How are the arts and humanities used in medical education? Results of a scoping review

Purpose Although focused reviews have characterized subsets of the literature on the arts and humanities in medical education, a large-scale overview of the field is needed to inform efforts to strengthen these approaches in medicine. Method The authors conducted a scoping review in 2019 to identify how the arts and humanities are used to educate physicians and interprofessional learners across the medical education continuum in Canada and the United States. A search strategy involving 7 databases identified 21,985 citations. Five reviewers independently screened the titles and abstracts. Full-text screening followed (n = 4,649). Of these, 769 records met the inclusion criteria. The authors performed descriptive and statistical analyses and conducted semistructured interviews with 15 stakeholders. Results The literature is dominated by conceptual works (n = 294) that critically engaged with arts and humanities approaches or generally called for their use in medical education, followed by program descriptions (n = 255). The literary arts (n = 197) were most common. Less than a third of records explicitly engaged theory as a strong component (n = 230). Of descriptive and empirical records (n = 424), more than half concerned undergraduate medical education (n = 245). There were gaps in the literature on interprofessional education, program evaluation, and learner assessment. Programming was most often taught by medical faculty who published their initiatives (n = 236). Absent were voices of contributing artists, docents, and other arts and humanities practitioners from outside medicine. Stakeholders confirmed that these findings resonated with their experiences. Conclusions This literature is characterized by brief, episodic installments, privileging a biomedical orientation and largely lacking a theoretical frame to weave the installments into a larger story that accumulates over time and across subfields. These findings should inform efforts to promote, integrate, and study uses of the arts and humanities in medical education

The prism model: advancing a theory of practice for arts and humanities in medical education

Introduction: The arts and humanities have transformative potential for medical education. Realizing this potential requires an understanding of what arts and humanities teaching is and what it aims to do. A 2016 review of exclusively quantitative studies mapped three discursive positions (art as intrinsic to, additive to or curative for medicine) and three epistemic functions (art for mastering skills, perspective taking, and personal growth and activism). A more inclusive sample might offer new insights into the position and function of arts and humanities teaching in medical education. Methods: Informed by this 2016 framework, we conducted discursive and conceptual analyses of 769 citations from a database created in a recent scoping review. We also analyzed the 15 stakeholder interviews from this review for recurring themes. These three analyses were iteratively compared and combined to produce a model representing the complex relationship among discursive functions and learning domains. Results: The literature largely positioned arts and humanities as additive to medicine and focused on the functions of mastering skills and perspective taking. Stakeholders emphasized the intrinsic value of arts and humanities and advocated their utility for social critique and change. We offer a refined theory of practice—the Prism Model of four functions (mastering skills, perspective taking, personal insight and social advocacy)—to support more strategic use of arts and humanities in medical education across all learning domains. Discussion: The Prism Model encourages greater pedagogical flexibility and critical reflection in arts and humanities teaching, offering a foundation for achieving its transformative potential

Neolithic pits and Late Bronze Age roundhouses in the Upper Ury Valley, Aberdeenshire

Archaeological monitoring of works on a gas pipeline route in Aberdeenshire, north-west of Inverurie, resulted in the discovery and excavation of several groups of Neolithic pits and four Bronze Age roundhouses. The Neolithic pits were concentrated around the Shevock Burn, a small tributary of the Ury, and in the East and North Lediken areas to the north. They produced significant assemblages of Early Neolithic Impressed Ware and of Modified Carinated Bowl. The Bronze Age roundhouses included the heavily truncated remains of a post-built structure near Pitmachie, the remains of a pair of ring ditch structures near Little Lediken Farm, and another ring ditch structure close to Wrangham village

