Humanising Healthcare

Belonging - med school workshop 2024

“the sense of security and support one has resulting from a belief in being accepted and valued for being their ‘authentic self.’” (MIT)

'Belonging is about students engaging meaningfully in what they do, able to adapt and adjust and afterwards remembering the medical school fondly' - workshop attendee

Safety is a core idea and perhaps links with Harvard Professor Amy Edmonson's Psychological Safety: a shared belief held by members of a team that the team is safe for interpersonal risk taking and in writing on 'The Fearless Organsation' How can we welcome others and be ourselves?

Foundations of belonging from student perspective (5233 students) WONKHE report 2022 (scroll down for report)

Connection

• the greatest impact that universities can have on students’ sense of belonging is to improve the way they connect their students

Inclusion

•access to and accessibility of teaching and learning

•whether the course content, and those teaching it, were diverse and representative.

Support

• Well-defined, clearly articulated, inclusive support systems and networks are fundamental

Autonomy

•One of the key recommendations in this section, particularly with reference to developing more inclusive content, is for co-creation to become standard practice.

Core ideas discussed included:

Student engagement is needed for lived experience expertise on what enables belonging here
Consider belonging at transition points - value e.g. of Stepping Stones, transition to clinical spaces and the liminal space between qualifying and starting on the wards
Design for informal spaces for students to connect online e.g. kettle boiling informal breakout, and face to face
Design for spaces for staff to connect and for students and staff to connect e.g. co-creation in curricular spaces or in extra- curricular spaces for example Barts and The London Arts staff - student exhibition

From a previous clinical educator workshop on belonging and mattering 2022 we identified the importance of:

Psychological safety (getting to know the students, cake, welcome, introductions, chat etc)
Onboarding students rapidly into the team (community of practice)
Authentic tasks so students feel valued
Co-creation around learning experiences (agency)
Enabling learning at the zone of proximal development

This is mirrored in a Student iBSc (2022-23) on belonging on the wards

interviewed 7 students from Barts and The London and SGUL 2022 - 23

Findings

Importance of being welcomed and recognised including psychological safety (use of names rather than 'medical student')
Inclusion and participation in the clinical team (helpful to be involved - but can easily feel disempowered, excluded, undervalued)
Addressing student curriculum learning needs

Also included, is placement organisation - (structure brings safety)

We All Belong Here by Natasha Jade Austin

Y5 Medical student

I started this drawing several years ago and it was originally comprised of a single skyline only. After re-discovering the partly finished sketch recently, I was inspired to complete the piece through the lens of the theme 'belonging'. Nearing the end of my medical school career, I have had such a privilege to meet and become friends with people from all over the world, and the famous landmarks I chose to include in the concoction of skylines represent those who have had an impact on my life and the fact that my life would be entirely different if I hadn't had the chance to meet them. Upon finishing this piece, I feel it also has an additional meaning to me now. It encompasses the values that Barts prides - we are so warmly welcoming to all those lucky enough to be a part of this community, from the first day of university to the last. For me personally, I believe and hope to always feel like I belong to the Barts community.

'For me personally, I believe and hope to always feel like I belong to the Barts community'.

For more information

This is the WONKHE report on belonging 2021-22

For links to methodology groups and communities of practice on belonging and more

WonkHE Building-Belonging-October-2022.pdf

Building belonging a year on - how has higher education changed? | WonkheA year since Wonkhe and Pearson launched research on student belonging, David Gilani takes stock of the impact it has had across the sector

RAISE 2023 - David Gilani presentation - Student belonging: critiquing simplistic notions of its factors and links to student successPresentation from the 2023 RAISE conference - focused on critiquing simplistic depictions of student belonging utilising breadth of existing research on the topic

Results of a systematic critical literature review carried out by David Gilani Jan - Apr 2023

How arts methods can foster a sense of belonging in students | WonkheAll students experience a stage of adjustment when beginning university. However, underrepresented students may find this period of adjustment harder. Miranda Matthews argues that introducing these students to Arts Methods can ease this transition and foster a sense of belonging.

Belonging, flourishing, widening participation

Research

e.g. supported at Imperial toolkit for belonging research https://www.imperial.ac.uk/education-research/evaluation/what-can-i-evaluate/sense-of-belonging/tools-for-assessing-sense-of-belonging/

e.g. research streams in belonging https://www.imperial.ac.uk/education-research/our-work/sense-of-belonging/

Christopher D. Slaten, Zachary M. Elison, Eric D. Deemer, Hayley A. Hughes & Daniel A. Shemwell (2018) The Development and Validation of the University Belonging Questionnaire, The Journal of Experimental Education, 86:4, 633-651,

https://doi.org/10.1080/00220973.2017.1339009

Humanising Leadership

Park et al in their paper Co-Creating a Thriving Human-Centered Health System in the Post-Covid-19 Era draw upon organisational developmental research to conceptualise ways in which leaders can rebuild healthcare systems promoting workforce wellbeing.

Although these pandemic times are volatile and uncertain there is also cause for hope, historically pandemics have given rise to pan-systemic changes. In these times people and relationship matter more. There is an opportunity to humanise the leadership to deliver systemic changes.

Image by Dr Rachel Handley @hand_el_ee_why

Park et al draw upon evidence to suggest future healthcare leadership enacts the following:

Shared human vulnerability
Meaningful work
Self care and compassion
Equal voice
Reflective space
Relationships matter

Creative enquiry can support all of the above themes through the transformative nature of engaging in the symbolic and metaphorical languages of the arts.

'This was a day I wasn’t expecting to like. I loved it. I found the writing about being a GP actually quite emotional. I wasn’t expecting that either. I think this is because it gave me a chance to remember why I started all this in the first place. We don’t do this enough'.

(GP Educator Development Course Feedback, 2019)

Psychologically safe leadership

Psychological safety is 'a shared belief held by members of a team that the team is safe for interpersonal risk taking' (Amy Edmondson). Psychological safe leadership can create inclusive environments where teams and organisations can flourish.

Questions to ask

How can we alter our attitude to taking risks?

How can we have more open conversations?

How can we increase everyone's willingness to help?

How can we welcome others and be ourselves?

https://fearlessorganization.com/