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In spite of the growing knowledge and understanding of addiction as a chronic relapsing medical condition, individuals with substance use disorders (SUD) continue to experience stigmatization. Pregnant women who use substances suffer additional stigma as their use has the potential to cause fetal harm, calling into question their maternal fitness and often leading to punitive responses. Punishing pregnant women denies the integral interconnectedness of the maternal-fetal dyad. Linking substance use with maternal unfitness is not supported by the balance of the scientific evidence regarding the actual harms associated with substance use during pregnancy. Such linkage adversely impacts maternal, child, and family health by deterring pregnant women from seeking both obstetrical care and SUD treatment. Pregnant women who use substances deserve compassion and care, not pariah-status and punishment.

Substance use disorder (SUD) undermines social connection, identity, and well-being. While art therapy is formally incorporated into clinical treatment, far less is known about how informal, group-based creative activities contribute to recovery. This qualitative study examines whether and how participation in a creative arts group fosters social support and human flourishing among individuals with SUD. We conducted semi-structured, individual interviews of eight adults enrolled in SUD outpatient treatment at the Johns Hopkins Broadway Center for Addiction who voluntarily participated in a creative arts class. Recordings were transcribed and analyzed using an iterative, thematic approach. Analysis revealed four themes: (1) Social connectedness and support—artmaking fostered camaraderie, accountability, and peer encouragement; (2) Holistic and supportive environment—the group offered a safe, nonjudgmental space that affirmed participants beyond their addiction; (3) Emotional renewal through art—creative engagement reduced anxiety, promoted joy, and provided a constructive outlet for emotions; and (4) Reclaiming agency through artistic expression—participants experienced autonomy, skill development, and identity building, which fostered hope and personal growth. Overall, participants viewed artmaking as a catalyst for relational and personal transformation. These exploratory findings generate hypotheses for future research on the role of informal creative arts groups within recovery-oriented care settings.

Medical schools are increasingly incorporating the arts and humanities into their curricula, often emphasizing their benefits in enhancing students' clinical skills. However, the potential for these curricula to foster flourishing is equally, if not more, crucial. Although limited in scope, current literature suggests that art museum-based medical education, particularly as Visual Thinking Strategies, may support flourishing among medical learners-although more research is needed to assess the impact of these methods and their mechanisms on learners. In this article, the authors explore how integrating art museum-based programs into medical school curricula can enhance all five domains of the VanderWeele model of human flourishing: physical and mental health, happiness and life satisfaction, meaning and purpose, character and virtue, and close social relationships.

Professional identity formation is an important aspect of medical education that can be difficult to translate into formal curricula. The role of arts and humanities programs in fostering professional identity formation remains understudied. Analyzing learners' written reflections, we explore the relationship between an arts-based course and themes of professional identity formation. Two cohorts of learners participated in a 5-day online course featuring visual arts-based group activities. Both cohorts responded to a prompt with written reflections at the beginning and end of the course. Using a thematic analysis method, we qualitatively analyzed one set of reflections from each cohort. Themes included the nature of the good life; fulfilling, purposeful work; entering the physician role; exploration of emotional experience; and personal growth. Reflections written at the end of the course engaged significantly with art - including literature, poetry, lyrics, and film. One student disclosed a mental illness in their reflection. Our qualitative analysis of reflections written during a visual arts-based course found several themes related to professional identity formation. Such arts-based courses can also enrich learners' reflections and provide a space for learners to be vulnerable. (five short bullets conveying the main points) Arts-based courses can support learners' professional identity formation Reflection themes related to professional identity formation included entering the physician role, fulfilling clinical work, and personal growth At the end of the course, learners' reflections included significant engagement with art Reflective writing in small, arts-based learning communities can provide space for learners to be vulnerable The Role of Arts-Based Curricula in Professional Identity Formation: Results of A Qualitative Analysis of Learner's Written Reflections

The arts and humanities (A&H) have been identified as essential across the continuum of medical education, and have been integrated across a variety of settings for learners in undergraduate and graduate medical education. Despite the possible benefits of A&H-based education for practicing physicians, and the increasing demand for medical education faculty to provide such content to their learners, A&H programming in continuing medical education (CME) remains limited, and less is known about the feasibility, acceptability, and potential impacts of such interventions in CME. This study describes physicians' perceptions of the value and impact of an art-based CME intervention. Four stand-alone CME sessions using pedagogy from the visual arts were conducted over Zoom. A mixed-methods approach (post-session surveys, thematic analysis of focus groups) was applied to assess perceptions of relevance and role of arts in CME, and potential mechanisms for impact. Sixty physicians (North America, Europe, and Asia) registered for at least one session. 100% of survey respondents (  = 35) supported continued integration of arts-based approaches in CME. Over 90% found it relevant to their clinical practice, their roles as educators and their well-being. Participants highlighted how unique aspects of arts-based education facilitated positive impacts on clinical skills, openness to new perspectives and renewal and joy, but noted its \"nontraditional\" aspects as potential barriers. This study suggests that, while unfamiliarity and scepticism may inhibit use of A&H in CME, physicians may view arts-based CME as a unique way to enhance clinical skills and critical thinking while supporting well-being and a growth mindset amongst established educators.

