English Department

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Browsing English Department by Author "Ostherr, Kirsten"

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    Artificial Intelligence and Medical Humanities
    (Springer, 2020) Ostherr, Kirsten; Medical Humanities Program
    The use of artificial intelligence in healthcare has led to debates about the role of human clinicians in the increasingly technological contexts of medicine. Some researchers have argued that AI will augment the capacities of physicians and increase their availability to provide empathy and other uniquely human forms of care to their patients. The human vulnerabilities experienced in the healthcare context raise the stakes of new technologies such as AI, and the human dimensions of AI in healthcare have particular significance for research in the humanities. This article explains four key areas of concern relating to AI and the role that medical/health humanities research can play in addressing them: definition and regulation of “medical” versus “health” data and apps; social determinants of health; narrative medicine; and technological mediation of care. Issues include data privacy and trust, flawed datasets and algorithmic bias, racial discrimination, and the rhetoric of humanism and disability. Through a discussion of potential humanities contributions to these emerging intersections with AI, this article will suggest future scholarly directions for the field.
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    Death in the Digital Age: A Systematic Review of Information and Communication Technologies in End-of-Life Care
    (Mary Ann Liebert, Inc., 2016) Ostherr, Kirsten; Killoran, Peter; Shegog, Ross; Bruera, Eduardo
    Background: End-of-life (EOL) communication plays a critical role in ensuring that patients receive care concordant with their wishes and experience high quality of life. As the baby boomer population ages, scalable models of end-of-life communication will be needed to ensure that patients receive appropriate care. Information and communication technologies (ICTs) may help address the needs of this generation; however, few resources exist to guide the use of ICTs in EOL care. Objective: The primary objective was to identify the ICTs being used in EOL communication. The secondary objective was to compare the effectiveness of different ICTs in EOL communication. Methods: The study was a systematic review, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We systematically searched seven databases for experimental and observational studies on EOL communication between doctors and patients using ICTs, published in 1997ﾖ2013. Results: The review identified 38 relevant articles. Eleven types of technology were identified: video, website, telephone, videoconferencing, e-mail, telemonitoring, Internet search, compact disc, fax, PalmPilot, and short message service (SMS) text messaging. ICTs were most commonly used to provide information or education, serve as decision aids, promote advance care planning (ACP), and relieve physical symptom distress. Conclusions: The use of ICTs in EOL care is a small but growing field of research. Additional research is needed to adapt older, analog technologies for use in the digital age. Many of the interventions discussed in this review do not take full advantage of the affordances of mobile, connected health ICTs. The growing evidence base for e-health applications in related fields should guide future interventions in EOL care.
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    How Do We See COVID-19? Visual Iconographies of Racial Contagion
    (Duke University Press, 2020) Ostherr, Kirsten
    Contagion media have historically performed the dual functions of scientific and ideological persuasion, often deploying an iconography of racial contagion that combines these two functions. In efforts to halt the spread of the virus, health, science, and media organizations create visual imagery to teach the public to imagine we can see and therefore avoid contaminants that are invisible to the naked eye. Comparison of COVID-19 with other global disease outbreaks shows how a core set of contagion media visualizations are repeatedly deployed with subtle adaptations for unique diseases and display interfaces. The variations among different corpora of contagion media point to the interplay among persistent, transhistorical tropes, particular sites of meaning production, and novel technical affordances. This article will examine a subset of these representational techniques, including microscopic images of the virus, close-ups of disease vectors, global and local maps of contagion, health workers in biohazard suits, and visibly ill patients. The essay argues that techniques for visualizing the invisible produce a narrative logic of causality in COVID-19 that reinforces racist and xenophobic discourses of containment and control with direct and deadly consequences. Mitigation of this pandemic and future pandemics will require not only medical but also representational interventions.
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    Reflective Writing about Near-Peer Blogs: A Novel Method for Introducing the Medical Humanities in Premedical Education
    (Springer Nature, 2021) Bracken, Rachel Conrad; Major, Ajay; Paul, Aleena; Ostherr, Kirsten
    Narrative analysis, creative writing, and interactive reflective writing have been identified as valuable for professional identity formation and resilience among medical and premedical students alike. This study proposes that medical student blogs are novel pedagogical tools for fostering peer-to-peer learning in academic medicine and are currently underutilized as a near-peer resource for premedical students to learn about the medical profession. To evaluate the pedagogical utility of medical student blogs for introducing core themes in the medical humanities, the authors conducted qualitative analysis of one hundred seventy-six reflective essays by baccalaureate premedical students written in response to medical student-authored narrative blog posts. Using an iterative thematic approach, the authors identified common patterns in the reflective essays, distilled major themes, coded the essays, and conducted narrative analysis through close reading. Qualitative analysis identified three core themes (empathic conflict, bias in healthcare, and the humanity of medicine) and one overarching theme (near-peer affinities). The premedical students’ essays demonstrated significant self-reflection in response to near-peer works, discussed their perceptions of medical professionalism, and expressed concerns about their future progress through the medical education system. The essays consistently attributed the impact of the medical student narratives to the authors’ status as near-peers. The authors conclude that reading and engaging in reflective writing about near-peer blog posts encourages premedical students to develop an understanding of core concepts in the medical humanities and promotes their reflection on the profession of medicine. Thus, incorporating online blogs written by medical trainees as narrative works in medical humanities classrooms is a novel pedagogical method for fostering peer-to-peer learning in academic medicine.
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    Trust and privacy in the context of user-generated health data
    (Sage, 2017) Ostherr, Kirsten; Borodina, Svetlana; Bracken, Rachel Conrad; Lotterman, Charles; Storer, Eliot; Williams, Brandon
    This study identifies and explores evolving concepts of trust and privacy in the context of user-generated health data. We define “user-generated health data” as data captured through devices or software (whether purpose built or commercially available) and used outside of traditional clinical settings for tracking personal health data. The investigators conducted qualitative research through semistructured interviews (n = 32) with researchers, health technology start-up companies, and members of the general public to inquire why and how they interact with and understand the value of user-generated health data. We found significant results concerning new attitudes toward trust, privacy, and sharing of health data outside of clinical settings that conflict with regulations governing health data within clinical settings. Members of the general public expressed little concern about sharing health data with the companies that sold the devices or apps they used, and indicated that they rarely read the “terms and conditions” detailing how their data may be exploited by the company or third-party affiliates before consenting to them. In contrast, interviews with researchers revealed significant resistance among potential research participants to sharing their user-generated health data for purposes of scientific study. The widespread rhetoric of personalization and social sharing in “user-generated culture” appears to facilitate an understanding of user-generated health data that deemphasizes the risk of exploitation in favor of loosely defined benefits to individual and social well-being. We recommend clarification and greater transparency of regulations governing data sharing related to health.