Abstract
This paper reports on a study of an arts informed approach to ethics education in a health professions education context. The purpose of this study was to investigate students’ reported learning experiences as a result of engagement with an arts-informed project in a health professions’ ethics course. A hermeneutic phenomenological methodological approach was adopted for the study. The data were collected over 5 years, and involved analysis of 234 occupational therapy students’ written reflections on learning. Phenomenological methods were used. Five key themes were identified with respect to students’ reported learning including: becoming aware of values, (re) discovering creativity, coming to value reflection in professional life, deepening self-awareness, and developing capacities to imagine future practices. There appear to be a number of unique ways in which arts-informed approaches can contribute to health professions education including: activating imaginative engagement, fostering interpretive capacity, inspiring transformative understandings, offering new ways of knowing, deepening reflection, and heightening consciousness, while also enriching the inner life of practitioners. Innovative approaches are being used to introduce arts-informed practices in health professions curricula programs. The findings point to the promise of arts-informed approaches for advancing health sciences education.
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References
Allen, P. B. (1995). Art is a way of knowing. Boston, MA: Shambhala.
Benner, P. (1994). The tradition and skill of interpretive phenomenology in studying health, illness, and caring practices. In P. Benner (Ed.), Interpretive phenomenology: Embodiment, caring, and ethics in health and illness (pp. 99–128). Thousand Oaks, CA: Sage.
Bleakley, A., Marshall, R., & Brömer, R. (2006). Toward an aesthetic medicine: Developing a core medical humanities undergraduate curriculum. Journal of Medical Humanities, 27, 197–213. doi:10.1007/s10912-006-9018-5.
Blomqvist, L., Pitkala, K., & Routasalo, P. (2007). Images of loneliness: Using art as an educational method in professional training. The Journal of Continuing Education in Nursing, 38(2), 89–93. http://search.proquest.com.proxy1.lib.uwo.ca/docview/223312282?accountid=15115
Brett-MacLean, P. (2007). Use of the Arts in Medical and Health Professional Education. University of Alberta Health Sciences Journal, 4(1), 26–29.
Buzan, T. (2003). The mind map book. London: BBC Books.
Caeiro, C., Cruz, E. B., & Pereira, C. M. (2014). Arts, literature and reflective writing as educational strategies to promote narrative reasoning capabilities among physiotherapy students. Physiotherapy Theory and Practice,. doi:10.3109/09593985.2014.928919.
Casey, B. (2009). Arts-based inquiry in nursing education. Contemporary Nurse, 32(1–2), 69–82. doi:10.5172/conu.32.1-2.69.
Chinn, P. L., & Watson, J. (Eds.). (1994). Art and aesthetics in nursing (No. 14). Burlington, MA: Jones and Bartlett Learning.
Collett, T. J., & McLachlan, J. C. (2006). Evaluating a poetry workshop in medical education. Medical Humanities, 32(1), 59–64. doi:10.1136/jmh.2005.000222.
Connor-Greene, P. A., Young, A., Paul, C., & Murdoch, J. W. (2005). Poetry: It’s not just for English class anymore. Teaching of Psychology, 32(4), 215–221. doi:10.1207/s15328023top3204_2.
Crotty, M. (2003). The foundations of social research: Meaning and perspective in the research process. London: Sage.
Davey, N. (1999). The hermeneutics of seeing. In I. Heywood & B. Sandywell (Eds.), Interpreting visual culture: Explorations in the hermeneutics of the visual (pp. 3–29). London: Routledge.
de la Croix, A., Rose, A., Wildig, E., & Willson, S. (2011). Arts-based learning in medical education: The student’s perspective. Medical Education, 45(11), 1090–1100. doi:10.1111/j.1365-2923.2011.04060.x.
Desyllas, M. C., & Sinclair, A. (2014). Zine-making as a pedagogical tool for transformative learning in social work education. Social Work Education, 33(3), 296–316. doi:10.1080/02615479.2013.805194.
Dewey, J. (1934). Art as experience. NewYork, NY: Minton, Balch.
Eisner, E. (1998). What do the arts teach? Improving Schools, 1(3), 33–36.
