Current Medical Humanities Research Projects

Faculty Mentor: Dr. Chin Jou (Rice University)

Project Title
Captive Consumers: Hunger, Inequality, and Violence in American Prison Food

Project Description
This project is a book manuscript on prison food that I drafted and submitted this past June. The book manuscript discusses virtually every aspect of prison food in the United States, including nutrition and health. I hope to receive readers' reports on the manuscript soon, and expect to revise the manuscript in accordance with readers' reports and prepare it for publication in Spring 2025.

Tasks the student would be expected to perform
The selected student would probably be fact checking, copy editing, making sure endnotes correspond to text, and obtaining permissions to reproduce/publish photographs and other images from their sources. A student interested in a career in publishing and/or applying to graduate school in the humanities would probably get the most out of the tasks associated with this project.

Faculty Mentor: Dr. Luziris Pineda Turi (Rice University)

Project Title
U.S. Latine Health Research

Project Description
SPAN 333: U.S. Latine Health focuses on the most current research about the topic. In order to keep the course up to date, Dr. Pinea Turi seeks a student capable of gathering and doing a review of research articles focused on different medical humanities topics connected to the U.S. Latine population. English and Spanish proficiency required.

Tasks the student would be expected to perform
Research
Literature Review
Analysis

Faculty Mentor: Dr. Natasha Afonso (Texas Children's Hospital)

Project Title
Experiencing the ICU as a Limited English Proficiency Family Member: A Phenomenological Study

Project Description
Patients with limited English proficiency (LEP) face significant risks within the healthcare system, including increased medical errors, lower satisfaction rates, and longer hospital stays. These challenges are particularly pronounced in the intensive care unit, a high-stakes environment where critical decisions are made and clear communication between providers and families is essential. The experience of LEP family members in this setting is complex and often fraught with additional stress due to language barriers which can impair their understanding of care decisions, increase feelings of isolation and hinder participation in their loved one's care. This project aims to explore the unique experiences of LEP family members of ICU patients, uncovering the challenges they face as well as how these barriers may impact patient outcomes. Using a phenomenological approach, the student will conduct in-depth interviews with LEP family members of ICU patients to capture their personal narratives and understand the impact of language barriers on their ICU experience.

Tasks the student would be expected to perform
Conduct literature review on experience of Limited English proficiency patients/families while in the hospital.
Development of semi-structured interview to explore key topics such as clarity of medical information, emotional responses to ICU communication and interactions with healthcare providers.
Conduct in-depth Interviews with LEP family members of ICU patients to collect first hand narratives about their time in the ICU.
Transcribe and analyze the interviews to identify themes related to communication, trust and overall satisfaction with care.

Faculty Mentor: Dr. Michael Chang (Children's Memorial Hermann Hospital)

Project Title
Antibiotic Accountability: Minimizing Waste, Maximizing Sustainability in Healthcare

Project Description
There is a growing body of literature analyzing the impact of inefficient management of antibiotics at the hospital level. Significant quantities of antibiotics are wasted in pediatric hospitals including those in shortage. Beyond the economic impact, antibiotic waste is also related to supply chain resiliency and overall hospital waste and healthcare sustainability. (References: DOI: 10.1177/0018578719844164 and DOI: 10.1017/ice.2023.118)

The overall goal of this project is to examine antibiotic waste within a pediatric acute care hospital and identify opportunities for reducing waste. This project aligns with the medical humanities in the following ways: Environmental Impact: This project lets students explore the connection between healthcare and environmental sustainability, prompting discussions about how healthcare practices impact our environment in currently unaccounted ways. Stories and Communication: Talking to staff about their views on antibiotic use and waste can reveal everyday challenges and attitudes toward sustainability. These narratives could provide insights into the everyday challenges healthcare providers face in balancing effective patient care with sustainable practices. This aspect of the medical humanities brings human experiences and stories into the project, offering valuable qualitative data to support quantitative findings.

Tasks the student would be expected to perform
Qualitative and quantitative end-to-end examination of how antibiotic prescriptions flow through a pediatric acute care hospital. Qualitative tasks would include observations of social structures within inpatient pediatric teams that drive antibiotic prescriptions and how different types of healthcare providers interact and perceive their relationship to antibiotics, waste, and sustainability. Students would conduct interviews with providers, pharmacists, nurses, patient families about perceptions around antibiotic waste.
Students would perform quantitative data collection on the volume, cost, and impact of wasted antibiotics. Students would attempt to identify and develop interventions to reduce antibiotic waste. Students would also develop the communications and messaging to implement interventions, and subsequently try to measure quantitative outcomes from their intervention. Finally, students would develop and collect qualitative measures of perceptions of effectiveness of messaging and interventions to reduce antibiotic waste in the hospital.

