Browsing by Author "Beckman, Emily"

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    At a Loss for Words: Using Performance to Explain How Friends Communicate About Infertility
    (2023-06) Binion, Kelsey Elizabeth; Brann, Maria; Beckman, Emily; Bute, Jennifer J.; Longtin, Krista J.
    In the United States, approximately one in five women are unable to get pregnant after one year of trying. Due to the pervasiveness of pronatalism in Western society, having a child is widely assumed to be a natural and expected part of womanhood. Society’s master narratives reinforce these ideals and stigmatize the experiences of women who have infertility. This multi-phase research study examined how women discuss their infertility journey with their friends. The study’s aims were to understand friendships within the context of infertility, how the relationship affects a woman’s identity, and the communicative behaviors used in conversations. Fifteen interviews were conducted with women who experienced or are experiencing infertility and had discussed their past or current challenges with a friend. Results of a phronetic iterative analysis suggested that women who have personal experience with infertility (a) disclose to close/best friends, (b) communicate their identity as “broken,” (c) desire emotional support, and (d) strategically navigate conversations as they encounter positive and negative messages. These results were transformed into a performance, which included six monologues and a talkback. The purpose of the arts-based methodology was to disseminate results and assess the performance’s impact. Seventy-three individuals attended one of the two performances in April 2023, and 50 attendees completed the post-performance evaluation. The quantitative results suggest that attendees felt informed about the complexities of infertility, gained a new perspective, received advice about how to have future conversations, and did not feel offended by the content. Through a thematic analysis, four themes emerged from the two talkback sessions and evaluation comments: being informed about infertility as a health condition, appreciating the theatrical format to learn, connecting to the performance to understand the illness experience, and feeling comfortable navigating conversations about infertility. Despite the variance in infertility experiences, friends are essential social support figures as women navigate infertility, and there are best practices when having a conversation, as demonstrated in the performance. This study’s implications include providing communication strategies to support women with infertility and recognizing that an arts-based methodology can highlight counterstories, inform about a stigmatized health issue, and engage the community.
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    Bringing Clinical Organizational Ethics into Practice
    (2024-05) Swartwood, Brigitte Rene; Beckman, Emily; Haberski, Raymond; Hartsock, Jane; Helf, Paul R.; Meagher, Ashley
    This dissertation consists of four papers that focus on the integration of clinical organizational ethics (COE) concepts into clinical practice. As defined by Miller and Hartsock, COE is a distinct area of ethics that addresses recurrent clinical ethics dilemmas. These dilemmas are issue-based and arise directly from patient care, yet these issues affect multiple patients. The resolution of these dilemmas are often revisions of procedures, policies, or practices.1 By analyzing specific organizational-level policies and practices, I attempt to ground these theoretical ideas by considering their impact on clinical outcomes. These four papers illustrate the integration of COE into practice in three ways: conceptually, empirically, and through recommendation of change in practice. "Victims of Violence, Hospital Policies, and Potential for Bias" and "Opioid Prescribing, Hidden Influences, and the Cultural Impact of Christianity" conceptually discuss a policy or practice affecting clinical care. "Victims ofViolence ... " investigates the implications of No Information Status policies and suggests that they may burden bedside staff while providing a false sense of safety and may exacerbate existing health disparities. "Opioid Prescribing ... " examines how Christian frameworks may be implicitly shaping clinicians' approaches to opioid prescribing within the setting of chronic nonmalignant pain management. "Evaluation of Security Emergency Responses: Racial Disparities in Activation" uses empirical evidence to discuss racial disparities in security emergency responses (SERs) within a hospital. This paper used a retrospective, descriptive cohort study to illustrate ethical implications of polices that exacerbate health disparities. Finally, "The Importance of Data Collection in SERs" proposes a framework for collecting data and addressing SER challenges within an organization. This improvement in hospital practices will provide opportunities to address some of the complex challenges surrounding SERs. Collectively, these papers aim to fill gaps in the literature, challenge implicit biases, and address specific challenges in clinical care using a Clinical Organizational Ethics framework.
