Publications by authors named "P Haidet"

127 Publications

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

Perspect Med Educ 2021 Apr 29. Epub 2021 Apr 29.

Department of Medicine, Centre for Education Research & Innovation, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.

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.
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http://dx.doi.org/10.1007/s40037-021-00661-0DOI Listing
April 2021

How Are the Arts and Humanities Used in Medical Education? Results of a Scoping Review.

Acad Med 2021 Apr 6. Epub 2021 Apr 6.

T. Moniz is associate professor, Department of Communication Studies, Mount Saint Vincent University, Halifax, Nova Scotia, Canada; ORCID: https://orcid.org/0000-0002-5078-4611. M. Golafshani is a second-year medical student, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. C.M. Gaspar is a PhD candidate, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada; ORCID: https://orcid.org/0000-0003-0412-5495. N.E. Adams is associate librarian and assistant dean of foundational sciences, Penn State College of Medicine, Hershey, Pennsylvania; ORCID: https://orcid.org/0000-0003-0534-6716. P. Haidet is director of medical education research, Woodward Center for Excellence in Health Sciences Education, Penn State College of Medicine, Hershey, Pennsylvania. J. Sukhera is associate professor, Departments of Psychiatry and Paediatrics, and scientist, Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; ORCID: https://orcid.org/0000-0001-8146-4947. R.L. Volpe is associate professor and vice chair for education, Department of Humanities, Penn State College of Medicine, and director, Clinical Ethics Consultation Service, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania; ORCID: https://orcid.org/0000-0003-3406-9498. C. de Boer is director, Doctors Kienle Center for Humanistic Medicine, and founding director, Center Stage Arts in Health, Penn State College of Medicine and Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania. She is president, National Organization for Arts in Health, San Diego, California. L. Lingard is professor, Department of Medicine, and scientist, Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.

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 continuum of medical education 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 semi-structured 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 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.
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http://dx.doi.org/10.1097/ACM.0000000000004118DOI Listing
April 2021

The Prism Model for Integrating the Arts and Humanities Into Medical Education.

Acad Med 2021 Feb 2. Epub 2021 Feb 2.

Mount Saint Vincent University University of Toronto Dalhousie University Penn State College of Medicine Penn State College of Medicine Western University Penn State College of Medicine Penn State College of Medicine Western University.

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http://dx.doi.org/10.1097/ACM.0000000000003949DOI Listing
February 2021

Clinical decision support to improve management of diabetes and dysglycemia in the hospital: a path to optimizing practice and outcomes.

BMJ Open Diabetes Res Care 2021 Jan;9(1)

Department of Medicine, Public Health Sciences, and Humanities, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, USA.

Introduction: Innovative approaches are needed to design robust clinical decision support (CDS) to optimize hospital glycemic management. We piloted an electronic medical record (EMR), evidence-based algorithmic CDS tool in an academic center to alert clinicians in real time about gaps in care related to inpatient glucose control and insulin utilization, and to provide management recommendations.

Research Design And Methods: The tool was designed to identify clinical situations in need for action: (1) severe or recurrent hyperglycemia in patients with diabetes: blood glucose (BG) ≥13.88 mmol/L (250 mg/dL) at least once or BG ≥10.0 mmol/L (180 mg/dL) at least twice, respectively; (2) recurrent hyperglycemia in patients with stress hyperglycemia: BG ≥10.0 mmol/L (180 mg/dL) at least twice; (3) impending or established hypoglycemia: BG 3.9-4.4 mmol/L (70-80 mg/dL) or ≤3.9 mmol/L (70 mg/dL); and (4) inappropriate sliding scale insulin (SSI) monotherapy in recurrent hyperglycemia, or anytime in patients with type 1 diabetes. The EMR CDS was active (ON) for 6 months for all adult hospital patients and inactive (OFF) for 6 months. We prospectively identified and compared gaps in care between ON and OFF periods.

Results: When active, the hospital CDS tool significantly reduced events of recurrent hyperglycemia in patients with type 1 and type 2 diabetes (3342 vs 3701, OR=0.88, p=0.050) and in patients with stress hyperglycemia (288 vs 506, OR=0.60, p<0.001). Hypoglycemia or impending hypoglycemia (1548 vs 1349, OR=1.15, p=0.050) were unrelated to the CDS tool on subsequent analysis. Inappropriate use of SSI monotherapy in type 1 diabetes (10 vs 22, OR=0.36, p=0.073), inappropriate use of SSI monotherapy in type 2 diabetes (2519 vs 2748, OR=0.97, p=0.632), and in stress hyperglycemia subjects (1617 vs 1488, OR=1.30, p<0.001) were recognized.

Conclusion: EMR CDS was successful in reducing hyperglycemic events among hospitalized patients with dysglycemia and diabetes, and inappropriate insulin use in patients with type 1 diabetes.
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http://dx.doi.org/10.1136/bmjdrc-2020-001557DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7816906PMC
January 2021