AUTHOR]

Bilingual language process is a key factor in left side of the brain. The cognition of the learning modalities is very crucial for assimilation, organization, and interpretation of knowledge. The neurochemical events like estrogen, testosterone, dopamine 5HT, Oxytocin, nerve growth factor (NGF) play as neuro-endocrine brain axis for learning to cognition. The human cognition recognises the language in five stages that is input, status of language, getting access over the literature of that language, interaction with family, and finally social network communication. The factors influence the bilingual aspects include language exposure, genes, perception and receiving, neurochemical pathways, social communication, and environmental conditions. Apart from these elements the other external influencing factors like health humanities and technological advances and make a lot of impact on cognition processes and mental health. [ABSTRACT FROM AUTHOR]

The document "Arts Participation Amongst Healthcare Professionals: An Analysis of US Census Data" examines the involvement of healthcare professionals in the arts. Using data from the US Census Bureau, the study finds that healthcare professionals are less likely than the general population to engage in various arts activities. This suggests a need for further research and integration of the arts in clinical training to enhance empathy and reduce burnout among healthcare professionals. However, the study acknowledges limitations such as a small sample size and potential bias in self-reporting. [Extracted from the article]

Objective: To examine which met and unmet needs are discussed in stillbirth stories shared on YouTube with the aim to improve obstetric care. Design: Inductive thematic analysis of 19 English‐language stillbirth stories uploaded to YouTube. Setting: Online setting, YouTube video content. Sample: Women who experienced stillbirth and shared a video on YouTube talking about their experience. Methods: We conducted a thorough textual reading of the transcripts following Braun and Clarke's guidelines for thematic analysis. Main outcome measures: Codes were developed and grouped into themes. Results: Although some women actively used their birth videos to call out shortcomings in their care, most others used their platform for other purposes such as destigmatisation, awareness and support, and rather unintentionally provided insight into their met and unmet needs. When analysing their birth stories, three major themes emerged: choice and decision‐making, education and information, and behaviour of healthcare providers. Conclusions: This study demonstrates the value of birth stories in research. We identified three major opportunities for improvement of obstetric care: being provided with options and being able to make choices in the decision‐making process are clearly valued, but there are some caveats: women and other childbearing individuals need timely and continuous information, and more attention is needed for emotional intelligence training of healthcare providers. [ABSTRACT FROM AUTHOR]

This article examines the history and content of a forgotten American magazine, the Medical Pickwick. Published from 1915 to 1927, the Medical Pickwick was advertised as "a monthly literary magazine for and by physicians," publishing a striking array of content, including short stories, cartoons, jokes, anecdotes, poetry, autobiography, medical histories, book reviews, and much more. Digitized primary sources, specifically issues of the magazine and medical journals, are studied closely to narrate how medical professionals viewed and employed the Medical Pickwick as a publication. Mainly concerned as a project of recovery, this article situates the magazine within the context of ongoing discussions among researchers working at the intersection of medicine and literature, investigating how its varied content can provide insight into issues germane to the interests of both literary researchers and medical historians. Of particular importance is how its physician-based readership leveraged the magazine to pursue literary and humanistic projects, finding in the Medical Pickwick a venue that explicitly avoided printing technical material. The magazine, rather, was established and edited as a publication that attempted to draw physicians' attention to creative work that would distract them from the challenges of their careers. In what is only a brief exposition of this magazine's many pages, this article aims to stimulate future research into its texts and visual culture. [ABSTRACT FROM AUTHOR]

This article attends to the act of speaking after death as it is explored by Étienne Dolet, François Rabelais, and surgeon Ambroise Paré. Dolet addresses a poem to Rabelais in 1538 – the year of Rabelais's public dissection in Lyon – imagining a dissected corpse that is mute, in contrast to a garrulous, ineffective anatomist. This poetic consideration of voice and authority informs a new reading of Epistemon's resurrection in Pantagruel, where the exemplary value of Epistemon's testimony is reconsidered in relation to the overlooked medical feat of this episode, Panurge's suturing of Epistemon's neck. The article ends with a case history by Paré in which he sutured a patient's slit throat well enough for him to speak. Speaking with the dead is reconfigured from rhetorical flourish to medical fact, from poetry to fictional narrative to medical case history, allowing for a reconsideration of interdisciplinary method for early modern studies and beyond. [ABSTRACT FROM AUTHOR]

Background. The newly introduced 'Elective programme', a voluntary special study module in the final phase of the undergraduate medical curriculum, offers scope for new immersive, self-directed learning opportunities. We describe a programme of study for learning 'medical sociology' through the innovative use of humanities in medicine. Methods. Our elective module, called 'Community Health and Rock Music' (CHaRM), was a 2-week programme, merging the curricular subject of community health with 'rock music' as an exposure to the 'counter-culture' outside of the medical world. The half-day sessions consisted of: (i) watching/listening to a rock song-video without reading its lyrics; (ii) listening to the same song again but with lyrics; (iii) undertaking an emotionally stimulating activity (watching a movie, making a site-visit, etc.); and (iv) debriefing, to identify/discuss the underlying social determinants of health and their relevance in the grooming of a socially aware medical student. Formative assessment was intended to gauge levels of expression of the affective domain (attitude/emotions). Results. Seven of 143 students volunteered for this programme. Key learnings were a clear appreciation of the societal determinants of health (such as deprivation/discrimination/social structures); multi-level causation of diseases; social issues not addressed in traditional medical curriculum; personal growth; teamwork; and the role of empathy in medical practice. Additional learning was the exposure to the 'counter-culture of arts'. All 7 student assessments 'met expectation', with 4 of them 'exceeding expectation'. Conclusion. An 'elective programme' combining humanities with medicine is potentially an innovative, studentcentric and replicable model of learning that impacts the affective domain critical for doctors-in-training. [ABSTRACT FROM AUTHOR]

