Disorienting or Transforming? Using the Arts and Humanities to Foster Social Advocacy.

Introduction: The arts and humanities (AH) have transformative potential in medical education. Research suggests that AH-based pedagogies may facilitate both personal and professional transformation in medical learners, which may then further enhance the teaching and learning of social advocacy skills. However, the potential for such curricula to advance social advocacy training remains under-explored. Therefore, we sought to identify how AH may facilitate transformative learning of social advocacy in medical education. Methods: Building upon previous research, we conducted a critical narrative review seeking examples from the literature on how AH may promote transformative learning of social advocacy in North American medical education. Through a search of seven databases and MedEdPORTAL, we identified 11 articles and conducted both descriptive and interpretative analyses of their relation to key tenets of transformative learning, including: disorientation/dissonance, critical reflection, and discourse/dialogue. Results: We found that AH are used in varied ways to foster transformative learning in social advocacy. However, most approaches emphasize their use to elicit disorientation and dissonance; there is less evidence in the literature regarding how they may be of potential utility when applied to disorienting dilemma, critical reflection, and discourse/dialogue. Discussion: The tremendous potential of AH to foster transformative learning in social advocacy is constrained due to minimal attention to critical reflection and dialogue. Future research must consider how novel approaches that draw from AH may be used for more robust engagement with transformative learning tenets in medical education.

OTX2 mutation associated with severe myopia in a Canadian family.

PURPOSE: To describe a case of high myopia in a pediatric patient with a mutation in the OTX2 gene and further characterize the diverse ocular phenotypes of heterozygous OTX2 mutations. PATIENT AND METHODS: We describe a three-year-old girl who presented at two months old with abnormal eye movements and suspected retinal dystrophy. Clinical exam and electroretinography (ERG) were conducted, and molecular next generation sequencing (NGS) with the Inherited Retinal Dystrophies panel was completed in our patient and offered to the family. RESULTS: Further examination revealed progressive high myopia in our patient and her mother, alongside diffuse retinal thinning and normal ERG. NGS identified a likely pathogenic variant in the OTX2 gene (c.235 G > A) that was maternal in origin. There were no extra-ocular concerns in our patient, and brain MRI was normal. CONCLUSIONS: While OTX2 mutations are known to cause retinopathy, this case presents a unique phenotype through a heterozygous missense variant (c.235 G > A) underlying high myopia in a three-generation family. This case further supports the role of OTX2 in ocular development and demonstrates the variable expressivity of OTX2 mutations. Genetic testing in families with high myopia may be useful in future surveillance and preparation for ocular and extra-ocular complications associated with OTX2-syndrome presentations.