Krista Longtin

Permanent URI for this collection

https://hdl.handle.net/1805/40147

Improv(ing) Communication About Science and Health: How Theatre Can Help Experts Connect and Collaborate with the Community

Communication is a fundamental part of the human experience and a critical element of the scientific process. We’ve learned so much in the past 50 years about how to communicate effectively, especially in science and health, but we’ve struggled to get that new knowledge into education programs. Dr. Krista Longtin's research seeks to answer the questions: what is the best way to train experts on how to talk about science and health? And, how can we revise curriculum to teach physicians, scientists, and healthcare providers to communicate most effectively to non-experts, including patients, children, and policymakers?

Dr. Longtin is proud to have worked with multiple community organizations to improve science and health communication. For example, she worked with the Evangelical Community Church in Bloomington and the Center for Interfaith Cooperation to hold community conversations about the shared values between science and faith. Each year, the Communicating Science graduate minor program and workshop series trains hundreds of students and faculty on what works in communication strategies. Dr. Longtin and her collaborators actively seek to upend the “deficit model” of science communication, a misconception that just simply giving more information will change decision-making behavior. Rather than just sharing information, physicians and scientists must be engaged in helping their patients and community members see themselves as collaborators in sharing information and making decisions. By dispelling this myth and teaching collaborative communication, Dr. Longtin and her collaborators help regular Indiana people make better decisions about health and science every day.