Eisner, E. (2002). The arts and the creation of mind. New Haven, CT: Yale University Press.
Eisner, E. (2009). What education can learn from the Arts. Art Education, 62(2), 6–9.
Ferraris, M. (1996). History of hermeneutics (Luca Somigli, Trans.). Atlantic Highlands, NY: Humanities Press.
Gabbay, J., & Le May, A. (2011). Practice-based evidence for healthcare. London: Routledge.
Gadamer, H. G. (1975). Truth and method. New York, NY: Continuum.
Gadamer, H. G. (1996). Truth and method (2nd rev. ed., Joel Weinsheimer and Donald Marshall, Trans.). New York: Continuum.
Greene, M. (1995). Releasing the imagination: Essays on education, the arts, and social change. London: Routledge.
Greene, M. (2001). Variations on a blue guitar: The Lincoln Center Institute lectures on aesthetic education. New York, NY: Teachers College Press.
Greene, M. (2008). Education and the arts: The windows of imagination. Learning Landscapes, 2(1), 17–21.
Heidegger, M. (2008). Being and time. New York, NY: Harper and Row Publishers Inc. (original work published 1927).
Hughes, S. (2011). The leadership mask: A personally focused art based learning inquiry into facets of leadership. Reflective Practice, 12(3), 305–331. doi:10.1080/14623943.2011.571863.
Husserl, E. (1990). The idea of phenomenology (W. P. Alston, & G. Nakhnikian, Trans.). Norwell, MA: Kluwer Academic Publications (original lectures presented 1907).
Kearsley, J. H., & Lobb, E. A. (2014). ‘Workshops in healing’ for senior medical students: A 5-year overview and appraisal. Journal of Medical Humanities, 40(2), 73–79. doi:10.1136/medhum-2013-010438.
Kinsella, E. A. (2006). Hermeneutics and critical hermeneutics: Exploring possibilities within the art of interpretation. Forum Qualitative Sozialforschung/Forum: Qualitative Social Research 7(3). URN: urn:nbn:de:0114-fqs0603190.
Kinsella, E. A. (2007). Educating socially responsive practitioners: What can the literary arts offer health professional education? In D. Clover & J. Stalker (Eds.), The arts and social justice: Re-crafting adult education and community cultural leadership (pp. 39–58). Leicester: NIACE.
Kinsella, E. A. (2012). Practitioner reflection and judgement as phronesis: A continuum of reflection and considerations for phronetic judgement. In E. A. Kinsella & A. Pitman (Eds.), Phronesis as professional knowledge: Practical wisdom in the professions (pp. 35–52). Rotterdam: Sense Publishing.
Kinsella, E. A., & Vanstone, M. (2010). An international conference on engaging reflection in health professional education and practice: Emerging conversations on the arts in health and social care. Reflective Practice: International and Multidisciplinary Perspectives, 11(4), 409–415.
Kinsella, E. A., Phelan, S., & Bidinosti, S. (in press). An arts-based approach to ethics education in the health professions. In A. Peterkin, & P. Brett-MacLean (Eds.), Keeping reflection fresh: Top educators share their knowledge in health professional education. Kent: Kent State University Press.
Kinsella, E. A., Caty, M. E., Ng, S., & Jenkins, K. (2012). Reflective practice for allied health: Theory and practice. In L. English (Ed.), Adult education and health (pp. 297–321). Toronto, ON: University of Toronto Press.
Kinsella, E. A., Phelan, S., DiMuzio, T., & Kwong, J. (2008). Moral imagination: Three portraits. In J. Nisker (Ed.), From the other side of the fence: Stories from health care professionals (pp. 83–96). Halifax, NS: Pottersfield Press.
Kinsella, E. A., Phelan, S., Park Lala, A., & Mom, V. (2015). An investigation of students’ perceptions of ethical practice: Engaging a reflective dialogue about ethics education in the health professions. Advances in Health Sciences Education, 20(3), 781–801. doi:10.1007/s10459-014-9566-9.
