Transformative experiences at art museums to support flourishing in medicine.

PURPOSE: We implemented and evaluated a hybrid 4-week arts-based elective for clinical medical students to support flourishing. MATERIALS AND METHODS: Five students participated in early 2022. Twelve sessions occurred in-person at art museums and other cultural centers, and five occurred online. Sessions incorporated varied arts-based learning activities, including Visual Thinking Strategies, a jazz seminar, and a mask-making workshop. We evaluated the course via weekly reflective essays, interviews 6 weeks after the course, and pre-post surveys that included four scales with clinical relevance: capacity for wonder (CfW), tolerance for ambiguity (TFA), interpersonal reactivity index, and openness to diversity. RESULTS: Qualitatively, the course helped learners: 1) reconnect with individual characteristics and interests that had been neglected during medical education; 2) better appreciate others' perspectives; 3) develop identities as physicians; and 4) engage in quiet reflection, renewing their sense of purpose. Quantitatively, pre-post mean totals increased for the CfW (32.0 [SD 6.8] vs 44.0 [SD 5.7], p=.006) and TFA scales (16.4 [SD 5.2] vs 24.2 [SD 6.9], p=.033). CONCLUSIONS: This elective facilitated learners' connecting with themselves, others, and their profession with improvement in clinically-relevant measures. This provides further evidence that arts-based education can foster professional identity formation and be transformative for students.

Facilitating difficult conversations through art: creating an anti-racism digital image library for health professions education.

Racism has been recognised as a threat to patient outcomes, public health, and the healthcare workforce, and health professions (HP) educators and learners alike are seeking effective ways to teach anti-racism in HP education. However, facilitating conversations on race and racism in healthcare contexts can be challenging. Integrative arts and humanities approaches can engage learners in the critical dialogue necessary to educational interventions focused on anti-racism. Discussions of works of visual art, for instance, can leverage visual art as an avenue for indirection to balance introspection and revelation with psychological safety. Structured pedagogical frameworks that emphasise the perspectives and experiences of participants, such as the Visual Thinking Strategies approach, can lead to open-ended and collaborative discussions where participants can safely explore their assumptions in a space that encourages productive discomfort. Visual arts-based programs on anti-racism in HP are limited, though, in part because no collection of images exists to support HP educators in this endeavour. This paper describes the process of developing a digital image library to support HP educators seeking to generate discussions on race and racism as part of anti-racism curricula. We also highlight common themes, best practices, and potential pitfalls associated with use of the image library.

Mixed infections, cryptic diversity, and vector-borne pathogens: evidence from Polygenis fleas and Bartonella species.

Coinfections within hosts present opportunities for horizontal gene transfer between strains and competitive interactions between genotypes and thus can be a critical element of the lifestyles of pathogens. Bartonella spp. are Alphaproteobacteria that parasitize mammalian erythrocytes and endothelial cells. Their vectors are thought to be various biting arthropods, such as fleas, ticks, mites, and lice, and they are commonly cited as agents of various emerging diseases. Coinfections by different Bartonella strains and species can be common in mammals, but little is known about specificity and coinfections in arthropod vectors. We surveyed the rate of mixed infections of Bartonella in flea vectors (Polygenis gwyni) parasitizing cotton rats (Sigmodon hispidus) in which previous surveys indicated high rates of infection. We found that nearly all fleas (20 of 21) harbored one or more strains of Bartonella, with rates of coinfection approaching 90%. A strain previously identified as common in cotton rats was also common in their fleas. However, another common strain in cotton rats was absent from P. gwyni, while a rare cotton rat strain was quite common in P. gwyni. Surprisingly, some samples were also coinfected with a strain phylogenetically related to Bartonella clarridgeiae, which is typically associated with felids and ruminants. Finally, a locus (pap31) that is characteristically borne on phage in Bartonella was successfully sequenced from most samples. However, sequence diversity in pap31 was novel in the P. gwyni samples, relative to other Bartonella previously typed with pap31, emphasizing the likelihood of large reservoirs of cryptic diversity in natural populations of the pathogen.