Importancia de la implementación y divulgación de la Investigación en Humanidades en Salud / Importance of the implementation and dissemination of Humanities Research in Health

Las humanidades en salud y en particular sus enfoques críticos, son indispensables para fortalecer la investigación orientada a producir conocimiento respecto al estudio de los fenómenos relacionados con la salud, la enfermedad y la muerte desde sus dimensiones social, antropológica, histórica, ética y política. En este sentido, surge la necesidad de promover métodos de investigación a partir del planteamiento de preguntas sobre las experiencias de las personas que viven procesos de salud, enfermedad y muerte. Estas preguntas deben realizarse desde epistemologías interdisciplinarias que ayuden en la comprensión de dichas experiencias y a traducir el conocimiento derivado de la investigación en acciones centradas en las personas, con pertinencia social, cultural y ética. La intención es impulsar el diseño, implementación, evaluación y publicación de la Investigación de Humanidades en Salud, mediante el fortalecimiento de redes de investigación en salud interdisciplinar e interprofesional, con el propósito de fundamentar acciones efectivas en el marco del derecho de la población en la atención con equidad e inclusión. (AU)

The humanities in health, and particularly their critical approaches, are indispensable for strengthening research aimed at producing knowledge regarding the study of phenomena related to health, illness, and death from their social, anthropological, historical, ethical, and political dimensions. In this sense, we need to promote research methods and pose questions about the experiences of individuals undergoing processes of health, illness, and death. These questions should be approached from interdisciplinary epistemologies that aid in the understanding of such experiences and in translating the knowledge derived from research into people-centered actions, with social, cultural, and ethical relevance. The intention is to drive the design, implementation, evaluation, and publication of Health Humanities Research by strengthening interdisciplinary and interprofessional health research networks, with the purpose of substantiating effective actions within the framework of the population's right to equitable and inclusive care. (AU)

Repensar a Saúde Coletiva e o papel das Ciências Sociais e Humanas em Saúde / Rethinking public health and the role of social sciences and humanities in health / Repensar la Salud Colectiva y el papel de las Ciencias Sociales y Humanas en Salud

Este ensaio analisa conflitos e potencialidades das Ciências Sociais e Humanas em Saúde (CSHS) no campo da Saúde Coletiva e os desafios de atuar em uma área interdisciplinar. Inicialmente, apresentamos algumas particularidades das CSHS, dialogando com tensões internas. Em seguida, as metodologias qualitativas e seus usos nas pesquisas em Saúde Coletiva são problematizadas, mantendo um diálogo com as demais áreas. Por fim, apresentamos uma reflexão sobre as perspectivas futuras das CSHS e possíveis caminhos teórico-metodológicos que aprofundariam a transversalidade da área. Repensar as relações entre as áreas provoca uma reflexão sobre uma possível e oportuna reconfiguração da própria Saúde Coletiva. Os desafios nos colocam a necessidade de repensar a noção de CSHS; e de indagar sobre a linguagem que estamos construindo e sobre o que podemos fazer.(AU)

This essay analyzes the conflicts and potential of social sciences and humanities in health (SSHH) in the field of public health and the challenges of acting in an interdisciplinary area. We present some of the particularities of SSHH, dialoguing with internal tensions and then go on to problematize qualitative methodologies and their use in public health research, maintaining a dialogue with the other areas. Finally, we reflect upon the outlook for SSHH and possible theoretical and methodological pathways that would broaden the cross-cutting nature of the area. Rethinking relations between areas prompts reflection on a possible and timely reconfiguration of public health. The challenges give rise to the need to rethink the notion of SSHH, question the language we are constructing, and ask what we can do.(AU)

Este ensayo analiza conflictos y potencialidades de las Ciencia Sociales y Humanas en Salud (CSHS) en el campo de la Salud Colectiva y los desafíos de actuar en un área interdisciplinaria. Inicialmente, presentamos algunas particularidades de las CSHS, dialogando con tensiones internas. A continuación, las metodologías cualitativas y sus usos en las investigaciones de Salud Colectiva se problematizan, manteniendo un diálogo con las demás áreas. Finalmente, presentamos una reflexión sobre las perspectivas futuras de las CSHS y posibles caminos teóricos-metodológicos que profundizarían la transversalidad del área. Repensar las relaciones entre las áreas provoca una reflexión sobre una posible y oportuna reconfiguración de la propia Salud Colectiva. Los desafíos nos plantean la oportunidad de repensar la noción de CSHS, de indagar sobre el lenguaje que estamos construyendo y sobre lo que queremos hacer.(AU)