Kumagai, A. K. (2012). Acts of interpretation: A philosophical approach to using creative arts in medical education. Academic Medicine, 87(8), 1–7. doi:10.1097/ACM.0b013e31825d0fd7.
Kumagai, A. K., & Wear, D. (2014). “Making strange”: A role for the humanities in medical education. Academic Medicine, 89(7), 973–977. doi:10.1097/ACM.0000000000000269.
Lakoff, G., & Johnson, M. (1980). Metaphors we live by. Chicago, IL: University of Chicago Press.
Laverty, S. (2003). Hermeneutic phenomenology and phenomenology: A comparison of historical and methodological considerations. International Journal of Qualitative Methods, 2(3), 1–29. https://ejournals.library.ualberta.ca/index.php/IJQM/article/view/4510/3647
Lordly, D. (2014). Crafting meaning: Arts-informed dietetics education. Canadian Journal of Dietetic Practice and Research, 75(2), 89–94. doi:10.3148/75.2.2014.89.
Lyon, P., Letschka, P., Ainsworth, T., & Haq, I. (2013). An exploratory study of the potential learning benefits for medical students in collaborative drawing: Creativity, reflection and ‘critical looking’. BMC Medical Education, 13(1), 86. doi:10.1186/1472-6920-13-86.
Mahar, D. J., Iwasiw, C. L., & Evans, M. K. (2012). The mandala: First-year undergraduate nursing students’ learning experiences. International Journal of Nursing Education Scholarship, 5(9), Art.26. doi:10.1515/1548-923X.2313.
Mann, K., Gordon, J., & MacLeod, A. (2009). Reflection and reflective practice in health professions education: A systematic review. Advances in Health Sciences Education, 14(4), 595–621. doi:10.1007/s10459-007-9090-2.
McGarry, J., & Aubeeluck, A. (2013). A different drum: An arts-based educational program. Nursing Science Quarterly, 26(3), 267–273. doi:10.1177/089431841348200.
Miller, E., Balmer, D., Hermann, N., Graham, G., & Charon, R. (2014). Sounding narrative medicine: Studying students’ professional identity development at Columbia University College of Physicians and Surgeons. Academic Medicine, 89(2), 335–342. doi:10.1097/ACM.0000000000000098.
Milligan, E., & Woodley, E. (2009). Creative expressive encounters in health ethics education: Teaching ethics as relational engagement. Teaching and Learning in Medicine, 21(2), 131–139. doi:10.1080/10401330902791248.
Mitchell, M., & Hall, J. (2007). Teaching spirituality to student midwives: A creative approach. Nurse Education in Practice, 7, 416–424. doi:10.1016/j.nepr.2007.02.007.
Montgomery, K. (2006). How Doctor’s think: Clinical judgement and the practice of medicine. Oxford: Oxford University Press.
Ousager, J., & Johannessen, H. (2010). Humanities in undergraduate medical education: A literature review. Academic Medicine, 85(6), 988–998.
Park Lala, A., & Kinsella, E. A. (2011). Phenomenology and the study of human occupation. Journal of Occupational Science, 18(3), 195–209.
Perry, M., Maffulli, N., Willson, S., & Morrissey, D. (2011). The effectiveness of arts-based interventions in medical education: A literature review. Medical Education, 45, 141–148. doi:10.1111/j.1365-2923.2010.03848.x.
Rabow, M. W., Evans, C. N., & Remen, R. N. (2013). Professional formation and deformation: Repression of personal values and qualities in medical education. Family Medicine, 45(1), 14–18. doi:10.1097/ACM.0b013e3181c887f7.
Robinson, S. (2007). Using art in pre-registration nurse education. Health Education, 107(4), 324–342. doi:10.1108/09654280710759241.
Rodenhauser, P., Strickland, M., & Gambala, C. (2010). Arts-related activities across US Medical Schools: A follow-up study. Teaching and Learning in Medicine: An International Journal, 16(3), 233–239. doi:10.1207/s15328015tlm1603_2.
Schreiner, L., & Wolf Boronaro, G. P. (2012). Inner-outer boxes: An arts-based self-reflection experience about death and dying. Journal of Hospice and Palliative Nursing, 14(8), 559–562. doi:10.1097/NJH.0b013e31825ec187.