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6: Enhancing Vitality in Academic Medicine
(Wiley, 2013) Palmer, Megan M.; Hoffmann-Longtin, Krista; Ribera, Tony; Dankoski, Mary E.; Ribera, Amy K.; Nelson Laird, Tom F.
The prevalence of low satisfaction and increased stress among faculty in academic medicine makes understanding faculty vitality in this field more important than ever before. To explore the contributors to and outcomes of faculty vitality, we conducted a multi-institutional study of faculty in academic medicine (N = 1,980, 42 percent response rate). Faculty were surveyed about climate and leadership, career and life management, satisfaction, engagement, productivity, and involvement in faculty development. Analysis reveals that controlling for other factors, academic medicine faculty who participate regularly in faculty development activities are significantly more satisfied, engaged, and productive.
Active Learning on Center Stage: Theater as a Tool for Medical Education
(Association of American Medical Colleges, 2019-01-30) Hobson, Wendy L.; Hoffmann-Longtin, Krista; Loue, Sana; Love, Linda M.; Liu, Howard Y.; Power, Christine M.; Pollart, Susan M.; Obstetrics and Gynecology, School of Medicine
Introduction: Knowledge and skill development related to communication must incorporate both affective and behavioral components, which are often difficult to deliver in a learning activity. Using theater techniques and principles can provide medical educators with tools to teach communication concepts. Methods: This 75-minute faculty development workshop presents a variety of techniques from theater and adapts them for use in medical education. Using examples related to diversity and inclusion, this session addresses general educational and theater principles, role-play, sociodrama, applied improvisation, and practical aspects of involving theater partners. The session materials include a PowerPoint presentation with facilitator notes, interactive activities to demonstrate each modality, and an evaluation. The sessions can be extended to longer formats as needed. Results: Forty-five participants at Learn Serve Lead 2016: The AAMC Annual Meeting attended the 75-minute session. We emailed 32 participants 5 months after the conference, and eight responded. Participants reported that their confidence level in using theater techniques as a tool for medical education increased from low-to-medium confidence presession to high confidence postsession. All survey respondents who were actively teaching said they had made changes to their teaching based on the workshop. All commented that they appreciated the active learning in the session. Many indicated they would appreciate video or other follow-up resources. Discussion: Principles and techniques from theater are effective tools to convey difficult-to-teach concepts related to communication. This workshop presents tools to implement activities in teaching these difficult concepts.
Ask the parents: Testing the acceptability and usability of a hypospadias decision aid
(Elsevier, 2022) Binion, Kelsey; Miller, Andrew; Misseri, Rosalia; Kaefer, Martin; Longtin, Krista; Carroll, Aaron; Wiehe, Sarah E.; Chan, Katherine H.; Communication Studies, School of Liberal Arts
Introduction: In previous work, we engaged key stakeholders to create a web-based decision aid (DA) prototype to facilitate shared decision making about hypospadias. Objective: The study's objective was to use a human-centered design approach to assess the DA's acceptability and usability and revise it prior to pilot testing. Methods: We recruited English-speaking parents (≥18 years old) of sons with hypospadias (≤5 years) for a two-phase process of semi-structured phone/video interviews to obtain feedback about our DA prototype. DA webpages included: "Hypospadias," "Surgery Basics," "No Surgery," "Family Stories," "Help Me Decide," and "FAQs." In both phases, participants viewed the DA using the "think aloud" technique and completed several validated scales to evaluate its acceptability and usability. In phase 1, we collected feedback about the "Homepage" organization, values clarification methods (VCM), and webpage content. In phase 2, participants searched the DA for answers to hypospadias-related questions, provided feedback on testimonial videos and VCM, and shared their preferences about data visualizations. All interviews were audio recorded. After each phase, transcripts were qualitatively analyzed to identify key areas for revision. Revisions were made between phase 1 and 2 to improve the DA's acceptability and usability. Results: We interviewed 20 participants (10/phase): median age 33.7 years, 60% female, 80% White. Mean score on the Preparation for Decision Making Scale: 86.8 (out of 100). We revised: 1) VCM, focusing on pros/cons of surgery and question prompts, 2) "Homepage," adding webpage descriptions (Extended Summary Figure), 3) menu organization, 4) "Surgery Day" webpage, adding general anesthesia risk information, and 5) "Hypospadias" webpage, adding an icon bar graph to help participants visualize statistics. Participants thought the testimonial videos were relatable and the VCMs would prepare them for their visit with their child's urologist. Discussion: Ours is the first parent-centered DA developed and pre-tested for hypospadias. Using validated usability and acceptability scales, participants highly rated the DA in helping them arrive at a decision about surgery. Study limitations include the sample's lack of diversity (i.e., educated, health literate) and participants already decided about their son's hypospadias management before enrolling. To learn more about the DA's usability and acceptability, we plan to pilot test it in a clinical setting. Conclusions: Participants found our DA informative in understanding hypospadias. There was a high perceived level of preparation for hypospadias decision making. Participatory research methods, such as "think aloud," may be helpful when testing DAs as they privilege the patient's experience.
Black vs African American: Why are communication and clinical researchers not paying attention to what descendants of the African Diaspora want to be called, and why is that a problem?
(Indiana Medical Student Program for Research and Scholarship (IMPRS), 2020) Owusu, Raiven; Ridley-Merriweather, Katherine; Hoffmann-Longtin, Krista
