‘Whispers of inclusion amidst the shouts of omission’—Breaking stereotypes and discrimination using queer arts in medical education

Abstract

Using the ladder of inference, one can anticipate that inherent assumptions shape perceptions and drive decisions.¹ In medical education, therefore, embracing gender inclusivity requires training students to actively challenge their own biases to better understand the perspectives of gender-diverse patients. The problem with current educational practices is that they often take a passive approach when it comes to encouraging self-exploration of inherent biases. Therefore, students may miss opportunities to critically reflect on the stereotypes they bring into clinical encounters, perpetuating discrimination. To address this, art, with its profound capacity to evoke deep emotions, was utilised to encourage students to explore and reflect on their own biases.

A group of 24 final-year undergraduate medical students were selected through random sampling. A 9-item questionnaire with 5-point Likert scale measured students' baseline confidence in discussing gender diversity, recognising biases, providing inclusive care, addressing gender identity issues, applying inclusive language, and integrating gender diversity into clinical practice. In this 2-week flipped classroom programme, students were divided into six groups and then browsed the internet or visited museums to gather paintings and photographs that explicitly represented one or more gender identity from different cultural, social, or geographical contexts and portrayed an issue of challenge or confrontation. A session on ‘The Art of Seeing’ was conducted to orient learners to the Visual Thinking Strategies (VTS) essential for critical thinking through careful observation, interpretation and reflection of visual arts.

Students gauged each other's interpretations and synthesised a narrative report from queer communities' perspective, creatively describing the emotions, bias and discrimination faced and offering a reflective statement of how they aim to enhance inclusivity in their clinical practice. Each group presented their report followed by reflective discussions. The narratives were evaluated based on depth of interpretation, creativity, critical reflection, practical application, inclusive language and emotional insights.

Students perceived the programme to be highly impactful and there was a statistically significant increase in their confidence levels (2.1 ± 0.7 to 4.6 ± 0.5; p < 0.0001). In-depth small group interviews helped to explore the underlying reasons for this shift, revealing that exploring each other's perspectives to navigate solutions and creating a narrative helped students to consciously identify and understand physical, mental, social, & emotional challenges, while also facilitating respectful communication and a thoughtful commitment to promoting equality and empathy in future clinical practice.

One of the most striking realisations was how art could evoke an emotional engagement that typical medical curriculum often overlooks. This appeared to be the key to drive internal change. It turned abstract concepts of gender diversity into lived experiences, allowing students to better understand what it means to walk in the shoes of their patients. It reinforces that teaching, at its best, should not only inform but transform. Creating a vulnerable space for reflective discussions becomes pivotal as students identify their inherent biases, diversify their perspectives, and transform those into impactful change. This vulnerability is where real growth happens, both for students and educators.

Krishna Mohan Surapaneni: Conceptualization; investigation; funding acquisition; writing—original draft; visualization; methodology; validation; project administration; formal analysis; software; resources; supervision; data curation.

No conflict of interest to declare.