The Consortium for Humanities Ethics and Professionalism invited presentation: The Invisible Elephant Project by Marina Tsaplina


CHEP was formed to increase the awareness of the benefits of incorporating humanities within our education of physical therapy clinicians. Ethics and professionalism are founded in the humanities. With recognition of the importance of the patient experience and the need for therapeutic relationships with patients we sought to bring to ELC an educational session which fully illustrates the impact of art for enhancing understanding.

Methods and/or Description of Project

The Invisible Elephant Project is a project of THE BETES foundation1. THE BETES was born when Marina Tsaplina, who has lived with Type 1 since she was 2 years old, realized that the biomedical model of disease had taught her to relate to her diabetes as if it were a machine, and that this relationship did not serve her well-being. It provided only a partial picture, excluding the fundamental emotional reality that is inextricable from the illness experience; the subjective lived experience of chronic disease. A trained theater artist and puppeteer, she realized her artistic medium was uniquely suited to help bridge this critical gap, and that puppetry could help make the invisible, seen2.

The Invisible Elephant Project was developed through an online survey of close to 1000 people with Type 1 and Type 2 diabetes asking about how the possibility, or actual presence of physiological or psychological complications pervade the lives of people with diabetes. In depth phone interviews were done with 26 of the respondents and common themes from those personal accounts were incorporated into theatrical puppetry performances. The performance is followed by carefully facilitated discussions tailored to the needs of the specific audience2.

Diabetes is an increasingly common disease in the United States. It is suggested that 80% of the patients seen by physical therapists will have diabetes or pre-diabetes3. This patient population is therefore important to physical therapy education and we felt the presentation was relevant to all aspects of the curriculum.



Conclusions/Relevance to the conference theme: Through the Looking Glass: Transforming Physical Therapy Education

Humanities: Bringing art and evidence into PT education is a theme of the ELC 2017 and as the ACAPT Consortium for Humanities Ethics and Professionalism we hope to sponsor this educational offering which is provocative and transformative. Health promotion is a subtext of this presentation and it too is highly relevant to the education of future PTs.


THE BETES Invisible Elephant Project 1000Voices (bios)

Kirkness CS, Marcus RL, LaStayo PC, et al. Diabetes and associated risk factors in patients referred for
physical therapy in a national primary care electronic medical record database. Phys Ther. 2008;88:1408–

Course Objectives

Learning objectives

New appreciation of the sensitive, stigmatized and often misunderstood topic of diabetes complications.

New insight into strengthening communication between clinicians and patients and improving the therapeutic relationship

An appreciation of the power of art in evoking emotional understanding of patient lived experience.

Instructional Methods

Marina states “We utilize the unique tools of the performing arts - such as puppetry,
storytelling, and metaphor- to create artistic programming that shines a new light on people’s day-to-day experiences of chronic disease, allowing for individual discoveries and new realizations to emerge.”1
After an artistic performance there is an interactive facilitated discussion.

Tentative Outline/Schedule

10 minutes- Introduction and orientation

25 minutes - Performance

15 minutes - Audience participation exercises

40 minutes- Facilitated discussion and Q& A

BACK to Abstract Results

  • Control #: 2750961
  • Type: Educational Session
  • Event/Year: ELC2017
  • Authors: Marina Tsaplina, Dr. Jennifer Hastings
  • Keywords:

BACK to Abstract Results