“Traveling on Time”: transforming health through humanism and the arts

The U.S. medical community generally agrees that the time to address the inequities and racial biases that exist in the health care system is long past due. Many also agree that the time to take the first steps toward making real, transformational changes is now while the issue of racial disparities and injustices are foremost in the national mindset.

For members of the medical community who are exposed daily to racial inequities in the health care system and struggle with how to effect real, systemic change, the answers may just reside within themselves.

That’s the underlying message of a new project at The Ohio State University College of Medicine, “Traveling on Time, the Next Horizon for Health: Journeys to Equity, Inclusiveness and Transformation of Racism to Humanism.” This program uses art and humanism as agents for transforming individual, underlying racial biases into empathetic understanding and the ability to imagine an entirely new and different system—one that’s not merely changed, but truly transformed.

The distinction between the terms “changed” and “transformed” may not be immediately evident, but the team has built the program upon the essence of that very difference. Reflecting on the work of Wiley W. Souba, MD, Jennifer Garvin, PhD, MBA, division director and associate professor of Health Information Management and Systems and principal investigator for the project, describes change as a process of altering or improving something, but says transformation is different.

“It is creating a new way of being that is not currently in our present reality,” Dr. Garvin says. “In the face of structural racism, building equity requires a fundamental transformation that begins with self-awareness, self-regulation and leadership that extends from the individual to society.”

The transformation process, which is represented as a journey through time, begins with a series of interactive modules, each addressing a specific aspect of racial injustice. The process is portrayed through segments of the opera “Vanqui,” a tale of slavery, death and resurrection in pre-Civil War America. Combining music, poetry, drama, visual arts and dance, the opera provides a medium through which participants are taken on a personal journey to make an emotional connection, accessing their innermost feelings and attitudes, and opening the door for reflection, discussion and empathy. Participants learn how to reach possible solutions to their own implicit biases, guided by presentations in humanistic concepts, systematic racism, anti-racism action plans, and training in the expressive arts, communication and advocacy. A journal of personal reflections and insights helps to develop individual action plans that demonstrate how each person can make systemic, transformational change in their own sphere of influence. At the end of the program, a focus group and a 12-month survey help to evaluate and measure the individual action plans’ impact, as well as program effectiveness.

The program will open as an elective for medical students. It will be presented as two series of six modules each over a three-month period in the spring and fall of 2021, followed by an advanced competency course for medical professionals, including members of the medical school faculty and the health sciences community. An additional set of mini modules will be available for other professional development purposes. End of program evaluations will be used longitudinally to make corrections and achieve best practices, before taking the program on the road nationally.

The project emerged from a unique mix of talents representing various fields and backgrounds, brought together through love of the arts and humanism, and forged by a strong commitment to improving health equity through individual and systemic change that can only be described as transforming. Working closely with Dr. Garvin are award-winning composer Leslie Burrs, whose opera “Vanqui” provides the inspiration for the transformation process, and faculty emerita Linda Stone, MD, founder of the college’s humanism and medicine program. The team utilizes the work of the late, nationally acclaimed poet, author and librettist John Williams. Past presentations of the opera have also utilized the artwork of the late, renowned artist and painter David Driskel. The collaboration offers participants a beautifully orchestrated and powerfully moving experience to serve as a springboard for reflection, understanding, discussion and action.

The “Traveling on Time” project is funded by the American Association of Medical Colleges (AAMC), which supports the integration of humanism and the arts in medical education and has taken an aggressive role in advocating for immediate action in addressing the factors that cause racial inequities in the U.S. health care system.

The AAMC framework for Addressing and Eliminating Racism at the AAMC, in Academic Medicine and Beyond outlines the organization’s position and what the medical education community can do to make transformational systemic change through:

  • Institutional hiring, retention and advancement policies
  • Individual self-reflection on systemic racism
  • Collaborating with academic medical centers to advance anti-racism efforts within medicine
  • Advocating for change around health inequities affecting vulnerable communities
  • Advancing anti-racism efforts within the broader community, including policy making at the national level

As noted in the AAMC framework statement, “We have a window of opportunity where there’s a lot of attention on this topic. But it will not always be the case, because our nation has shown us before that we can acknowledge race issues and then somehow believe that they’ve gone away. We have to use this opportunity to make changes to the structures, policies and procedures that contribute to racism in the medical community while we have national attention on this topic.”