Faculty Mentor: Dr. Misti Ellsworth (Children's Memorial Hermann Hospital)

Project Title
Understanding Patient and Family Refusal of CHG bathing

Project Description
Hospital acquired infections (HAIs) contribute to significant patient morbidity and mortality. One pediatric central line associated blood stream infection (CLABSI) can increase the cost of care by $50,000 dollars and extend the hospitalization by up to 3 weeks (1). Daily chlorhexidine gluconate (CHG) bathing has been proven to reduce hospital acquired infections and is included in our maintenance bundle for central line care to prevent CLABSIs. Despite the evidence supporting this practice, compliance with daily bathing in our children’s hospital is currently not at our goal of 95%. Over the past 12 months, CHG bathing compliance across all units has ranged from 70-80%. Frequent reasons for missed CHG bathing include lack of nursing time, patient factors such as instability or hypothermia, and parent or patient refusal. Parent or family CHG bathing refusals account for 11-30% of missed baths. The reason for parent or patient refusal is not consistently documented and there is currently no process to address the refusal or to provide education on the benefits of CHG bathing. The aim of this project is to reduce CHG bathing refusals by 50% over the next 6 months. To accomplish this goal, we will identify the reasons for refusal, create a process to address these reasons and develop education on CHG bathing for patients and families. The student's work will engage with medical humanities through interviews to gain insight into the patient's perspective of CHG bathing. This will allow us to identify reasons behind refusals and help drive interventions that improve the experience for patients and families. The student and I will also partner with families to create educational materials to explain the "why" behind CHG bathing.

Goudie A, Dynan L, Brady PW, Rettiganti M. Attributable cost and length of stay for central line-associated bloodstream infections. Pediatrics. 2014 Jun;133(6):e1525-32. doi: 10.1542/peds.2013-3795. Epub 2014 May 5. PMID: 24799537; PMCID: PMC4258643.

Tasks the student would be expected to perform
Interview patients, parents, and families on CHG bathing experience
Interview healthcare workers on CHG bathing experience
Develop interventions to improve the experience for both patients
Create educational materials for patients and families

Faculty Mentor: Dr. Eugenia Georges

Project Title
Transnational Medical Education and Maternity Care Reform in Greece

Project Description
Greece has one of the highest rates of cesarean birth in the world. My project examines the ENGAGE Trial, the first nation-wide initiative to introduce innovative protocols and training programs across Greece to reduce unnecessary cesareans. Launched in 2021, the initiative was designed by a largely transnational consortium of diasporic Greek obstetricians, most of whom left Greece after the economic crisis to train and work in the UK. The student will assist in the analysis of life history narratives of the obstetricians and other medical professionals in the UK and Greece who been instrumental in the design and implementation of the initiative.

Tasks the student would be expected to perform
Assist with literature review on global medical brain drain, doctor's educational and training experiences in the diaspora, return migration and impact of practices in the country of origin; coding and assist in qualitative analysis of interviews; possible co-authorship of articles based on the project.

Faculty Mentor: Dr. Ilana Gershon

Project Title
The Pandemic Family

Project Description
I explore how US-American family dynamics shaped people’s responses to the pandemics, focusing on two aspects. First, I explore how particular structural roles in families shaped whose interpretation of Covid information would be acted upon. Second, I analyze how patterned forms of negotiations and decision-making within these families shaped people’s responses and interpretation to shifting medical information in the first two years of the pandemic. Using anthropological understandings of family decision-making as a starting point for understanding responses to medical knowledge, this research will offer an alternative understanding of health communication that situates the individual(s) in the network they are embedded in, and, in turn, enables more effective and active medical communication. The project highlights how socially intertwined people are as they disseminate and decide with others how to act upon the medical information they receive in culturally specific ways. My oral history interviews with families about their pandemic decisions revealed that the most pressing questions around how people responded to Covid-19 risks or government regulations were not whether or not individuals received clear medical information that they were equipped to interpret. Rather, people’s responses largely depended upon complex negotiations and decision-making within their families, shaped by cultural assumptions around who could tell another what to do. Any student researcher will learn qualitative techniques for analyzing people's interpretative strategies processing medical information.

