Art in Surgery: A Review of Art-based Medical Humanities Curricula in Surgical Residency.

OBJECTIVE: Numerous programs integrate arts and humanities methods to advance medical education competencies. Despite the highly visual and technical nature of the field of surgery, the current state of art utilization in surgical training is unclear. The purpose of this review is to gain a comprehensive understanding of how art has been utilized in surgical training, to investigate the purpose of such interventions, and to assess how art interventions may benefit surgeons. DESIGN: A systematic literature review using PRISMA methodology was conducted to identify articles published prior to February 2022 that investigated or described using art in surgical resident training. Qualitative themes were developed upon full review of the literature and categorized based on fundamental aspects of surgical education. The data was summarized by a narrative approach. RESULTS: Six hundred seventy-four unique articles were initially identified, thirteen of which met inclusion criteria. Twelve studies employed drawing or sculpture in surgical residency training; one discussed art observation to foster mindfulness, teambuilding, and empathy. Eight articles utilized art as an evaluation tool, 2 for didactic and archival purposes, one employed exercises in art analysis to improve empathy and physician wellbeing, and 2 described courses in which art making was treated as a foundational skill. No articles discussed use of art for honing diagnostic skills, observation, or patient communication - competencies that have been addressed in other fields. CONCLUSIONS: This review highlights the small number of examples in the medical literature about visual arts in surgical training. The existing art-based surgical humanities studies identify opportunities for curricular innovation within surgical training.

Perceived barriers and supports to accessing community-based services for Uganda's pediatric post-surgical population.

BACKGROUND: Access to pediatric surgical intervention in low-income countries is expanding, but investments in post-surgical care have received less attention. This study explored the barriers and supports for school-aged children to access post-surgical, community-based follow-up care in Uganda as perceived by community stakeholders. MATERIALS AND METHODS: This qualitative exploratory case study used in-depth, semi-structured interviews and in-country site visits among Ugandan organizations providing follow-up care to school-aged children in Uganda after surgery. Data from eight interviews and eight site visits were coded, analyzed, and cross-tabulated with a modified grounded theory approach. RESULTS: Four key barriers to community-based follow-up care were identified: discrimination, financial barriers, geographical barriers (including transportation), and caregiver limitations to support recovery. Three key supports to successful access to and participation in community-based post-surgical recovery were identified: disability awareness, the provision of sustained follow-up care, and caregiver supports for reintegration. CONCLUSIONS: Increasing awareness of disability across local Ugandan communities, educating caregivers with accessible and culturally aware approaches, and funding sustainable follow-up care programming provide promising avenues for pediatric post-surgical recovery and community reintegration in contemporary Uganda.Implications for rehabilitationMultiple, intersecting factors prevent or promote access to post-surgical community-based services among school-aged children in Uganda.The most prominent barriers to pediatric community reintegration in Uganda include discrimination, lack of financial resources, geographical factors, and caregiver limitations.Community and interprofessional alliances must address disability awareness and sources of stigma in local contexts to promote optimal recovery and reintegration after surgery.Collaborative efforts are needed to develop sustainable funding for community-based care programs that specifically support pediatric post-surgical recovery and reintegration.Efforts to provide appropriate and empowering caregiver education are critical, particularly in geographical regions where ongoing access to rehabilitation professionals is minimal.