Training interprofessional faculty in humanism and professionalism: a qualitative analysis of what is most important

Introduction: The capacity of healthcare professionals to work collaboratively influences faculty and trainees’ professional identity formation, well-being, and care quality. Part of a multi-institutional project*, we created the Faculty Fellowship for Leaders in Humanistic Interprofessional Education at Boston Children’s Hospital/ Harvard Medical School. We aimed to foster trusting relationships, reflective abilities, collaboration skills, and work together to promote humanistic values within learning environments. Objective: To examine the impact of the faculty fellowship from participants’ reports of “the most important thing learned”. Methods: We studied participants’ reflections after each of 16 1½ hour fellowship sessions. Curriculum content included: highly functioning teams, advanced team formation, diversity/inclusion, values, wellbeing/renewal/burnout, appreciative inquiry, narrative reflection, and others. Responses to “What was the most important thing you learned?” were analyzed qualitatively using a positivistic deductive approach. Results: Participants completed 136 reflections over 16 sessions–77% response rate (136/176). Cohort was 91% female; mean age 52.6 (range 32-65); mean years since completion of highest degree 21.4; 64% held doctorates, 36% master’s degrees. 46% were physicians, 27% nurses, 18% social workers, 9% psychologists. 27% participated previously in a learning experience focusing on interprofessional education, collaboration or practice. Most important learning included: Relational capacities/ Use of self in relationships 96/131 (73%); Attention to values 46/131 (35%); Reflection/ Self-awareness 44/131 (34%); Fostering humanistic learning environments 21/131 (16%). Discussion: Results revealed the importance of enhancing relational capacities and use of self in relationships including handling emotions; attention to values; reflection/self-awareness and recognition of assumptions; and fostering humanistic learning environments. These topics should receive more emphasis in interprofessional faculty development programs and may help identify teaching priorities. *Supported in part by a multi-institutional grant from the Josiah Macy, Jr. Foundation (Dr. Branch as PI; Dr. Rider as site PI).

Developing a collaborative, humanistic interprofessional healthcare culture: a multi-site study

Introduction:Developing a collaborative, humanistic interprofessional healthcare culture requires optimal relational skills, respect, interpersonal cohesion, and role clarity. We developed a longitudinal curriculum to engender these skills and values in institutional leaders. We report results of a qualitative study at seven US-based academic health centers to identify participants’ learning. Methods:At each institution, participants from at least three different professions met in small group sessions twice-monthly over nine months. Sessions focused on relational capacities to enhance leadership and professionalism, and utilized critical reflection and experiential learning to promote teamwork, self-knowledge, communication skills, and address challenges encountered by a healthcare team. Participants completed reflective responses to open-ended questions asking what knowledge, insights, or skills they gained by working in this interprofessional group and applications of their learning. Five investigators analyzed the anonymized responses using the constant comparative method. Results:Overarching themes centered on relationships and the strength of the relational nature of the learning. We observed learning on three levels: a) Intrapersonal learning included self-awareness, mindfulness, and empathy for self that translated to reflections on application of these to teamwork and teaching; b) Interpersonal learning concerned relational skills and teaching about listening, understanding others’ perspectives, appreciation/respect for colleagues, and empathy for others; c) Systems level learning included teaching skills about resilience, conflict management, team dynamics and cultural norms, and appreciation of resources from interprofessional colleagues. Discussion:A curriculum focusing on humanistic teaching for leaders led to new insights and positive changes in relational perspectives. Learning occurred on multiple levels. Many learners reported revising previous assumptions, a marker for transformative learning. Humanistic faculty development can facilitate deep bonds between professions.

Humility in Seminary Student Formation: A Mixed Method Community Action Study

This cross-sectional mixed method community action study exploring the virtue of humility was conducted as part of a collaborative practical theology project at a pluralistic, ecumenical Mainline Protestant seminary. Students ( N = 65) in a spiritual formation graduate class completed quantitative measures of humility, spiritual well-being, differentiation of self (DoS), mentalization, and mindfulness, while open-ended qualitative data captured their perspectives about the role of humility in formation. Qualitative results revealed important nuances about emerging religious leaders’ views on humility, including experiencing this virtue as (a) facilitative to their vocational growth (e.g., promoting learning, self-understanding, relational connections, and deeper spirituality), (b) challenging (e.g., self-deprecating, unnecessary, and contrary to ministry), or (c) some combination of both. Quantitative results documented positive associations between relational capacities (e.g., DoS, mentalization) and humility, and these links were mediated by mindful awareness. Implications for measuring and promoting holistic spiritual development among emerging religious leaders are discussed.