Tasks the student would be expected to perform
An undergraduate research assistant will code my interviews using Taquette, conduct literature review searches on the most recent publications about Covid’s effect on families, and record, clean up, and code AI-transcriptions of webinars oriented toward nannies.

Faculty Mentor: Dr. Kirstin Matthews

Project Title
The Privilege of Medical Freedom

Project Description
The Medical Freedom Movement gained traction in the past two decades around discussions of healthcare autonomy and consent increased. Once considered a fringe movement, it has evolved as a key political topic. Vaccine mandates and access to unproven therapies in particular are highly contested issues with Medical Freedom advocates arguing that the individual’s right to make decisions for their own health is more important that public health and protections from the marketing of fraudulent health products. However, where does medical freedom begin and end? Who are promoting these ideas and who can access medical freedom? This project explores how medical freedom is discussed and defined by advocates and in the literature. The goal is to assess how one’s identity can shape the extent to which they can access medical freedom. Student researchers will assist Dr. Matthews and Baker researchers with a literature review, manuscript preparation, development of outreach materials, and other administrative tasks.

Tasks the student would be expected to perform
Student researchers will:
• Conduct literature reviews using PubMed or Google Scholar search engines;
• Analyze publications and new media on Medical Freedom;
• Help with manuscript preparation and editing;
• Develop outreach materials via Canva or Adobe Suite; and
• Conduct administrative tasks.

Past Medical Humanities Research Projects

Health Aesthetics: An Exhibit and Discussion on Art in the Medical Humanities

Faculty Mentor: Dr. Travis Alexander
Spring 2024

Project Description
In the late spring, Rice will host an event that combines a small art exhibit with an associated panel discussion of scholars on the role art can play in the medical humanities. It will be open to Rice and the Houston community. Student Researchers will assist me in planning, promoting, and coordinating the event.

Project Report (Submitted by Camila DeAlba)
Health Aesthetics was a panel and art exhibition featuring Pato Herbert by the Rice University Medical Humanities Research Institute. Dr. Travis Alexander, a Lecturer in Medical Humanities at Rice, planned and hosted the event with my assistance as an MHRI fellow. The panel discussion featured Amanda Caleb, Pato Herbert, and Megan Voeller and examined the role of visual art in medical humanities research and teaching. The gallery opening featured a small collection of Pato’s recent works dealing with themes across health and medicine. Pato Hebert is a visual artist and educator currently working as an associate art professor and chair at NYU Tish School of the Art’s Department of Art and Public Policy. Amanda Caleb is a professor of Medical Humanities at Geisinger Commonwealth School of Medicine and Megan Voeller is a Philadelphia-based educator, curator, writer, and director of Humanities at Thomas Jefferson University whose work focuses on critical intersections of contemporary art and health.

Having this event annually would allow the Rice Medical Humanities Research Institute to explore the vast amount of social issues present in healthcare. It would even be a means of mapping the everchanging social landscape of healthcare. The event could also involve more scholar-student collaboration by showcasing student art and asking students to speak at panels about their experience with art and education. This fellowship has not only given me more experience with event planning at Rice but has continued to add to my understanding of medicine as a field with several interconnected dimensions.

Inclusive engineering design of bioelectronic form factors to monitor hypertension among US Hispanics/Latinos

Faculty Mentor: Dr. Raudel Avila
Spring 2024-Fall 2025

Project Description
Bioelectronic devices with soft mechanics, wireless connectivity, and electronic components that continuously track physiological signals can be placed epidermally on key locations to track hypertension and other cardiovascular risk factors. These devices, with form factors that rely on miniaturized geometries with soft-hard composite material architectures, aim to expand medical diagnostics capabilities beyond hospitals and clinics. However, the deployment of these devices is not homogenous as one size fits all patients type of approach. The cultural connection of technology and medicine in respective communities needs to be considered in the design to ensure patient adoption and continuous use. The prevalence of hypertension (30% of Hispanics have high blood pressure) and other cardiovascular diseases among Hispanic Americans makes diagnostic and treatment a critical need among the community where additional economic, language, and educational barriers increase the risk of accurate diagnostics and patient compliance. The student project will focus on identifying the key engineering design elements and proposing a conceptual design strategy that can eliminate one or multiple barriers to accelerate medical technology adoption among US Hispanics/Latinos for diagnostic and treatment of hypertension.

