Kate Rossiter

After the crash: Research-based theater for knowledge transfer

Introduction: The aim of this project was to develop and evaluate a research‐based dramatic production for the purpose of transferring knowledge about traumatic brain injury (TBI) to health care professionals, managers, and decision makers. Methods: Using results drawn from six focus group discussions with key stakeholders (consumers, informal caregivers, and health care practitioners experienced in the field of TBI) and relevant scientific literature, a 50‐minute play was produced for the purpose of conveying the experiences of TBI survivors, informal care providers, and health practitioners and best practice for TBI care. A self‐administered postperformance survey was distributed to audience members at the end of four performances in Ontario, Canada, to evaluate the plays efficacy. Two hundred ninety‐one questionnaires were completed. The questionnaire had five questions scored on a 5‐item Likert scale with space for open‐ended comments. Results: Consistently high mean scores from the questionnaires indicate that theater is a highly efficacious and engaging method of knowledge transfer, particularly for complex material that deals with human emotion and interpersonal relationships. Discussion: Responses supported the effectiveness of drama as a knowledge translation strategy and identified its potential to impact practice positively.

Bearing Response-Ability: Theater, Ethics and Medical Education

This paper addresses a growing concern within the medical humanities community regarding the perceived need for a more empathically-focused medical curricula, and advocates for the use of creative pedagogical forms as a means to attend to issues of suffering and relationality. Drawing from the ethical philosophy of Emmanuel Levinas, I critique the notion of empathy on the basis that it erases difference and disregards otherness. Rather, I propose that the concept of empathy may be usefully replaced with that of ethical responsibility, which suggests a shared sense of humanity outside the boundaries of presumed knowledge of the other. To illustrate this argument, I theorize the importance of theater within medical education. Theater, I argue, may engender ethical responsibility in the Levinasian sense, and thus may allow learners to differently engage with the experience of the suffering other. As such, I examine Margaret Edson’s widely used play Wit as a platform for such an ethical encounter to occur. Thus, rather than working to understand the value of theater in medical education in terms of knowledge and skill acquisition, I theorize that its primacy within medical curricula arises from its ethical/relational potential, or potential to engender new forms of inter-human relationality.

The Last Straw! A board game on the social determinants of health

Context and setting Optimising doctor–patient communication and ensuring that all people receive quality health care requires that doctors understand the influence of social contexts and cultural backgrounds on patients’ health beliefs and behaviours. Cross-cultural curricula have often taken a categorical and potentially stereotypical approach to cultural awareness, one that embeds patients within static ‘cultures.’ Although the notion that members of discrete groups uniformly behave in distinctive ways is an unproductive and potentially dangerous oversimplification, an understanding of the range of variations in cultural beliefs can be helpful in the clinical encounter. Rather than memorising social or cultural ‘facts,’ students should be aware of the points of variance across a spectrum of socio-cultural contexts. Why the idea was necessary Conventional evaluation methods, such as multiple-choice examination questions, are poorly suited to the kinds of generative thinking and knowledge framework construction that are important in preparing for diverse medical encounters. To assess the evolution of students’ knowledge frameworks regarding socio-cultural health care issues, we piloted the use of concept maps, which are visual representations of the cognitive analysis of a case that display both relevant concepts and links between them. What was done The pilot study was conducted over two quarters (autumn of 2006 and 2007) and included two cohorts of Year 4 students who enrolled in an elective course on socio-cultural issues in health care. The full-time, 2-week course included seminars and experiential exercises led by faculty members in medical anthropology and internal medicine. At the beginning of each course, students received brief training in the process of concept mapping, which included identifying discrete ideas, ranking them by importance and establishing hierarchical relations among them. The students were then presented with a short, written case scenario (which included elements related to socio-cultural contexts, health care ethics and culturally responsive health care) and asked to construct a (pre-instruction) concept map. The identical scenario was presented at the end of the course and students constructed a post-instruction concept map. Evaluation of results and impact Twenty concept maps (10 preand 10 post-instruction) were analysed independently by two raters who were blinded to both the identity of the student and the temporal order of the map pairs. All maps were correctly categorised as either preor post-instruction. Although these students had self-selected to participate in an advancedlevel elective on socio-cultural issues in health care, their concept maps revealed evolution in terms of both complexity and depth, indicating that the degree of potential change in the general medical student population may be even greater. This finding was corroborated by the students’ self-assessments that the course furthered their understanding of the ‘inter-relationships among health, illness, culture and health disparities’ (mean = 5, using a 5-point scale where 5 indicates ‘strongly agree’) and the ‘influence of personal, cultural, ethnic and spiritual identities and beliefs on the experience of health and illness’ (mean = 5). Concept mapping holds promise as a method of assessing ‘meaningful’ knowledge, specifically in terms of the expected changes and differences in the knowledge frameworks of medical students after instruction in socio-cultural issues in health care.

University‐community engagement: a case study using popular theatre

Purpose – The purpose of this paper is to examine the use of popular theatre (PT) as a pedagogical tool around which a community service learning (CSL) senior undergraduate course was oriented, specifically assessing the university student learning experience from this work relative to PT processes and CSL objectives.Design/methodology/approach – This paper presents a case study based on participant observations made by the course instructor, and reflective journal entries written by the university student participants.Research limitations/implications – Educational partnership efforts of this nature require that they be tailored to contingent circumstances: locale, time constraints, spaces of interaction, willingness, effort and abilities of the group partners, and other particularities of community. Given this, we see learning outcomes as replicable, though shaped in various ways by the circumstances of specific situations.Practical implications – The paper demonstrates that by recognizing and relying u...