Problem: Descendants of African Diaspora (DADs) in the U.S. experience greater health disparities than other racial or ethnic minority groups. Many factors play a role, including their lack of participation in clinical trials. By refusing to participate, DADs cannot benefit from medical research. The barriers to recruiting DADs is well discussed in literature, but we found no research suggesting that mislabeling participants could be creating another barrier. This essay delves into the history of labeling DADs to illuminate the existing tensions between the use of “Black” and “African American” and the impact they may have on recruitment. Processes: Communication Theory of Identity and Critical Race Theory shaped our analysis of this mislabeling issue and its possible implications. Both theories offer insight into how an individual shapes and is simultaneously shaped by communication. We reviewed, summarized, and coded literature in the academic and popular press to answer the research question: How can mislabeling DADs possibly deter them from participating in clinical trials? Findings: Within DADs, there are several subgroups with different cultural heritages that contribute to how people identify. Therefore, no “catch-all” label can be used to accurately describe DADs. Academic and popular press literature indicate that preferences exist amongst this group for how they wish to be identified. Researchers should realize that “Black” and “African American” are not perceived the same by many DADs and should refrain from using them interchangeably. Conclusion: Given the current Black Lives Matter movement, it is imperative that health communication scholars and health researchers consider how language shapes participation and research outcomes for DADs. More research is needed to determine if the use of “Black” and “African American” interchangeably creates another barrier to the recruitment of DADs. However, if possible, researchers should take time to note the preferences of their target populations prior to recruitment.
Bridging the gap for future clinician‐educators
(Wiley, 2018-12) Dilly, Christen K.; Carlos, W. Graham; Hoffmann-Longtin, Krista; Buckley, John; Burgner, Anna; Medicine, School of Medicine
Background In contrast to the training required in the UK, opportunities for medical education training in the USA are limited. Resident‐as‐teacher programmes are typically insufficient to prepare trainees to be successful clinician‐educators, but few pursue formal education degrees. We sought to assess the need for, and feasibility of, a training pathway for subspecialty fellows in a large Department of Medicine that would prepare our trainees to become effective educators. Methods Quantitative and qualitative methods were used. Previous fellowship applicants and current programme directors were surveyed to determine the potential benefits of the programme. A pilot programme was conducted with fellows interested in education to determine the feasibility of the programme. Pilot participants were interviewed regarding the benefits that they gained from the pilot and the logistical challenges that they experienced. In contrast to the training required in the UK, opportunities for medical education training in the USA are limited Results Five highly ranked fellows would have scored our programmes higher if we offered this training pathway. Pilot participants and fellowship programme directors agreed that there is a compelling need for such a training pathway. A number of themes arose from the interviews that enabled us to build the framework for a strong programme. Discussion Our findings suggest that a clinician‐educator training pathway that draws from multiple subspecialties has the potential to improve recruitment, provide needed career counselling and skills development to trainees, and to build a community of educators that will benefit the institution. Important insights from pilot participant interviews will inform the programme design, in order to keep trainees engaged and overcome logistical challenges.
Building Faculty Learning Communities for Medical Education Scholarship in a Multi-Campus System: Four Years of Experience
(2024-04) Kochhar, Komal; Longtin, Krista; Wilson, Shawn; Ho, Monling; Brokaw, James; Hobson, Tara; Wallach, Paul
The Indiana University School of Medicine employs a large geographically distributed system of medical education composed of 8 regional medical campuses and the main medical campus in Indianapolis. An inherent challenge is being able to provide relevant faculty development opportunities across the state. Beginning Fall of 2019, we implemented Faculty Learning Communities (FLCs) specifically designed to develop faculty competence in medical education research. Each FLC team consisted of 4-6 medical educators engaged in a collaborative educational research project led by an experienced faculty mentor. In addition to the group work, participants were expected to attend a series of monthly seminars to build foundational skills in educational research. To date, 69 medical educators (both preclinical/clinical) have participated in 13 FLC teams. To assess participant satisfaction, surveys were administered at the mid-point and end of each FLC team’s term (68% cumulative response rate). By the end of their term, approximately half of the participants had submitted their work for publication or presentation. A successful FLC program requires strong administrative oversight and organization but can easily be replicated elsewhere.
By chance or by design? How clerkship and course directors navigate academic medicine
(Office of the Vice Chancellor for Research, 2015-04-17) Hoffmann-Longtin, Krista
Academic medical centers (AMCs) are complex, bureaucratic organizations with multiple, interconnected missions and constituencies (Brater, 2010). What happens in the classroom affects the operating room and lab. As the responsibilities to treat patients, discover new medical knowledge, and train future physicians become more complex, it is critical to define and situate the pathways to and roles of medical education leaders within the system, so that institutions can fully benefit from their contributions. This study uses an organizational communication lens to develop a theoretical understanding of the relationship between faculty members who are clerkship and course directors (CDs) and AMCs in the U.S. Clinical faculty who become CDs often do so because they are gifted educators. They are responsible for developing faculty, as well as managing curriculum and assessment. These complex roles often lack clear position descriptions and expectations. Though CDs value education, they may face economic pressures to spend more time in clinical duties at the expense of their education responsibilities (Cooke et al., 2006). This can create conflicts in organizational identity and values, as well as an unclear path to tenure, promotion, and rewards (DeAngelis, 2004). This study uses in-depth interviews to explain how CDs manage the multiple (sometimes competing) values and priorities of their roles. Semi-structured interviews were conducted with eight CDs, from institutions of similar size and type, to investigate three interrelated concepts: how faculty become CDs; how they make sense of their roles and values in relationship to those of the institution; and how the structure of AMCs shapes the roles and values of CDs. A qualitative approach, as applied in this study, is useful to understand behavior in complex organizational contexts (Castillo-Page et al., 2012). Interview findings were aggregated into significant narratives and organized by theme, including: pathways