Project Report (Submitted by Elena Carusetta and Vedha Penmecha)
The project outlines the conceptualization, design, modeling, and analysis of a bioelectronic device featuring inclusive engineering principles to monitor hypertension among the Hispanic/Latino populations in the United States. We are focused on ensuring the adoption and continuous use or adherence to these technologies within the Hispanic/Latino communities by considering both the engineering and cultural aspects of technology and medicine in the conceptualization and design process.

Thus far we have identified specific needs and design components of the project. Through the ABAQUS modeling we have worked to develop a 2D design for what the potential prototype of the device might look like. We have looked into the literature about which parameters to include in order to ensure accurate blood pressure readings from a cutaneous level. Such parameters include arterial structure, skin tone, and displacement, as well as other pertinent information. From the public health side, we have created maps that utilize national health service data to understand the general barriers affecting the Houston-are Latino/Hispanic population. Beyond social factors, there are additional challenges that these patients face such as “white-coat effect” on blood pressure as well as a gap in culturally competent care.⁴ This information will help
inform us what the gap is currently both socially and geographically in order to better tailor the integration and distribution of the blood pressure device. This is a general overview of specific steps we have taken and knowledge we have gained this semester.

Family and health caregiver perceptual impact on management of pediatric pain, sedation, delirium and withdrawal in critical ill children

Faculty Mentor: Drs. Natasha Afonso and Aarti Bavare (Texas Children's Hospital)
Spring 2024-Fall 2025

Project Description
Critically ill children admitted to an intensive care unit (ICU) are very likely to need pain management and/ or sedation to accomplish clinical goals of critical care. The pain and sedative medications need to be judiciously used and weaned so that they do not allow for undue suffering or cause side effects and withdrawal syndrome. Critical illness and sedative medications also place the patients at risk of experiencing delirium (an uncomfortable state with alteration of attention, consciousness, and cognition, with a reduced ability to focus). The state makes patients not feel like normal people and impacts their response to therapies and eventual health outcomes.

Patients and family members are crucial partners of health caregivers in determining pain thresholds and diagnosing delirium. To treat patients and families as people there needs to be a strong collaborative relationship that health caregivers need to build with them to understand their preferences and develop a comprehensive shared responsibility plan for pain, sedation, delirium and withdrawal management. For both, health caregivers and patients' families; socio cultural backgrounds, prior experiences and beliefs guide assessment of pain and hence the response to mitigate it.

Our goal is to understand the spectrum of perceptions about pain, sedation, delirium, withdrawal management preferences that exist in our patient's families and nurses and understand the associations if any with their sociodemographic characteristics.

The impact of inclusion of personalized stories into the medical record

Faculty Mentor: Dr. Nirica Borges and Dr. Aine Cooke (Texas Children's Hospital)
Spring 2024-Fall 2025

Project Description
Understanding a patient’s values and preferences are key to providing high quality Patient Centered Care. Hospitalized patients may encounter dozens of healthcare providers, and hospital care teams face challenges in sharing complex clinical and non-clinical information over time. This project aims to address this deficit by creating a Narrative in the patient or family’s own words about their child. Students will develop a narrative of a hospitalized child’s story to share in the medical record, and assess the impact of this on clinical care teams. They will collaborate with children (if age appropriate) and families in developing a narrative of the child’s family life, likes and dislikes, daily routine, and anything else the family wishes is included. We will then survey healthcare providers to assess if the story was helpful to them in providing Patient Centered Care.

Project Report (Submitted by Sarah Davidson and Kai Hyodo)
This project, entitled “The impact of inclusion of personalized stories into the medical record,” is a narrative medicine project led by Dr. Nirica M. Borges and Dr. Aine Cooke. The project involves collecting stories about the lives of young children with life-threatening heart conditions. Typically, we speak with the parents and ask them about the sources of comfort for their child, the impact of their child’s disease on their life, and any specific information they want care-providers to know. The goal of this project is to improve the quality of care by giving a voice to the patients and their unique needs, wants, desires, and stories. Instead of taking an illness-centered approach, this narrative medicine project takes a human-centered lens, focusing on the patient’s personal experiences and beliefs. From the interviews we conducted, we found that narratives can help physicians and nurses get to know patients and their families on a deeper level, allowing them to form powerful, personal relationships. The next steps would be to give the interview write-ups to care providers. Then, surveys should be designed to gauge how the narratives impacted the quality of care from the perspectives of both the patients and providers.