Antropoceno, ciências humanas e historiografia / Anthropocene, human sciences and historiography

Resumo O artigo mostra, inicialmente, como as discussões sobre o Antropoceno têm se deslocado de maneira cada vez mais significativa para o campo das ciências humanas. Em seguida, tomando como ponto de partida a proposta de que as ciências humanas deveriam contribuir para a compreensão do "metanível consequencial" dos estudos sobre o Antropoceno, discute como alguns trabalhos produzidos nesse campo têm lidado com as relações entre causas, efeitos e consequências diante das condições do novo regime planetário, considerando de maneira especial as discussões sobre a "tecnosfera". Conclui indicando o potencial das novas perspectivas ontológicas das ciências humanas para a ampliação dos horizontes explicativos e comunicativos da historiografia.

Abstract The article initially presents an increasingly significant move of discussions about the Anthropocene towards humanities and social sciences. Then, taking as a starting point the proposal that these fields could contribute to the understanding of the "consequential meta-level" of studies on the Anthropocene, it discusses how some works produced in humanities and social sciences have dealt with the relationship between causes, effects and consequences regarding the new planetary regime, with a special focus on the debate about the "technosphere." It concludes by indicating the potential of the "ontological turn" to expand the explanatory and communicative horizons of historiography.

"Novo normal", velhos problemas: ciências sociais e humanas na formação médica em tempos de pandemia / "New normal", old problems: social and human sciences in medical training during the Covid-19 pandemic

Resumo: Introdução: A pandemia escancarou as determinações de classe, raça e gênero nos processos saúde-doença-cuidado, afetando de modo muito mais dramático as periferias e, especialmente, as populações negras e indígenas. Ademais, colocou em destaque e amplificou uma postura negacionista ao mesmo tempo que gerou expectativas elevadas quanto ao papel das ciências biomédicas para o enfrentamento da pandemia no Brasil, apesar de a literatura ser contundente sobre o caráter imprescindível das Ciências Sociais e Humanas (CSH). Relato de experiência: Neste artigo, descrevemos criticamente a experiência docente em disciplinas de CSH em uma faculdade de Medicina ao longo do ano de 2020, enfatizando os múltiplos impactos produzidos pela Covid-19. Discussão: Além de apresentar como os temas caros às CSH são abordados nas disciplinas, nas suas ementas e nas matrizes pedagógicas, este texto discute as alterações e os percalços provocados pela necessidade de - para "estar em sala" no contexto da maior crise sanitária dos últimos cem anos - adaptar-se ao abalo da separação entre os mundos do trabalho e da casa e a convivência com os sentimentos pandêmicos de medo, luto e desalento que atingiram docentes e discentes. Conclusão: A pandemia trouxe para perto da realidade de estudantes e docentes temas caros ao âmbito das CSH, como a discussão sobre a determinação social do processo saúde-doença-cuidado e a reflexão sobre a quem servem tanto a ciência quanto a ideologia do obscurantismo que a nega. Na experiência que relatamos, utilizamo-nos da atualidade desses debates para nos aproximar da realidade dos estudantes, em um contexto em que o isolamento social e o ensino remoto tornaram as relações mais esgarçadas.

Abstract: Introduction: The pandemic revealed the impact of class, race and gender determinations on health-disease-care processes, as it had a far more dramatic effect on the poor city outskirts and especially black and indigenous communities. Furthermore, it highlighted and amplified a negationist attitude towards scientific knowledge. At the same time, it has made biomedical sciences the sole deposit of our hopes, despite the fact that the literature is overwhelming about the essential role of the Social and Human Sciences (SHS). Case report: In this paper, we propose to describe the teaching experience in SHS disciplines at a medical school throughout the year 2020, emphasizing the impacts produced by Covid-19. Discussion: One objective of the article is to present how these discussions were approached in the disciplines and their challenges and potential. Another is to present the pedagogical menus and matrices used in these disciplines and address the changes and mishaps caused by the need to, firstly, "be in the classroom" in the context of the biggest health crisis of the last one hundred years, and secondly, adapt to the upheaval of the separation between the worlds of work and the home and living with pandemic feelings of fear, mourning and discouragement that affected teachers and students. Conclusions: The pandemic brought students and teachers closer to the reality of themes that are within the scope of the SHS, such as the discussion on the social determination of the health-disease-care process and the reflection on whom is served by both science and ideology of the obscurantism that denies it. In the experience reported, we used the current nature of these debates to bring us closer to the students' reality, in a context in which social isolation and distance learning made relationships more frayed.