The article "Intersex Medical Photography, Sous Rature (Under Erasure): Haunted Colonial Histories and Decolonial Intersex Futurities" explores the ways in which certain bodies and corporeal features are pathologized and produced as abnormal by eugenic ideologies. The author focuses on South African medicine and its colonial and racist underpinnings, debunking the claim that intersexuality is disproportionately common among Black South Africans. The article highlights the activism of South African intersex individuals in contesting pathologization and advocating for bodily autonomy and self-determination. The author also discusses the unique methodological approach of the book, which intentionally excludes medical photographs of intersex individuals to disrupt the objectifying logics of colonial medicine. Overall, the article offers a decolonial perspective on intersexuality and envisions more just and inclusive futures. [Extracted from the article]

This article presents the testimonies of 24 faculty members of Arts and Humanities from five Spanish universities on the use of digital technology resources and their benefits for learning and educational inclusion of students with disabilities. They were selected by their own students with disabilities for their inclusive practices. Using a qualitative methodology, two semi-structured individual interviews were conducted with each participant to analyse different areas of inclusive pedagogy: beliefs, knowledge, designs and actions. The data were progressively analysed through a system of categories and inductive codes. The results show the digital resources that faculty members put into practice, as well as the different uses they make of them. In addition, the participants highlighted a number of benefits that digital technology has for the learning of all students, including those with disabilities. Finally, these results are discussed with those of previous studies, offering recommendations for the university to move toward a more inclusive education. [ABSTRACT FROM AUTHOR]

Purpose: The Korean Society of Medical Education (KSME) was founded in 1983 and celebrated its 40th anniversary in 2023. This study examines the evolution of topics discussed at KSME conferences from 1971 through 2023, highlighting shifts in the focus of medical education. Methods: We analyzed 90 KSME conferences over 5 decades (1970s, 1980s, 1990s, 2000s, and 2010s), categorizing the topics into three eras based on emerging themes and continuity. Results: Consequently, 37 topics covered at the conference were categorized. Ten topics continuously appeared from the 1970s to the 2010s, including future directions of medical education, teaching methods, faculty development, and curriculum. The topics from the 1970s to the 1990s included 14 areas, such as medical education evaluation, non-undergraduate curriculum, communityrelated, and research. Thirteen new topics emerged after the 2000s, such as social accountability, student support, professionalism, and quality improvements. The most common topics under innovations in medical education, a case of curriculum innovation at universities that began after 2000, were clinical clerkship, curriculum development, and medical humanities. Conclusion: KSME’s selection of conference topics has been strategically aligned with societal needs and the evolving landscape of medical education. Future topics should continue to address relevant societal and educational challenges. [ABSTRACT FROM AUTHOR]

Health disparities education is an integral and required part of medical professional training, and yet existing curricula often fail to effectively denaturalize injustice or empower learners to advocate for change. We discuss a novel collaborative intervention that weds the health humanities to the field of health equity. We draw from the health humanities an intentional focus retraining provider imaginations by centering patient narratives; from the field of health equity, we draw the linkage between stigmatized social identities and health disparities. We describe a longitudinal health equity curriculum for the Hospice and Palliative Medicine fellowship in Memphis, Tennessee, to give trainees exposure to the concept of structural violence and how it affects clinical care. The curriculum was developed in partnership with humanities and social sciences faculty who staff a Health Equity academic program at a small liberal arts college in Memphis. This curriculum has been implemented for the past four years in support of 22 hospice and palliative medicine fellows. Group debriefs and a mixed methods survey have revealed widespread and lasting impact towards understanding health equity concepts, enhanced communication and treatment of patients, and empowerment to address the broader needs and policies affecting patients and the communities in which they live. Ultimately, we model an educational initiative that integrates equity across the full scope of healthcare practice and equips learners with skills for sustaining compassionate practices, focusing on equity-oriented, person-centered care across the full scope of healthcare practice. [ABSTRACT FROM AUTHOR]

Much innovation has taken place in the development of medical schools and licensure exam processes across the African continent. Still, little attention has been paid to education that enables the multidisciplinary, critical thinking needed to understand and help shape the larger social systems in which health care is delivered. Although more than half of medical schools in Canada, the United Kingdom, and the United States offer at least one medical humanities course, this is less common in Africa. We report on the "liberal arts approach" to medical curricula undertaken by the University of Global Health Equity beginning in 2019. The first six-month semester of the curriculum, called Foundations in Social Medicine, includes courses in critical thinking and communication, African history and global political economy, medical anthropology and social medicine, psychology and health, gender and social justice, information technology and health, and community-based training. Additionally, an inquiry-based pedagogy with relatively small classes is featured within an overall institutional culture that emphasizes health equity. We identify key competencies for physicians interested in pursuing global health equity and how such competencies relate to liberal arts integration into the African medical school curriculum and pedagogical approach. We conclude with a call for a research agenda that can better evaluate the impact of such innovations on physicians' education and subsequent practices. [ABSTRACT FROM AUTHOR]