During this experience, we improved our understanding of qualitative research and gained a new perspective on healthcare. We learned that physicians currently take a very medical-focused approach that often detracts from the patient’s individualized experience. However, by creating a space for patients to share their own stories, hospitals can be transformed into more friendly, inviting, and caring spaces.

Deer Trails Through the Woods: A Neurocognitive Fairytale

Faculty Mentor: Dr. Marcia Brennan
Spring 2024

Project Description
This Research Assistant position would provide assistance to the professor with a book project currently in development. Through an imaginative engagement with neuroaesthetics, this book presents the imagery of the forest as a creative metaphor for re-envisioning the structures of the human brain, the distressing mental health conditions of anxiety and OCD, and the process of finding a better pathway forward. By engaging these subjects, this book will contribute meaningfully to forging new pathways within the resonant fields of Aesthetics, Neuroaesthetics, Education, and Psychology. The student research portion is described below.

Project Report (Submitted by Madison Zhao)
I’ve always had a passion for neuroscience and visual arts, and a particularly keen interest in finding ways to combine the two. Prior to matriculation, I wanted to find opportunities in the growing field of Neuroaesthetics. Working on illustrations for Deer Trails has allowed me to grow in my understanding of the field by finding creative ways to visualize neuroanatomy for lay populations. I’ve been able to make numerous visual aids that metaphorically incorporate aspects of the academic neuroscience field. I’ve read papers on brain imaging studies to create more accurate reflections of mental illness. With each drawing I find myself more curious and engaged in the field of Neuroaesthetics. What started as a general interest has now formed into specific questions I have for the growing field. I continue to wonder how art can be used to make complex neuroscience concepts accessible, or how they may specifically impact children’s understanding of mental illnesses. As a student majoring in both Neuroscience and Visual Arts, I doubted I would find such a perfect research experience to aid my academics. This project has allowed me to draw on both my creative and scientific skills to create visual outputs rooted in scientific concepts. This fellowship continues to redefine my interests in the medical humanities. I envision a future of medicine where the Humanities work in tandem with science to create a better, more holistic system of care. Ultimately, I hope to bring the skills I’ve gained through this fellowship into my future career as a physician.

Medical Interpreter Narratives

Faculty Mentor: Dr. Kirstin Matthews
Spring 2024

Project Description
Non-English speakers and those who have limited English proficiency often rely on the services of others to interpret what healthcare providers are telling them and to make their own needs and questions understood. These medical interpreters play a critical role in advancing the well-being of under-served, marginalized, or otherwise vulnerable people, but often face their own unique ethical challenges different from others in the healthcare system. This project will develop of an open-access collection of narratives from medical interpreters and host a workshop at Rice University to disseminate the collection.

Project Report (Submitted by Mia Baumann)
This past semester, I had the opportunity to collaborate on the medical interpreter narratives project, which empowered interpreters from many different backgrounds to share their perspectives and experiences in a manuscript intended for the Narrative Inquiries in Bioethics Journal. My role was to design dissemination materials for the manuscript and compile a comprehensive list of attendees from the Houston area for the workshop, which aimed to share the results of the project with healthcare professionals to raise awareness of the challenges of medical interpreters in their home institutions. It was incredibly rewarding to attend the medical interpreter narratives dissemination workshop with a lively group of physicians, interpreters, and bioethicists that I had helped assemble. Many physicians were unaware of the complexities of interpretation or the ways in which they could facilitate the role of an interpreter. I had also volunteered as an interpreter in a previous semester, and the workshop broadened my understanding of the role as well. Because of this experience, I, like many of the other workshop attendees, recognize that interpreters should not be regarded as mere translation machines, but rather dynamic mediators with the power to advocate for patients and empathize with them. As artificial intelligence continues to enter into the dialogue between physicians and patients, it’s more important than ever for interpreters to incorporate their humanity within their roles. Compassionate, patient-centered care is a skill that AI has yet to grasp, making it essential to the modern-day interpreter. The most competent interpreters are those that recognize that embracing their humanity in patient encounters is a sign of empathy and strength, not weakness.

AI for Health Equity

Faculty Mentor: Dr. Kirsten Ostherr

Project Description
Student researchers will work with Dr. Ostherr to identify, analyze and summarize AI for healthcare projects and their intended or likely impact on issues related to health equity and inequity. Additional work will involve interviews with patient advocates related to their perspectives on AI regulation. The resulting work will form a database and reports to be posted on the Medical Humanities Research Institute website, presented at conferences, and published in peer-reviewed journals.