The Use of Art in Health Professions Teaching

Integration of Arts and Humanities in Medical Education

• The Association of American Medical Colleges (AAMC) initiated the FRAME project, highlighting the role of Arts and Humanities in medical education.
• A 2020 AAMC report emphasized the necessity of incorporating Arts and Humanities across the continuum of health professions education to build competencies and sustain well-being.

Evidence of Benefits

• There is extensive evidence, including randomized controlled trials and observational studies, demonstrating the positive impacts of exposure to the Arts and Humanities on health professions learners.
• Benefits include enhanced communication skills, observation skills, critical thinking, tolerance of ambiguity, and awareness of implicit biases.

Clinical and Educational Value

• Engaging with art, such as observing and reflecting on visual artworks, has significant implications for trainee and faculty well-being, person-centered care, and creating equitable learning and clinical environments.

The PRISM Model

• An expansive scoping review published in Academic Medicine in 2022 led to the development of the PRISM model, outlining four core functions of Arts and Humanities in medical education:
  • Mastering Skills
  • Perspective Taking
  • Personal Insight
  • Sociocultural Critique/Social Advocacy

Relevance to Accreditation and Competency Standards

• The functions of the PRISM model align with competencies required by accreditation bodies, emphasizing the importance of self-reflection, collaborative practice, critical thinking, and structural competency.

Gap in Faculty Development

• Despite the broad evidence base, opportunities for health professions educators to engage with Arts and Humanities pedagogies are limited.
• Less than 5% of studies focus on faculty learners and continuing education in arts-based activities.

Skills and Attributes Enhanced by Art-Based Education

• Key skills and attributes improved through art-based education include observation skills, communication skills, empathy, visual literacy, and well-being, supported by a body of evidence.

Impacts of Art-Based Education: Art-based education positively impacts observation skills, communication skills, empathy, visual literacy, and well-being.

Prism Model: The Prism Model, developed by Moniz and colleagues, outlines four core functions for integrating arts into health professions education: mastering skills, perspective-taking, personal insight, and social advocacy.

Application of Prism Model:

• For building professional identity, activities like the Personal Responses Tour help learners gain personal insights and appreciate diverse perspectives.
• For empathy development, activities involve close observation and interpretation, such as analyzing relationships in paintings and creating meaningful gifts or collaborative poems.
• For community partnership in patient care, visiting local murals fosters perspective-taking, personal insight, and social advocacy by reflecting on historical and social contexts in healthcare.

Introduction to Visual Thinking Strategies (VTS)

• VTS is an evidence-based framework developed over 30 years ago by Abigail Housen and Philip Yenawine.
• It is widely used and researched in health professions education (HPE) and other educational settings worldwide.

Purpose and Approach of VTS

• VTS encourages open discussions of works of art without requiring prior knowledge or expertise.
• Participants are prompted by three questions: “What’s going on in this picture?”, “What do you see that makes you say that?”, and “What more can we find?”

Benefits of VTS

• Enhances observation, communication skills, tolerance of uncertainty, openness to diverse perspectives, and empathy.
• Promotes critical thinking, collaboration, intellectual curiosity, and openness to the unfamiliar.

Implementation and Facilitation

• The facilitator plays a crucial role, guiding discussions, paraphrasing responses neutrally, and linking participants’ responses.
• Discussions focus on participants’ views and experiences, encouraging multiple perspectives and shared inquiry.

Structure of VTS Sessions

• Begin with a brief preface and set community expectations.
• Conduct the VTS discussion with the three key questions, followed by a debrief to process and reflect on the experience.

Resources and Community of Practice

• Various resources are available for faculty to develop VTS facilitation skills.
• No prior art history or artistic skills are required, and a community of practice is growing among health professions educators.

Personal Responses Tour (PRT)

• Participants explore art galleries individually, reflecting on a prompt, then share their selections and reflections with the group.
• Promotes community building, empathic listening, multiple perspectives, and personal reflection.
• Limited but promising evidence suggests PRT enhances empathy and offers a reprieve from clinical work.

Group Poem Activity

• Small groups create a collective poem based on phrases inspired by a work of art.
• Enhances observation, communication, empathy, teamwork, and reevaluation of perceptions.
• Participants learn there is no “right way” to interpret art, fostering appreciation of diverse perspectives.

Reflective Writing

• After discussing a work of art, participants reflect individually through writing in response to a prompt.
• Supports introspection, metacognition, empathy, and group cohesion when shared aloud.

Back-to-Back Drawing

• One participant describes an artwork while another draws it without seeing it, then they compare results.
• Practices observation, clear communication, active listening, and interpretation.
• Highlights the importance of clarity in communication and parallels patient interactions.

Drawing a Sculpture from Various Viewpoints

• Participants draw a sculpture from different physical viewpoints.
• Encourages perspective-taking, reflection on community, and embracing diverse interpretations.
• Enhances understanding of the importance of multiple viewpoints in healthcare.

Outdoor Art Exploration

• Activities can extend to outdoor settings, such as nature walks or forest baths, to find and share new sights and sounds.
• Promotes personal reflection and connection with the environment.

Identify Partners

• Collaborate with art or museum educators, local artists, and communities.
• Engage students as partners, adapting activities based on their feedback and suggestions.

Diversity of Images

• Select a diverse range of images in terms of medium, time period, artists, and represented subjects.

Establish Psychological Safety

• Set guidelines and expectations to create a safe learning environment.
• Preface activities and debrief discussions to boost psychological safety.

Ensure Rigor in Evaluation

• Look beyond well-being and observation skills to evaluate program outcomes.
• Gather and use learner reflections to improve and adapt teaching methods.