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    Empathy and its implications for prosocial behavior and engagement with the arts
    (2018-02-12) Kou, Xiaonan; Konrath, Sara; King, David; Ottoni-Wilhelm, Mark; Beckman, Emily; Davis, Mark
    This dissertation contains three essays examining empathy and its implications for prosocial behavior and arts engagement. Empathy here refers to both compassion and concern for others (emotional empathy) and the understanding of the feelings and needs of others (cognitive empathy). Empathy is fundamental to our social life, and this dissertation explores its implications for two essential components of social life: prosocial behavior and arts engagement. Chapter 2 examines how three dimensions of the Interpersonal Reactivity Index (IRI; Davis, 1983)—empathic concern, perspective taking, and personal distress—are associated with charitable giving, and whether these associations vary across charitable causes. Using data from a nationally representative sample of American adults, the study confirms that the three IRI dimensions are associated with charitable giving in different ways. Chapter 3 focuses on the interplay of trait empathy and people’s tendencies to diversify (spread out) their prosocial behavior. By analyzing data from two samples of American adults, this study reveals that people with higher empathic concern (emotional empathy) versus higher perspective taking (cognitive empathy) have distinct patterns in how they spread out their monetary gifts, but trait empathy is not associated with the distribution of time spent in helping others.
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    From “A Spoonful of Sugar” to Operation Warp Speed: COVID-19 Vaccines and Their Metaphors
    (Harvard Law School, 2020-12-15) Silverman, Ross D.; Head, Katharine J.; Beckman, Emily; Health Policy and Management, School of Public Health
    We must remain cognizant of the many ways metaphors may distort, divide, or misrepresent important details.
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    A Human Paradox: The Nazi Legacy of Pernkopf’s Atlas
    (2019) Hartsock, Jane; Beckman, Emily; Medical Humanities & Health Studies Program
    Eduard Pernkopf’s Atlas of Topographical and Applied Human Anatomy is a four-volume anatomical atlas published between 1937 and 1963, and it is generally believed to be the most comprehensive, detailed, and accurate anatomy textbook ever created. However, a 1997 investigation into “Pernkopf’s Atlas,” raised troubling questions regarding the author’s connection to the Nazi regime and the still unresolved issue of whether its illustrations relied on Jewish or other political prisoners, including those executed in Nazi concentration camps. Following this investigation, the book was removed from both anatomy classrooms and library bookshelves. A debate has ensued over the book’s continued use, and justification for its use has focused on two issues: (1) there is no definitive proof the book includes illustrations of concentration camp prisoners or Jewish individuals in particular, and (2) there is no contemporary equivalent to this text. However, both points fail to address the central importance of the book, not simply as part of anatomy instruction, but also as a comprehensive historical narrative with important ethical implications. Having encountered a first edition copy, these authors were given a unique opportunity to engage with the text through the respective humanities lenses of history, ethics, and narrative. In doing so, an instructive and profound irony has surfaced: Nazis, including Pernkopf, viewed specific groups of people as less than human, giving rise to unthinkable atrocities perpetuated against them. However, these same individuals became the sources for the creation of the Atlas, which served as the model for primary instruction on the human form for more than half of the twentieth century. In this article, we recount the difficult and somewhat opaque provenance of this book, engage the ethical questions surrounding both its creation and its use, and ultimately propose a pedagogical methodology for its continued use in medical education.
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    Medical Student as Playwright: Dramatizing Imelda
    (2022) Beckman, Emily; Larimer, Angeline; Medical Humanities, Liberal Arts
    Critical engagement with fiction has the potential to prompt development of personal empathy. Playwriting can foster an even deeper understanding of patient space and motivation by challenging students with the responsibility of creating characters, bringing to light common misperceptions of societal intersections and highlighting awareness of societal complexities. The opportunity to animate characters provides students the chance to examine difficult themes within a safe space environment. For three years our medical students have been prompted to write a script inspired by Richard Selzer’s short story “Imelda” which addresses issues of access, equality, gender, race and class in an international setting, as well as ethical considerations in best practices. Students are instructed on the mechanics of scriptwriting, and are expected to write one complete scene. Students then participate in an in-class scriptwriting workshop where they are asked to assign roles to classmates and direct a staged reading for the class, after which a discussion takes place. Throughout the process, students imagine the life of another, and move beyond their own comfort zones to articulate that life in a creative and expressive way. This process is much like those which exist in the practice of medicine involving communication, active listening, close attention to nuance, collaboration and performance. This paper examines the benefits of incorporating an applied theatre playwriting workshop into medical education, specifically within a narrative medicine curriculum and included samples of text from student scripts, a larger analysis of the two-year exercise, and recommendations for future iterations.