Background For learners underrepresented in medicine (UIM), a heightened sense of belonging may be critical to creating shared awareness of diversity and fostering an inclusive educational environment. Despite ongoing efforts from academic medical institutions to promote and retain diverse individuals, few studies have investigated the foundational role of pre-health professions education in shaping students’ sense of belonging, and fewer still have leveraged the potential of arts- and humanities-based approaches in doing so. This study aimed to evaluate the perceived impact of race- and gender-diverse visual representations of health professionals on pre-health students’ sense of belonging. Methods Twenty-eight pre-health professions students at one large undergraduate academic institution were randomized to one of two study groups. Each group participated in a visual arts-based workshop to discuss images depicting either gender- and race-diverse or non-diverse health professionals. All participants completed a pre- and post-workshop survey consisting of select items from the Professional Identity Questionnaire (PIQ), as well as an additional open-ended survey after viewing the images from the other study group. Changes in PIQ item scores were analyzed using chi-square statistics, and free-text survey responses underwent thematic analysis. Results Although PIQ item score changes were not statistically significant in either group, both showed an overall directional increase that was more pronounced in the study group exposed to diverse images. Qualitative analysis of responses to open-ended survey items were grouped into four overarching themes: “Diversity, equity, and inclusion (DEI) converges with other aspects of intersectional identity,” “sense of belonging drives motivation,” “perceptions of medicine are shaped early in training,” and “cross-group exposure stimulates metacognitive thinking.” Conclusion Integrating arts and humanities programming into pre-health professions education may help cultivate a sense of belonging among UIM students, providing a robust platform for the critical dialogues essential in advancing inclusivity within healthcare settings.

We implemented and evaluated a hybrid 4-week arts-based elective for clinical medical students to support flourishing. 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. 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). 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.

Medical education comprises intense periods of transition, which can significantly impact student well-being, as well as personal and professional development. In 2020, medical students navigating transitions from pre-clinical to clinical roles were also experiencing the historic forces of the COVID-19 pandemic and ongoing societal reckoning with systemic injustice and racism, likely heightening the usual challenges associated with these transitions. Reflection has been suggested as a tool for facilitating such transitions, and arts-mediated approaches hold promise in inspiring authentic reflection, yet they are rarely used to prompt medical student reflection. This article describes common themes in medical students' reflections on a specific period of transition during a unique moment in history, via qualitative analysis of their narrative responses to visual arts-mediated reflective prompts. The authors used a visual arts-based activity to explore medical students' hopes and concerns as they transitioned to clinical clerkships between the 2019-2020 and 2020-2021 academic years at one academic institution. Qualitative analysis using an exploratory constructivist approach revealed that students' reflections often focused on identity within three main themes: the personal self, the professional self, and the social self. Within these categories, subthemes included uncertainty and concerns focusing on medical training and knowledge, the sense of hope and value inherent to their social connections, critiques of the culture of medical education, and reflections on complicity and responsibility in racial injustice. This article not only provides a cross-sectional snapshot of the experiences of medical students during a historic moment, but also provides themes to guide discussions on training transitions and describes a low-cost, adaptable approach to facilitating deep exploration and reflection on tumultuous moments in training.

Introduction. The role of the visual arts in medical education has been understudied, especially with regard to program evaluation and learner assessment of complex competencies such as professional identity, team building, and tolerance for ambiguity. We designed a study to explore how an integrative art museum-based program might benefit 3rd and 4th year medical students. Methods. We piloted 6 sessions with 18 participants. Evaluation methods included post-session surveys and semi-structured focus groups, which we qualitatively analyzed using an open-coding method. Results. Seven themes emerged from the analysis related to the overarching realms of 'form' and 'function.' 'Form' themes included structural elements of the sessions that enabled engagement: (1) group format, (2) methods (e.g., discussion prompts, activities), (3) setting (e.g., physical space of the museum, temporal space), and (4) objects (e.g., paintings, sculptures). 'Function' themes included the personal and professional value and meaning derived from the sessions: (1) appreciation of others, (2) critical skills, and (3) personal inquiry. Discussion. Our results expand what is known about the role of the visual arts in medical education by suggesting that the visual arts may facilitate clinically relevant learning across a range of competencies via specific formal aspects (group format, method, setting, objects) of art museum-based pedagogical methods.

Objective The authors conducted a systematic review of the published literature to identify interventions to prevent and/or reduce burnout among medical students and residents. Methods The authors searched 10 databases (from the start of each through September 21, 2016) using keywords related to burnout, medical education, and prevention. Teams of two authors independently reviewed the search results to select peer-reviewed, English language articles describing educational interventions to prevent and/or reduce burnout among medical students and/or residents that were evaluated using validated burnout measures. They assessed study quality using the Medical Education Research Study Quality Instrument and the Cochrane Risk of Bias Tool. Results Fourteen studies met inclusion criteria and all used the Maslach Burnout Inventory as at least one measure of burnout. Four were single group pre-post studies, 6 non-randomized two-group studies, and 4 randomized controlled trials. None of the studies were designed specifically to target burnout prevention. In 12 studies, residents were the targeted learners. Six of the 14 studies reported statistically significant changes in burnout scores: 5 reported improvement and 1 reported worsening of burnout. Of the 5 studies that reported statistically significant benefit, 1 studied a complementary and alternative medicine elective, 1 studied the Respiratory One Meditation method, and 3 studied duty hour changes. Conclusions This review highlights the need for rigorously designed studies in burnout prevention and reduction among residents and especially medical students.