Impact of diversity representation in art on pre-health professions students' sense of belonging: A randomized experimental study

Background: For learners underrepresented in medicine (UIM), a heightened sense of belonging may be critical to creating shared awareness of diversity and fostering an inclusive educational environment. Despite ongoing efforts from academic medical institutions to promote and retain diverse individuals, few studies have investigated the foundational role of pre-health professions education in shaping students' sense of belonging, and fewer still have leveraged the potential of arts- and humanities-based approaches in doing so. This study aimed to evaluate the perceived impact of race- and gender-diverse visual representations of health professionals on pre-health students' sense of belonging.

Methods: Twenty-eight pre-health professions students at one large undergraduate academic institution were randomized to one of two study groups. Each group participated in a visual arts-based workshop to discuss images depicting either gender- and race-diverse or non-diverse health professionals. All participants completed a pre- and post-workshop survey consisting of select items from the Professional Identity Questionnaire (PIQ), as well as an additional open-ended survey after viewing the images from the other study group. Changes in PIQ item scores were analyzed using chi-square statistics, and free-text survey responses underwent thematic analysis.

Results: Although PIQ item score changes were not statistically significant in either group, both showed an overall directional increase that was more pronounced in the study group exposed to diverse images. Qualitative analysis of responses to open-ended survey items were grouped into four overarching themes: "Diversity, equity, and inclusion (DEI) converges with other aspects of intersectional identity," "sense of belonging drives motivation," "perceptions of medicine are shaped early in training," and "cross-group exposure stimulates metacognitive thinking."

Conclusion: Integrating arts and humanities programming into pre-health professions education may help cultivate a sense of belonging among UIM students, providing a robust platform for the critical dialogues essential in advancing inclusivity within healthcare settings.