to the role; a conflict in values; inconsistent funding; and structural challenges. A grounded theory was developed to explain the process by which CDs manage their complex roles. Findings from this study indicate that CDs are critical to the education mission and can be powerful in shaping the institution, though they face significant challenges. They can feel isolated, because each institution might only have a few individuals that serve these functions. Diverse responsibilities of CDs might also mean that their paths to promotion are unclear or tenuous. Further research is necessary to understand the process of socialization and impact of the reward structure for CDs. Clerkship and course directors do seem to value their sense of organizational identification within multiple contexts, including the medical school, discipline, and the hospital system. In the same vein, it would be helpful to have a better understanding of the connections among their multiple identifications. Additionally, exploring the identification of university faculty in multiple settings may serve to expose subtle differences for identification management used in different contexts for faculty with different roles. Results of the study can be used to shape policies and faculty development efforts for CDs, leading to a clearer sense of purpose and reward system. A deeper understanding of the experiences of CDs benefits both faculty and institutions. Faculty receive more role clarity and individual agency, and AMCs receive information on how to better meet the needs of this population, thus improving the efficacy of medical education.
Communication Between Registered Nurses and Family Members of Intensive Care Unit Patients
(AACN, 2022-12-01) Dees, Mandy L.; Carpenter, Janet S.; Hoffman-Longtin, Krista; School of Nursing
Background Effective communication between intensive care unit patients and their families and nurses promotes relationship-centered care and improves nurses’ ability to meet patient and family needs. However, communication with these patients is challenging because of their critical illness. Families often become surrogate decision makers for adult intensive care unit patients. Objective To systematically assess available evidence on communication between adult intensive care unit patients and their families and nurses as the initial step in developing nursing strategies to strengthen communication skills. Methods In this integrative review, the method of Whittemore and Knafl was used to synthesize findings from qualitative and quantitative (descriptive and experimental) research. Results The review revealed a variety of research designs, measurement tools, and types of interventions. The qualitative findings suggest that nurses can strengthen relationship-centered care by regularly updating patients’ families and providing information that can assist with decision-making. The quantitative findings suggest that nurses should be mindful of family members’ needs for assurance, comfort, and support. Providing information on patient status can help alleviate family concerns. Conclusions Improved communication between patients and families and intensive care unit nurses is essential to strengthen relationship-centered care. Additional research is needed to better understand the communication needs of adult patients and their families in the intensive care unit.
The Conscientious Use of Images Illustrating Diversity in Medical Education Marketing
(Wolters Kluwer, 2020) Hernandez, Rachael; Hoffmann-Longtin, Krista; Patrick, Shawn; Tucker-Edmonds, Brownsyne; Livingston, Nikki; Communication Studies, School of Liberal Arts
An institution's marketing materials are an important part of presenting its culture. In 2018, communication professionals in the Office of Faculty Affairs, Professional Development, and Diversity at the Indiana University School of Medicine recognized after reviewing the literature that using images illustrating diversity in marketing materials may have unintended negative consequences and could potentially reflect poorly on the institution. Representations of diversity that are discordant with the actual demographics of an institution can create distrust among faculty, students, and staff who discover an institution is not as diverse or supportive of diversity as their marketing materials suggest. If institutions adopt an aspirational approach to images and depict more diversity than actual demographics reflect, the authors of this Perspective recommend that they both develop marketing materials that present a widely diverse selection of images and demonstrate transparency in their communication strategies.To improve their promotional materials, the authors conducted an analysis of their institution's strategy for selecting images for these materials, identified institutional goals related to the strategic use of images, created training materials for staff, and drafted a public-facing statement about diversity in images. These measures are a significant step forward in cultivating the ethical use of images illustrating diversity. In the future, institutions should highlight their approaches to using images to portray diversity, as well as photograph and document a wide range of events that represent diverse topics and individuals. When these images are used for marketing purposes, it is also important to ensure that they are used in an appropriate context and not selected with the single goal of presenting diversity. Future research should focus on how underrepresented students and faculty interpret the use of diverse images in marketing, as well as their preferences for the use of their own images in marketing materials portraying diversity.
Creating Choice and Building Consensus: Invitational Rhetoric as a Strategy to Promote Vasectomies in the United States
(University of Florida Press, 2022-03-03) Longtin, Krista; Binion, Kelsey; Communication Studies, School of Liberal Arts
According to a recent study by the Brookings Institution (Reeves & Krause, 2016), vasectomies are safer, more effective, and less expensive than most other voluntary sterilization methods. While the procedure has grown in popularity in recent years, particularly in the United Kingdom and Canada, it is much less common in the United States. This discrepancy can be attributed to both social (a perception that contraception is “women’s work”) and policy-based factors (lack of coverage under the Affordable Care Act). This paper examines the role and extent to which invitational rhetoric could be a useful communicative lens for both partners and providers considering vasectomies, thus increasing access to and utilization of the safe, effective, and affordable procedure. In this policy brief, we suggest strategies for incorporating invitational rhetoric into health professions education curricula, patient counseling literature, and policy language in order to address some of the social stigma around the procedure.

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