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    Patient Preferences Matter: A Qualitative Inquiry With Patients About the Surgical Decision for Osteosarcoma in the Lower Extremity
    (2020-06) Panoch, Janet Elizabeth; Goering, Elizabeth; Parrish-Sprowl, John; Hoffman-Longtin, Krista; Beckman, Emily
    Purpose The experience of surgical patient decision-making for amputation, rotationplasty, or limb salvage surgery for the lower extremity was explored with osteosarcoma survivors and parents. Issues and patient concerns were examined prospectively in Facebook posts and retrospectively in personal interviews. Recommendations were sought for the development of a decision aid. Methods A qualitative inquiry was conducted in two studies: 1) a content analysis of 15 Facebook posts on the Osteosarcoma and Ewing’s Sarcoma Support Group about the surgical decision, and 2) a narrative analysis of 20 interviews with survivors and parents about their lived experience. The interview guide was informed by a knowledge translation theoretical model. In-person or video interviews included 29 parents or adolescent-young adults between the ages of 14-71 across 15 states. Results Participants were concerned about making the best decision for themselves or their child. Having little time to make the decision contributes to feeling overwhelmed and uninformed. The lack of information about options, potential limitations, prosthetic needs, and long-term functional outcomes impacts the decision-making process. Resources for finding information are limited. Shared decision-making approaches were preferred though many decisions were made by the surgeon. Patients felt unprepared for complications encountered after limb salvage. Conclusions Limb salvage surgery remains the gold standard for most providers; participants felt there was a bias on the surgeon’s part for salvage. Potential complications and uncertainties of each option were largely omitted in consultations; information about living with a prosthesis is an unmet need for decision-making. The decision affected their quality of life in ways they did not anticipate, resulting in additional decisions. Implications The findings of this study can be used in medical education for orthopedic surgeons to understand the long-term outcomes of limb salvage surgery. Patient preferences matter in the decision and patients who are involved in the decision are more satisfied if they are prepared for the unknown and potential complications. Recommendations for a decision aid include an online format, content that includes a discussion of uncertainties as well as complications of each option, patient stories for long-term outcomes, and resources for psychosocial support.
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    Voices from the Newspaper Club: Patient Life at a State Psychiatric Hospital (1988-1992)
    (Springer, 2020-05-21) Beckman, Emily; Nelson, Elizabeth; Labode, Modupe; Medical Humanities and Health Studies, School of Liberal Arts
    The authors conducted a qualitative analysis of thirty-seven issues of The DDU Review, a newsletter produced by residents of the Dual Diagnosis Unit, a residential unit for people who had diagnoses of developmental disability and serious mental illness in the Central State Hospital (Indiana, USA). The analysis of the newsletters produced between September 1988 and June 1992 revealed three major themes: 1) the mundane; 2) good behavior; and 3) advocacy. Contrary to the authors’ expectations, the discourse of medicalization—such as relations with physicians, diagnoses, and medications—receive little attention. Instead, the patient-journalists focus on prosaic aspects of institutional life. The patients used their writing as a form self-definition and advocacy. The authors argue that even though it is tempting to consider the patients’ emphasis on good behavior as evidence of institutional control, internalized discipline, and medicalization, a more nuanced interpretation, which focuses on how the patients’ understood their own experiences, is warranted. Researchers must also recognize the ways in which The DDU Review reveals the patient-journalists’ experience of an institutional life that includes non-medical staff (attendants, secretaries, and therapists), varied social relationships among patients, and negotiated freedoms.
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    “You will have changed profoundly”: A letter writing exercise for 4th Year medical students
    (Medical Humanities Group at UCMS and GTBH, 2022-08-04) Beckman, Emily; Head, Katharine J.; Gramelspacher, Anna Maria; Medical Humanities, Liberal Arts
    Introduction: Reflective writing, an exercise where students respond to a prompt in writing and then read their writing aloud in class, is a core component of Narrative Medicine. Student writings often reveal truths about their own experiences moving through medical education, including the identity transformation they experience. Method: The purpose of this study was to ask fourth year medical students (N=15) enrolled in Narrative Medicine elective courses at two large U.S. Midwestern medical schools to reflect on their medical school experience. The students were asked to write a letter in response to the following prompt: “if you could tell your 1st day of medical school self anything, what would it be?” Results: Through thematic analysis, the authors identified three major themes in these letters, including student reflections of medical school as a journey, identity transformation and identity management within medical school, and the value of important relationships and the role they play in the medical student experience. Discussion: We conclude the paper with a discussion on what we can learn from these student letters, calling for more attention to the vulnerability of students as they progress through medical school and more research on the kinds of transformation students experience. Medical students can be vulnerable, and the system that has been created for them to develop into empathetic, skilled physicians often contributes to that vulnerability. Therefore, institutions should not only allow students to reflect and give voice to their experience, but also encourage a reimagining of certain aspects of medical education.