Value Rational Return of Medical Humanities Education under the Concept of People First / 中国医学伦理学

The concept of people first has important inspirations for the value rational return of medical humanities education in the new era. It is consistent with the educational value, curriculum attribute, and practical attribute of medical humanistic education, and puts forward new requirements for the value rational return of medical humanities education in terms of educational supply content, practical curriculum setting, educational development form, and educational effect evaluation. Medical colleges and universities should further adhere to the medical humanities education concept centered on people’s health, optimize the practice curriculum of medical humanistic education, innovate the practice platform of medical humanistic education, and construct a value evaluation mechanism of medical humanistic education, so as to promote the value rational return of medical humanities education under the concept of people first.

Research on the Integration of Local Excellent Traditional Culture into Ideological and Political Education in Medical Colleges and Universities: Taking Fujian as an Example / 中国医学伦理学

The organic integration of local excellent traditional culture and ideological and political education in medical colleges and universities is an important content of deeply studying and implementing General Secretary Xi Jinping’s important discourse of inheriting and enriching the excellent traditional Chinese culture, and promoting the comprehensive integration of Chinese excellent traditional culture into college education. The integration of them is helpful to improve the effectiveness of ideological and political education, enhance the cultural confidence of medical students, and cultivate their professional spirit. Guided by Marxist theory and the methods of "creative transformation and innovative development", a group of typical ideological concepts, moral norms, and humanistic spirits such as patriotism, basic civic ethics, medical professional ethics, and global health concepts were selected, and then targeted integrate them into ideological and political education through specific paths such as basing on classroom teaching, enhancing campus culture, and strengthening social practice to cultivate medical talents with noble medical ethics and exquisite medical skills in the new era.

Multi-link Linkage Research on Medical Humanistic Education by Integrating Narrative Medical Materials / 中国医学伦理学

Taking the current situation and problems of medical humanities education as the background, the concept of narrative medicine was used to sort out and integrate various course materials of medical humanities, explore the multi-link linkage mode of medical humanities education, and organically integrate medical humanities courses scattered in medical education activities such as medical ethics, health law, doctor-patient communication, and health policy science with teaching stages, teaching resources, and teaching methods, forming vivid narrative medical materials throughout the entire process of medical humanities education, and improving teaching efficiency by sharing and optimizing resources. Through questionnaire analysis, it was found that there are many unsatisfactory aspects of medical humanities education. Further analysis of the issues focuses on the contradiction between learning willingness and time allocation, the lack of synchronization between teaching and social development, the lack of integration between courses, and insufficient innovation in teaching methods. Based on these, countermeasures were put forward to integrate narrative medical materials of medical humanities courses and build a platform for the application and communication of narrative medical materials.

Preliminary Exploration of Integrating Narrative Medicine into General Practice Education / 中国医学伦理学

In the context of a healthy China, strengthening humanistic literacy education for general medical students reflects the demands of the times, promotes the transformation of medical models, and has important practical significance in reducing the work burnout of general practitioners in practice. Integrating narrative medicine into general practice student education is conducive to implement the patient-centered concept of general practice, provide continuous and systematic medical services, and further improve the humanistic literacy of general practitioners. Based on these, this paper proposed the relevant paths of integrating narrative medicine into student education in general medicine, including changing educational concepts and integrating educational resources, boldly carrying out curriculum reforms and innovating educational methods, fully utilizing parallel medical records and reflective writing, as well as cultivating the habit of lifelong learning.

