From Colored to Black: a narrative medicine approach to theatre and community reconciliation.

OBJECTIVE: The purpose of this article is to analyze the research concepts underlying the construction of a theatrical health intervention on Black well-being, narrative medicine and what we reference as intentional locative healing. STUDY DESIGN: Descriptive postintervention evaluation. METHODS: This short communication article provides specific examples on how to practically implement elements of narrative medicine into an artistic health intervention and in postproduction assessments. RESULTS: Creative interventions that are designed to engage wellness on both an individual and communal level yield more nuanced findings. We recommend embedding reflexive exercises in the intervention for creators, the intended audiences, and jointly within both groups. This approach is in alignment with how narrative medicine is practiced in a clinical setting. It also emphasizes multiple opportunities to integrate close readings and deepen empathetic attentiveness. In addition, in an applied theatrical context, location can be meaningfully used to: 1) address historical tensions in spatial and social communities; 2) provoke curative dialogue to ease said tensions; and 3) ascribe a more restorative meaning to that spatial or social site. CONCLUSIONS: To innovate the discourse and further inform the practice of narrative, arts-based public health interventions, it is important to audit the theoretical thinking that helped guide the creative process. Those intending to engage narrative medicine should take care to remain keenly aware of narrative humility at every step.

Even Mists Have Silver Linings: Promoting LGBTQ+ Acceptance and Solidarity through Community-Based Theatre in India.

OBJECTIVES: This project aimed to assess the effectiveness of a community-based theatre intervention to improve attitudes towards and increase knowledge about LGBTQ+ communities among audiences in Mumbai, India. STUDY DESIGN: This study was a program evaluation using pre- and post-show surveys that incorporated an adapted version of The Riddle Scale: Attitudes Towards Difference and questions assessing self-reported knowledge about LGBTQ+-related issues to assess changes in attitudes and knowledge after viewing the theatre intervention. METHODS: An original 90-min devised play was created by a company of Indian, American, and Canadian theatre artists using Participatory Action Research methods and was designed to bring audiences to a deeper understanding of LGBTQ+ identity. The show was performed four times in Mumbai, India, and pre-/post-show surveys were collected at each performance. Audience survey responses were analysed using parametric and non-parametric descriptive statistics as appropriate, and Likert scale questions were compared using Wilcoxon Signed Rank for non-parametric data. RESULTS: A total 184 surveys were completed across four performances between March 7 and 14, 2020. Significant increases in audiences' self-reported knowledge of LGBTQ+ identity, impacts of discrimination, and struggles faced by LGBTQ+ communities were reported after viewing the show. Furthermore, attitudes towards LGBTQ+ rights, understanding of the challenges of being LGBTQ+ in India, and recognition of the contributions LGBTQ+ individuals make to society improved significantly among our audiences after test. The play further fostered increased acceptance of prosocial behaviours towards LGBTQ+ individuals with higher percentages of audiences recognizing the importance of standing up to homophobia and anti-gay attitudes. While these observations were seen across audiences, they were particularly pronounced among cisgender heterosexual men and audiences ages 18-24. CONCLUSION: Community-based theatre intervention is highly acceptable and effective as a medium for informing positive attitudes, improving knowledge, and promoting acceptance of and solidarity towards LGBTQ+ communities among young adult heterosexual audiences.

Physician career development: toward building a model.

Virtually no managed care organization provides a comprehensive and integrated program for physician career development. That's the principal finding of a survey we carried out in Spring 1994 in which we interviewed several individuals who have proven instrumental in the creation of career development programs at their managed care organizations. We started our research with the hypothesis that career development programs for physicians--frequently the most highly paid category of employees and the ones often most directly involved in the delivery of health care--should parallel the mission of the organization. In many of the organizations we surveyed, the mission included clinical excellence, managerial competence, research, teaching, community service, and building shareholder equity. While each organization offered some component of career development--usually clinical improvement and management development--very few offered programs that fostered the continued professional development of physicians in other aspects of their missions. In most cases, even in organizations with stronger career development agendas, the programs were passive and were rarely linked to the overall "corporate" goal of the managed care institution. This critical disconnect makes it extremely difficult for health care organizations to develop a workable system of accountability for their career development programs.