Schwind, J. K., Beanlands, H., Lapum, J., Romaniuk, D., & Fredericks, S. (2014a). Fostering person-centered care among nursing students: Creative pedagogical approaches to developing personal knowing. Journal of Nursing Education, 56(6), 343–347. doi:10.3928/01484834-20140520-01.
Schwind, J. K., Lindsay, G. M., Coffey, S., Morrison, D., & Mildon, B. (2014b). Opening the black-box of person centred care: An arts-informed narrative inquiry into mental health education and practice. Nursing Education Today, 34(8), 1167–1171. doi:10.1016/j.nedt.2014.04.010.
Schwind, J., Zanchetta, M., Aksenchuk, K., & Gorospe, F. (2013). Nursing students’ international placement experience: An arts-informed narrative inquiry. Reflective Practice, 14(6), 705–716. doi:10.1080/14623943.2013.810619.
Seedhouse, D. (1998). Ethics: The heart of health care. Chichester: Wiley.
Skye, E. P., Wagenschutz, H., Steiger, J. A., & Kumagai, A. K. (2014). Use of interactive theater and role play to develop medical students’ skills in breaking bad news. Journal of Cancer Education, 29(4), 704–708. doi:10.1007/s13187-014-0641-y.
Smith, R. L., Bailey, M., Hydo, S. K., Lepp, M., Mews, S., Timm, S., & Zorn, C. (2004). All the voices in the room: Integrating humanities in nursing education. Nursing education Perspectives, 25(6), 278–283. doi:10.1043/1094-2831(2004)025<0278:ATVITR>2.0.CO;2.
Smythe, E. A., Ironside, P. M., Sims, S. L., Swenson, M. M., & Spence, D. G. (2008). Doing Heideggerian hermeneutic research: A discussion paper. International Journal of Nursing Studies, 45, 1389–1397.
Staricoff, R. (2004). Arts in health: A review of the medical literature. London: Arts Council of England.
Svenaeus, F. (2000). The hermeneutics of medicine and the phenomenology of health: Steps towards a philosophy of medical practice. Boston, MA: Kluwer.
Tattersall, C., Powell, J., Stroud, J., & Pringle, J. (2011). Mind mapping in qualitative research. Nursing Times, 107(18), 20–22.
Thomas, S., & Pollio, H. (2002). Listening to patients: A phenomenological approach to nursing research and practice. New York, NY: Springer.
Thompson, T., Loamont-Robinson, C., & Younie, L. (2010). ‘Complusory creativity’: Rationales, recipes, and results in the placement of mandatory creative endeavor in a medical undergraduate curriculum. Medical Education Online, 15. doi:10.3402/meo.v15i0.5394.
Van Manen, M. (1997). Researching lived experience: Human science for an action sensitive pedagogy. London, ON: The Althouse Press.
Walton, P. (2012). Beyond talk and text: An expressive visual arts method for social work education. Social Work Education, 31(6), 724–741. doi:10.1080/02615479.2012.695934.
Wehbi, S. (2014). Arts-informed teaching practice: Examples from a graduate anti-oppression classroom. Social Work Education, 34(1), 46–59. doi:10.1080/02615479.2014.937417.
White, C. B., Perlman, R. L., Fantone, J. C., & Kumagai, A. K. (2010). The interpretive project: A creative educational approach to fostering medical students’ reflections and advancing humanistic medicine. Reflective Practice, 11(4), 517–527. doi:10.1080/14623943.2010.505718.
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Appreciation is extended to the Social Sciences and Humanities Research Council of Canada for funding of this research. The authors would like to thank University of Western Ontario for support of this research, and offer special thanks to the student participants for generously granting permission for their written reflections to serve as data for this study.
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Kinsella, E.A., Bidinosti, S. ‘I now have a visual image in my mind and it is something I will never forget’: an analysis of an arts-informed approach to health professions ethics education. Adv in Health Sci Educ 21, 303–322 (2016). https://doi.org/10.1007/s10459-015-9628-7
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DOI: https://doi.org/10.1007/s10459-015-9628-7