Co-word Analysis of the Current Situation of Narrative Medicine Research in China in the Past Decade / 中国医学伦理学

【Objective:】 The co-word analysis method was used to analyze narrative medical literature studied in China in the past 10 years to explore the research status in this field and lay a foundation for further research. 【Methods:】 Using "narrative medicine" as the theme term, with the limited time interval of 2013—2022 to retrieve for relevant literature in CNKI, Wanfang, and VIP databases, and include literature that meets the research standards. Bicomb2 was used to perform keyword statistics and analysis on the downloaded literature. Ucinet6.0 and Netdraw were used to draw co-occurrence analysis graphs to visualize the co-occurrence relationship between high-frequency keywords. 【Results:】 A total of 565 papers were included and 31 high-frequency keywords were extracted. The co-occurrence relationship diagrams showed that the current research hotspots of narrative medicine in China include traditional Chinese medicine, nursing, general practice, evidence-based medicine, medical ethics, hospice care, chronic diseases, cancer and other popular disciplines and diseases. Most of them were about enhancing the empathy and humanistic caring ability of medical personnel and improving doctor-patient communication to improve the doctor-patient relationship, as well as doing well in medical humanities education and cultivating narrative ability through parallel medical records and reflective writing. The research on gerontology, improving the professional identity of medical staff, integrating literature and medicine, and the impact on patients were relatively few. 【Conclusion:】 At present, narrative medicine in China has achieved many achievements in fields such as nursing, traditional Chinese medicine, general practice medicine, chronic diseases, cancer, medical humanities education, and improving doctor-patient relationships. In the future, in-depth exploration can be conducted from the use of narrative medicine in multi-disciplinary and disease fields, trying different training methods, and synchronous cultivation of teachers and students, so as to build a more comprehensive narrative medicine system.

Cognitive Analysis and Countermeasures of Medical Humanistic Service Ability Based on the Perspective of Medical Staff in Public Hospitals / 中国医学伦理学

【Objective:】 To explore the cognition of medical staff in public hospitals regarding the medical humanistic service ability, and to discuss, analyze, and put forward targeted suggestions based on statistical data. 【Methods:】 A self-designed questionnaire survey was conducted among 825 medical staff randomly selected from public medical institutions in Nanjing, Central, Northern and Southern Jiangsu Province. SPSS21.0 was used to analyze the data. 【Results:】 The average score of medical staff’s familiarity with medical humanities was 3.64 points. In the cognition of the components of medical humanistic service ability, the doctor-patient communication ability accounted for the highest proportion (90.82%). There were differences in the cognition of medical staff with different demographic characteristics on the dimensions of appearance and behavior ability, doctor-patient communication ability, and patient care ability (P<0.05). The surgeon’s cognition of the importance of medical humanities was lower than that of the other four departments (P<0.05). 【Conclusion:】 Medical staff needed to improve their medical humanistic service abilities, and the cognition of humanistic differences among different categories of personnel needed to be adjusted. Public hospitals were suggested to clarify the evaluation elements and standards of medical humanistic services, and focus on solving cognitive differences to improve medical humanistic service abilities, speeding up the construction of humanistic hospitals, promoting medical humanistic service abilities. In addition, it was also necessary to improve the quality of medical humanistic education in colleges and universities through ideological and political courses.

Research on Improving Humanistic Quality of Medical Students in Obstetrics and Gynecology Based on Blend-learning / 中国医学伦理学

Under the new situation of rapid development of medical science and technology, how to effectively cultivate medical students’ humanistic spirit and comprehensively improve medical quality is an important responsibility of medical college teachers. Blend-learning can guide students to immersive learning in multiple dimensions and forms. Obstetrics and Gynecology is one of the main compulsory courses for clinical medical students, which is faced more sensitive and vulnerable female patients, and required higher humanistic quality training for medical students. Through the construction of the blend-learning platform, medical humanities can be better integrated into the content and teaching design of medical education, and students can be more appropriately imperceptibly trained in medical humanities in obstetrics and gynecology teaching, so as to enhance medical students’ medical humanities quality in the process of obstetrics and gynecology diagnosis and treatment, and improve doctor-patient relationship.

Discussion on the Discipline Structure of Chinese Medical Humanities Based on the Views of Chinese Scholars / 中国医学伦理学

Discipline structure, as the core of discipline construction, plays an important role in promoting the prosperity of medical humanities. By sorting out the Chinese scholars’ division of the structure of medical humanities in China, this paper preliminarily discussed the existence of the subordinate discipline of medical humanities in China, and preliminarily verified the rationality and feasibility the viewpoint of "building a first-class discipline of medical humanities under the medical category, and forming a subordinate discipline of medical humanities based on horizontal association". At the same time, this paper put forward the view that the structure of medical humanities in China should be determined according to the needs of the current social development in China, and the concepts and criteria contained in the division of the Chinese discipline catalogue, so as to pave the way for the follow-up research.