Making Music, Building Roads

This chapter explores how the analyses of audible infrastructures presented in this volume connect to the established and growing body of literature on civic infrastructures from scholars in the humanities and social sciences. There are clearly convergent interests between those who work on roads, water, and energy systems, on the one hand, and those who study the production, circulation, and reproduction of sound, on the other. To analyze the materialities of music making, as with civic infrastructures, is to investigate the relational capacities of the materials from which things are made, the diverse types of labor through which these materials become integral to their emergent forms, and the uneven distribution of access to the wider structures that underpin the circulation and reproduction of such forms. In particular, the chapter focuses on how the relationship between the hardware of engineered systems and the software of sociality creates new possibilities for thinking about the politics of infrastructure. The chapter explores these resonances between audible and civic infrastructures by considering the M1 Symphony, a work commissioned by the British Broadcasting Corporation to mark the sixtieth anniversary of the opening of Britain’s first long-distance motorway. The example provokes reflection on the relationship between media and infrastructure, between composition and improvisation, and between ontological experiment and artful design.

Building relational capacities from institutional arrangements: lessons based on the construction of Salvador's subway system

This article aims to study the construction process of the subway system in the Brazilian cities of Salvador and Lauro de Freitas, investigating the constraints of state agencies to build this subway infrastructure. By examining the structures created to produce this urban infrastructure policy, this paper tries to explain how institutional arrangements of public policies condition state agency, in other words, how they enhance or undermine the formation of policy capacities to deliver subway infrastructure. The qualitative analysis of the data suggests that the design of institutional arrangements and their change influence the availability and mobilization of actors, resources, competences and policy instruments towards the promotion of efficacy and legitimacy in this policy.

Building relational capacities from institutional arrangements: lessons based on the construction of Salvador's subway system

This article aims to study the construction process of the subway system in the Brazilian cities of Salvador and Lauro de Freitas, investigating the constraints of state agencies to build this subway infrastructure. By examining the structures created to produce this urban infrastructure policy, this paper tries to explain how institutional arrangements of public policies condition state agency, in other words, how they enhance or undermine the formation of policy capacities to deliver subway infrastructure. The qualitative analysis of the data suggests that the design of institutional arrangements and their change influence the availability and mobilization of actors, resources, competences and policy instruments towards the promotion of efficacy and legitimacy in this policy.

Political Lament: Extinction, Grief, and Embodied Silence

This article confronts the ongoing tragedy of extinction in the Anthropocene from the standpoint of grief and embodied affect. It argues that when confronted with the death of an animal other – be it in public and political settings or in personal encounters of suffering – that silent grief is an embodied form of protest to the triumphalist and anthropocentric narratives of the neoliberal petro-state. In developing an account of suffering and grief from Miguel de Unamuno the argument proceeds to account for an embodied political praxis which subverts political structures aimed at marginalizing animal-others. Finally, in dialogue with Maurice Merleau-Ponty, the article concludes with a reflection on how scholarly activities in the mode of grief might enact relational capacities with the broader animal and natural world.

MOBILIZATION OF POLITICAL-RELATIONAL CAPACITIES BY STATE GOVERNMENTS: an analysis of the formulation of the state plan for solid waste in Tocantins

The National Solid Waste Policy provides for the elaboration of national, state, micro-regional, intermunicipal and municipal plans for integrated waste management (Brasil, 2010). Therefore, the objective was to analyze the political-relational capacities mobilized by the network formed by the actors/ participants in the Technical Workshop for the elaboration of the State Plan for Solid Waste of Tocantins (PERS/TO), which took place in October 2015 in Palmas. Reports were collected from the Secretariat of Environment and Water Resources (Semarh) and a questionnaire was applied to the participants of the technical workshop, which sought to identify the interests of the various actors and investigate the structure and function of the network. The data were analyzed with the support of the Visone 2.7 software.

Beyond participation: when citizen engagement leads to undesirable outcomes for nature-based solutions and climate change adaptation

Scholars and practitioners are increasingly promoting so-called nature-based approaches for urban climate change adaptation. There is widespread consensus that they both support and require transdisciplinary approaches, notably by involving citizens in the change process and finding innovative ways to unite different actors’ efforts and capacities. However, there is little empirical evidence regarding the actual value of citizen involvement to sustainability in this field. Against this background, this paper examines whether (or not) current forms and conditions of citizen involvement help to create a platform to support nature-based solutions and ensure a transformative adaptation process. The results show that under current conditions, citizen engagement often hampers sustainable outcomes. In fact, current structures and mechanisms for mainstreaming nature and climate considerations into sectoral planning are limited and, furthermore, neglect citizen involvement. In addition, there is a blind spot with respect to personal spheres of transformation toward sustainability regarding citizens, civil servants, and decision-makers. Key constraints are power structures and the lack of cognitive/emotional and relational capacities required for improved democratic governance. If we are to tap into the potential of nature-based solutions to increase climate adaptation governance, we need targeted financial and human resources, and greater capacity to overcome current constraints and support all levels and phases of mainstreaming, notably planning, implementation, monitoring, and learning.