Comparison of Patient and Surgeon Expectations of Total Hip Arthroplasty

OBJECTIVES: Analysis of discrepancies between patient and surgeon expectations before total hip arthroplasty (THA) should enable a better understanding of motives of dissatisfaction about surgery, but this question has been seldom studied. Our objectives were to compare surgeons' and patients' expectations before THA, and to study factors which affected surgeon-patient agreement. METHODS: 132 adults (mean age 62.8+/-13.7 years, 52% men) on waiting list for THA in three tertiary care centres and their 16 surgeons were interviewed to assess their expectations using the Hospital for Special Surgery Total Hip Replacement Expectations Survey (range 0-100). Patients' and surgeons' answers were compared, for the total score and for the score of each item. Univariate analyses tested the effect of patients' characteristics on surgeons' and patients' expectations separately, and on surgeon-patient differences. RESULTS: Surgeon and patient expectations' mean scores were high (respectively 90.9+/-11.1 and 90.0+/-11.6 over 100). Surgeons' and patients' expectations showed no systematic difference, but there was little agreement on Bland and Altman graph and correlation coefficient was low. Patients had higher expectations than surgeons for sports. Patients rated their expectations according to trust in physician and mental quality of life, surgeons considered disability. More disabled patients and patients from a low-income professional category were often "more optimistic" than their surgeons. CONCLUSION: Surgeons and patients often do not agree on what to expect from THA. More disabled patients expect better outcomes than their surgeons

Transforming schooling through digital disruption : Big data, policy teaching and assessment

The chapter adopts a cross-disciplinary approach, drawing on three sets of literature, education policy and governance, assessment and testing, and the impact of the digital on how learning occurs. Utilizing a “socio-technical education data imaginary” we proffer ideas and challenges regarding possibilities for more productive and educative uses of digital technologies, data, and the affordances of both. The chapter explores the broader backdrop of digital disruption in education and relevant research literatures. This includes consideration of the changing policy and practice contexts and the rapidly evolving terrain of educational assessment. The authors discuss the impact of digital disruption on assessment and testing, including a focus on computer adaptive testing and new immersive forms. The place of edu-businesses and philanthropists in relation to these matters is also considered. Following this, we address digital disruption in and through big data, including the work of algorithms; digital disruption and its impact on teaching; and the need for new forms of teacher digital and data literacies. This leads into an overview of the chapters and provocations in the collection. Overall, the collection provides a catalyst for examining the place of digital disruption at a critical juncture of human history and the emerging transformation of schooling, teaching, testing, and learning. The authors note that we are at the very beginning of addressing profound educative, ethical, legal, privacy, and technical complexities, along with aporias of human+data interactions in general, in education, and in machine learning in particular

Digital learning assessments and big data : Implications for teacher professionalism

Big data and digital learning assessments are becoming a central part of schooling systems, affecting education policy as well as school and classroom practices. Such growing centrality must be understood as part of the broader digital disruption that has resulted in data playing a more substantial role in educational practices and system monitoring. This disruption can be traced to enhanced computational capacity, but also to the rise of neoliberal politics and the re-structuring of governance according to accountability principles. The potential of big data and digital learning-assessments is widely recognized. However, there is also growing awareness of the many challenges and risks entailed by such transformations. This paper identifies and discusses these challenges, and suggests possible strategies to tackle such issues. Particular attention is paid to the impact of digital disruption on teachers’ identities and work, including a risk of deprofessionalisation. The paper argues that teacher professional judgement needs to be at the centre of quality school provision and be used in conjunction with the data produced through digital learning assessments. This move requires, in turn, a reprofessionalisation effort – that is, to provide teachers with the opportunity to develop the skills involved in analysing and turning data into pedagogical action

Neolithic pits and Late Bronze Age roundhouses in the Upper Ury Valley, Aberdeenshire

Archaeological monitoring of works on a gas pipeline route in Aberdeenshire, north-west of Inverurie, resulted in the discovery and excavation of several groups of Neolithic pits and four Bronze Age roundhouses. The Neolithic pits were concentrated around the Shevock Burn, a small tributary of the Ury, and in the East and North Lediken areas to the north. They produced significant assemblages of Early Neolithic Impressed Ware and of Modified Carinated Bowl. The Bronze Age roundhouses included the heavily truncated remains of a post-built structure near Pitmachie, the remains of a pair of ring ditch structures near Little Lediken Farm, and another ring ditch structure close to Wrangham village