Problems and development strategy of quality-oriented education for the medical students of the colleges and universities / 中华医学教育探索杂志

This article introduces American development process of quality-oriented education in colleges and universities which symbolizes practical teaching theory, and analyzes the reason that it is hard for colleges and universities to develop medical talents with strong humanistic quality and innovative ability. This article points out that medical colleges and universities need to make systematic standard and plan for quality-oriented education of practical teaching. The role of teachers is converting from single disseminator of theory knowledge to the instructor, organizer and participant of study. Meanwhile, the information technology should be embedded in practical teaching, which has profound effects on quality-oriented education development of medical students.

Imágenes de una pandemia. Un relato desde la Unidad de Pacientes Críticos / Images of a pandemic. A tale from the Critical Care Unit

Cuando supimos la noticia y después, mientras nos enterábamos de los primeros casos fuera de China, y luego los alarmantes reportes desde Europa y USA, nunca imaginamos la magnitud que tendría la actual pandemia por el virus SARS-CoV-2 en nuestro país y a nivel mundial, en nuestros hospitales, y en nuestras vidas (Huang et al., 2020). Como nunca, nos enfrentábamos a un enemigo agresivo y letal, aún desconocido en su comportamiento, y del que también podíamos ser víctimas al estar en la primera línea de la defensa.

A writer’s suicide: On creativity, mental health, gender and ethics

The correlation between creativity and mental illness has been at the centre of ongoing debates for quite some time. This has its roots in the Romantic era (late 18th to mid-19th century), when melancholia and madness were considered to be the signs of creativity and genius. Because of this, writers like Virginia Woolf, Sylvia Plath, Anne Sexton, Charlotte Perkins Gilman, and many other prominent creative minds have been represented in popular narratives as having reached the heights of their creative careers while struggling with their mental health. This paper addresses the need for moving away from Romantic era notions of the relationship between madness, genius, and melancholia that reinforce the inseparability of the writer and the text, thereby trivialising the real causes and effects of mental illness. The paper also addresses the need for a health humanities intervention within the Indian literary public, using examples from the existing narratives on the late Malayalam writer Rajelakshmy ? an established woman writer in the 1960s ? who died by suicide in her mid-thirties. This paper will also reflect on the author’s own experience of reading and working with Rajelakshmy’s writings over the years.

Reflective narratives during the Covid-19 pandemic: an outlet for medical students in uncertain times

Reflective narratives on personal experiences, observations, thoughts and concerns were used as a method of helping medical students process the Covid-19 pandemic and their lives. This involved individual writing, anonymous submission, on-line group reading of selected narratives on a voluntary basis and facilitated discussions. Students felt that this was a safe method to voice their feelings and thoughts, to understand themselves better and to gain new perspectives. Though small numbers of students participated, there appears to be a greater potential to use reflective narrative writing coupled with facilitated group discussions in medical education to help students cope with external and internal stress, to better understand themselves, to relate to others and possibly to become more empathic. Keywords: Education, medical, reflective narrative, Covid-19, wellbeing strategies, humanities, medical students.

Construction and Validation of a Questionnaire to Assess the Physician-Patient Relationship and its Association with Bioethical Principles / Construcción y validación de un cuestionario para evaluar la relación médico-paciente y su asociación con los principios bioéticos / Construção e validação de um questionário para avaliar a relação médico-paciente e sua associação com os princípios bioéticos

Abstract Physician-patient relationship (PPR) is a professional-interpersonal relationship that serves as the basis for health management. We aimed to develop an instrument for patients to assess the medical attention received in the outpatient clinic. A 21 question instrument was administered to evaluate its reliability and consistency. The intraclass correlation coefficient was 0.81 (p < 0.05); to fulfill the bioethical principles, the intraclass correlation coefficient was 0.740 (p < 0.05), allowing us to get familiar with the perception of patients who attended the Nephrology Service. The survey showed autonomy as the most reported principle (69 %), followed by dignity (67 %) and justice (60 %). Courtesy, punctuality, and respect make the disease and its treatment more bearable, in addition to promoting the ethics of third parties.

