111 A NM intervention on the OB-GYN work floor using site-specific poetry INTRODUCTION Stigmatization and poor awareness of many women’s health concerns s is a major public health problem (1-5). For instance, heavy menstrual bleeding (HMB) can have a significant impact on daily life, leading to pain, discomfort, and social isolation. Due to the societal stigma surrounding many women’s health issues, women might feel embarrassed or ashamed to seek help (1, 2, 6). Because of lack of understanding of signs and symptoms amongst healthcare professionals, women might be misdiagnosed or receive inadequate treatment, further exacerbating their physical and emotional distress (3, 7). In addition, healthcare professionals might not have sufficient training to recognize and address the underlying causes of women’s health concerns, such as bleeding disorders or sexual abuse. A wide variety of workplace trainings and workshops are available, but the vast majority focus on professional development (6, 8-15) or patient information groups and applications (16-19). In other words, these interventions fail to offer advice or practice in breaching sensitive and taboo topics with patients and colleagues or in sharing critical selfreflection with peers. When considering how to optimize support for women with women’s health concerns, it may therefore be more fruitful to devote more time in multidisciplinary sessions to discussion concepts and concerns that are independent of diagnoses, such as ‘distress’ or ‘shame’ (20). Guided reflection on clinicians’ workplace experiences and personal perspectives may also help them identify and become more attuned to patients’ perspectives and support needs (13-15). Moreover, there is evidence that interprofessional collaborative practice is needed to work effectively and with high quality of care in healthcare teams (21). We contend that arts-based interventions provide the ideal setting for meaningful self-reflection, dialogue, and discussion amongst healthcare professionals (22-25). Arts-based interventions have already proven to be a potent strategy for overcoming participants’ discomfort when breaching sensitive topics (12) and have been shown to foster reflection on the ways in which contextual factors influence and shape clinical practice, and how they may facilitate or impede change (19, 26). They can also help stimulate a broader commitment to social justice, antiracism, and environmental advocacy by encouraging participants to “see, name, understand, and act” upon the injustices they observe and experience (12, 27-30). What makes an arts-based intervention so effective is the fact that an artistic work can serve as a “conversational mediator” or “third thing” that opens up a safe space where confrontational topics or strong emotions can be explored and shared in a safe and non-incriminatory environment (31, 32). Narrative medicine (NM) constitutes a widely studied and practiced arts-based educational method that was first developed at Columbia University in the United States, and is also one of the narrative-based interventions heralded by the World Health Organization (WHO) as a valuable means to improve clinical practice (33, 34). Most NM studies focus on medical school or clerkship settings (15, 35) but have found that it can be an effective pedagogic tool that leads to positive improvements in various professional competencies (36, 37). Yet we still know little about its use and effectiveness in work floor settings or in situations where professionals and patients participate together to discuss lived experiences (7, 38). 7
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