Art Heals Whole Personhood: Using the Arts to Improve Medical Education

In January 2020, at the beginning of the pandemic, Dr. Elizabeth Lahti, Director of Narrative Medicine from Oregon Health Science University School of Medicine (OHSU SOM); John Weber, JSMA Executive Director; and Lisa Abia-Smith, JSMA Director of Education, met to discuss expanding the Art Heals program and furthering collaboration to improve the health and lives of Oregonians. The JSMA had already developed one research study in 2016, examining the impact of teaching Artful Observation workshops to 3rd -year medical students from OHSU in Portland who were completing a 6-week residency at PeaceHealth Riverbend Hospital. That study, investigated by Dr. Patricia Lambert and Co-Principal Investigator Lisa Abia-Smith, revealed how studying works of art using Visual Thinking Strategies (VTS) could improve visual acuity and observation skills.

In fact, the arts and humanities are increasingly being included in health sciences education to improve providers’ diagnostic tools, empathy, resiliency, and communication skills. After that initial meeting in January 2020, OHSU and the JSMA spent eight months co-creating Whole Personhood in Medical Education Curriculum, which emphasizes the arts and humanities with an equity lens. All artwork and reading materials were created by BIPOC, persons with disability, or LGBTQ+ artists. We also selected artists from the JSMA collection and works on loan as part of Shared Visions, including artists Belkis Ayón, Rick Bartow, Kerry James Marshall, Wendy Red Star, and Hung Liu.

After research approval from both UO and OHSU, we began an Intervention and Study Design in January 2021. For the next nine months, a team from OHSU and JSMA taught the curriculum during OHSU’s Intersessions, which are 2-week blocks between terms. Each class session was taught on Zoom for 105 minutes and covered themes such as cancer, cognitive impairment, pain, and infection. Students were divided into groups of 6-10 for reflection and discussion, led by a trained facilitator in narrative medicine, including JSMA museum educators Lisa Abia-Smith, Hannah Bastian, and Sherri Jones.

Intervention: Although we began teaching the classes in January 2021, we formally conducted the study and intervention in the Spring of 2021 and researched the impact pre and post of 184 medical students.

Study Design/ Methodology: We utilized pre-post surveys using the Interpersonal Reflexivity Index (IRI) scale on perspective taking and empathy concern, as well as open-ended questions for qualitative analysis to report the impact on bias and reflection. We conducted pre- and post-surveys for 184 students, and 121 participants took part in at least one intersession.

Results: Participants of narrative medicine sessions showed the largest increases in their arts and bias score.

Key Points From The Quantitative Findings

Art and Bias

This had the biggest change across all scales and participants.

53% of participants showed an improvement on the arts and bias scale.

Perspective Taking

Second largest effect among participants of all subgroups.

43% of participants overall showed an improvement in perspective taking.

Implications:

This innovative curriculum led to a general increase in perspective taking, empathy, reflection, and bias awareness among medical students. The OHSU/JSMA team believes more medical schools need to consider incorporating and expanding such curriculum, not only for medical students, but for other healthcare professions as well. More scholars, educators, and policy makers are urging medical schools to provide training that emphasizes a range of marginalized populations, to increase humility and empathy. Institutions such as museums can play a critical role in supporting students to become physicians who engage and reflect on topics of bias, stigma, privilege, and inequities. This intervention demonstrated how creating space in a demanding educational environment to reflect, connect, and pause can positively affect all medical students’ educational experience, motivation, and sense of community. The artsbased strategies were viewed as positive and even essential to becoming a more effective and better health care provider.