Resumen La relación médico-paciente (RMP) es una relación profesional-interpersonal base para la gestión de la salud. Nuestro objetivo fue desarrollar un instrumento que permitiera evaluar la presencia de los principios bioéticos en la atención médica recibida en la consulta externa de una institución hospitalaria. El instrumento quedó constituido por 21 reactivos para evaluar su confiabilidad y consistencia. El coeficiente de correlación intraclase fue de 0,81 (p < 0,05); para el cumplimiento de los principios bioéticos, fue de 0,740 (p < 0,05). El cuestionario mostró que la autonomía fue el principio más reportado (69 %), después la dignidad (67 %) y justicia (60 %). La presencia de los principios de la bioética ampliados hace más llevadera la enfermedad.

Resumo A relação médico-paciente é uma relação profissional interpessoal, base para a gestão da saúde. Nosso objetivo foi desenvolver um instrumento que permitisse avaliar a presença dos princípios bioéticos na atenção médica recebida na consulta de uma instituição hospitalar. O instrumento foi constituído de 21 reativos para avaliar sua confiabilidade e consistência. O coeficiente de correlação intraclasse foi de 0,81 (p < 0,05); para o cumprimento dos princípios bioéticos, foi de 0,740 (p < 0,05). O questionário mostrou que a autonomia foi o princípio mais relatado (69%), depois da dignidade (67%) e da justiça (60%). A presença dos princípios da bioética ampliados torna a doença mais suportável.

On the cultivation of medical students' humanistic quality from the perspective of virtual simulation teaching / 中华医学教育探索杂志

Based on the characteristics of medical specialty, this research group has developed the virtual simulation experiment teaching project of Chinese revolutionary morality (red medicine spirit). This project uses 3D simulation technology and OpenGL technology to build a virtual experimental learning environment based on WebGL, learn general Fu Lianzhang's glorious deeds and immersive experience of the inheritance and development of the spirit of red medicine by contemporary "heroes in harms way" in the fight against the COVID-19 epidemic in the form of 3D animation interaction. Through research, it is found that virtual simulation teaching is conducive to promoting students' understanding and mastery of medical humanities and improving students' satisfaction with teaching, with good popularization value.

Research on effectiveness of O-PIRTAS model in medical humanities English teaching / 中华医学教育探索杂志

Objective:To explore whether the introduction of the O-PIRTAS (objective, preparation, instructive vedio, review, test, activity, summary) teaching model can help in curriculum learning and improve students' medical humanities literacy.Methods:Taking 118 sophomores of clinical medicine and nursing majors from Xiamen Medical College as control group, and 122 students as experimental group and as control group, the research lasting 8 weeks was carried out around five modules. The control group adopted the traditional teaching mode, while the experimental group used the O-PIRTAS model. After teaching, by comparing the exam results and issuing questionnaires, the teaching effects of the two methods on students' caring ability, empathy, emotional intelligence and supportive communication ability were compared. SPSS 22.0 was used for t test and chi-square test. Results:The average score of the experimental group [(83.61±2.13) points] was higher than that of the control group [(78.03±2.02) points], with significant differences ( t=3.60, P<0.001). As for the statistical analysis of the questionnaire, the students in experimental group scored higher in empathy, emotional intelligence and supportive communication skills than those in control group ( t=-3.20, P=0.002; t=-3.93, P<0.001; t=-4.00, P<0.001). Conclusion:Applying O-PIRTAS flipped classroom teaching model to medical humanities English courses helps to improve students' curriculum learning and medical humanities literacy, improve the effectiveness of the classroom and better play the educational role of the curriculum.

16. Using Humanities and Art to Teach Medical Professionalism / 医学教育

It is said that “medicine is an art based on science,” but education in the art is not well practiced in medical education in Japan compared to education in the science. In a survey of medical students in the U.S., medical students who were exposed to literature, music, theater, visual arts, and other humanities had better empathy, emotional evaluation, and self-efficacy1). Medical humanities education, which is practiced mainly in Europe and the United States, is value education with humanities subjects to overcome dehumanizing medical practices, medical students and medical professionals, and to cultivate professionalism in physicians, such as humanity and altruism. This article focuses on “philosophical dialogue” and “improv” as practical examples of arts education in medicine in Japan that use the humanities and the arts to teach professionalism.