Finding the Necessary Distance Theorizing Ethnographic Research–Based Theater

Over the past two decades, methodological approaches that operate at the intersection of theater and ethnography have gained both popularity and critical attention. However, given the newness of these endeavors, certain methodological and theoretical elements of such approaches remain unexplored. This is particularly the case in fields such as health research, where people often use theater as a tool of knowledge translation. This article aims to broaden and enrich the growing canon of work in this area in two directions. First, it provides an empirical example of a theatrical script that emerged from a health research project informed both by ethnographic and creative, performance-based practices. In this project the authors used fictionalized accounts of history to help audiences engage with contemporary cultural/ethical issues regarding pandemic planning and response. Second, the authors theorize that this project can be usefully understood as having incorporated a hermeneutic approach to inquiry, and we introduce the notion of mimetic distance as a means of making sense of this project’s success. This article asserts that these theoretical contentions provide further interpretive and creative scope for ethnographic research–based theater and, thus, can usefully expand this growing field.

‘If You Have a Soul, You will Volunteer at Once’: Gendered Expectations of Duty to Care during Pandemics

Duty to care has been identified as a pressing ethical issue in contemporary discussions of pandemic preparedness; however, nuanced discussions of this complicated issue are relatively limited. This article presents historical data from the experience of the 1918 influenza pandemic in Brantford, Ontario in Canada, demonstrating that, in the face of an actual pandemic, the particular construction of duty to care as both moral and gendered meant that women were placed at a greater personal risk during this time. Given that women still dominate the front lines of healthcare work, we argue that it is critical for current stakeholders to reflect on how these historical patterns may be replicated in contemporary pandemic planning and response.

The Last Straw!: A Tool for Participatory Education about the Social Determinants of Health

Background: In response to a scarcity of teaching tools regarding the social determinants of health (SDOH), Kate Reeve and Kate Rossiter created The Last Straw! board game, an innovative participatory education tool to facilitate and engage critical thinking about the SDOH. Objectives: The Last Straw! is designed to encourage discussion about the SDOH, promote critical thinking, and build empathy with marginalized people. Methods: The game begins as each player rolls the dice to create a character profile, including socioeconomic status (SES), race, and gender. Based on this profile, players then receive a certain number of “vitality chips.” Moving across the board, players encounter scenarios that cause them to gain and lose chips based on their profile. The player who finishes the game with the most chips wins the game. The game can be facilitated for a variety of audiences, including both players with no prior knowledge of the SDOH and those experienced in the field. Conclusions: The game has been played with students, policymakers, and community workers, among others, and has been met with immense enthusiasm. Here, we detail the game’s reception within the community, including benefits, limitations, and next steps.

Recounting Huronia Faithfully: Attenuating Our Methodology to the “Fabulation” of Truths-Telling

If telling the truth is considered vital to research methodology, what happens in methodological spaces where “telling the truth” is futile? In this article, we examine the limitations, possibility, and even desirability of normative forms of empirically verifiable truth-telling and the potentialities for storied or fabulated truths with regard to knowledges that have historically been dismissed by their audiences as unreliable and even deceptive. To do so, we draw from critical theory, and Deleuzian theory in particular, to offer a detailed theoretical framework for understanding the notion of fabulated truth. We then turn to our own research to describe a project that embraced the potential of fabulation as a deeply generative methodological practice in regard to better understanding experiences of trauma. This project, which involved working alongside people with intellectual disabilities who have survived institutional incarceration, used fluid arts-based methods to help engage the affective force of trauma to story multiple truths about an otherwise unspeakable history.

Pushing Ecstasy: Neoliberalism, Childbirth, and the Making of Mama Economicus

In 2011, I gave birth to my daughter unmedicated, at home, and assisted by a midwife—just as I had planned. She was healthy. I was healthy. It was, in the order of things, the “perfect” birth. Perfect, except that the birth was overwhelming, painful, and frightening, and I came away from the experience feeling as though I had fallen short—had failed, or been failed. When I expected to feel exultant, empowered, and proud, I simply felt empty, sad, and numb. Why had I expected ecstasy, and why did this failed promise indicate my overall failure as a mother? This experience echoed the experience of other newmothers around me—predominantly well-educated, middle-class women. Despite their good health and the good health of their babies, somehow their children’s births had let them down and left them feeling depressed and ashamed. Indeed, this disappointment resonates at a larger, cultural level. For example, journalist Judith Woods has documented her bitter disappointment with her agonizing labors that defied her birth plans, despite the fact that both births resulted in healthy, happy children. In trying to reconcile her feelings about her birth experiences with tales of triumphant, transformative birth trumpeted within contemporary birthing literature, Woods notes that “if you didn’t experience ecstatic epiphanies when giving birth it is hard—no, make that impossible—to read about another woman doing so without feeling resentful and cheated.” This article considers the seemingly paradoxical, minority world response to birthing experiences in which both mother and baby emerge healthy and whole, but where mothers are left with a keen sense of disappointment. In particular, I examine the growing cultural tide that advocates for ecstatic, or orgasmic, birth. To do so, I engage three key texts—midwife Elizabeth Davis and doula Debra Pascali-Bonaro’s Orgasmic Birth, physician Sarah Buckley’s Ecstatic Birth: Nature’s Hormonal Blueprint for Labor, and spiritualist Jeanice Barcelo’s website Birth of a New Earth—that illuminate and exemplify the