Fostering Wonder Through the Arts and Humanities: Using Visual Thinking Strategies in Medical Education.

ABSTRACT: Philosophers and scientists alike argue that wonder-that emotion or state of consciousness in which one's attention is fixed on phenomena beyond one's comprehension-is the central virtue and driving force of all education. As in general education, wonder is central to all aspects of academic medicine's tripartite mission; a sense of wonder fuels the delivery of humanized patient care, sparks scientific discoveries, and supports engagement in lifelong learning. Despite its importance throughout medicine, developing a capacity for wonder among physicians has not been a stated goal of medical education, and innovative methods to foster a capacity for wonder have not been explored. There is a growing interest in the arts and humanities in medical education, and evidence suggests that these can support the development of a diverse array of clinically relevant skills and attitudes (including close observation, critical thinking, empathy, and tolerance for ambiguity) in medical learners across the learning continuum. However, even the potential of these methods to support a capacity for wonder has not yet been fully explored. In this article, the authors explore how one of the most widely used and studied arts-based learning activities in medical education, Visual Thinking Strategies, can help develop a capacity for wonder among physicians. They illustrate how Visual Thinking Strategies support the central elements of wonder-based pedagogy (i.e., exploration, improvisation, imagination, personal interest, and the ethos of educators) previously developed in education theory.

Transformative experiences at art museums to support flourishing in medicine.

PURPOSE: We implemented and evaluated a hybrid 4-week arts-based elective for clinical medical students to support flourishing. MATERIALS AND METHODS: Five students participated in early 2022. Twelve sessions occurred in-person at art museums and other cultural centers, and five occurred online. Sessions incorporated varied arts-based learning activities, including Visual Thinking Strategies, a jazz seminar, and a mask-making workshop. We evaluated the course via weekly reflective essays, interviews 6 weeks after the course, and pre-post surveys that included four scales with clinical relevance: capacity for wonder (CfW), tolerance for ambiguity (TFA), interpersonal reactivity index, and openness to diversity. RESULTS: Qualitatively, the course helped learners: 1) reconnect with individual characteristics and interests that had been neglected during medical education; 2) better appreciate others' perspectives; 3) develop identities as physicians; and 4) engage in quiet reflection, renewing their sense of purpose. Quantitatively, pre-post mean totals increased for the CfW (32.0 [SD 6.8] vs 44.0 [SD 5.7], p=.006) and TFA scales (16.4 [SD 5.2] vs 24.2 [SD 6.9], p=.033). CONCLUSIONS: This elective facilitated learners' connecting with themselves, others, and their profession with improvement in clinically-relevant measures. This provides further evidence that arts-based education can foster professional identity formation and be transformative for students.

The role of arts-based curricula in professional identity formation: results of a qualitative analysis of learner's written reflections.

BACKGROUND: Professional identity formation is an important aspect of medical education that can be difficult to translate into formal curricula. The role of arts and humanities programs in fostering professional identity formation remains understudied. Analyzing learners' written reflections, we explore the relationship between an arts-based course and themes of professional identity formation. MATERIALS AND METHODS: Two cohorts of learners participated in a 5-day online course featuring visual arts-based group activities. Both cohorts responded to a prompt with written reflections at the beginning and end of the course. Using a thematic analysis method, we qualitatively analyzed one set of reflections from each cohort. RESULTS: Themes included the nature of the good life; fulfilling, purposeful work; entering the physician role; exploration of emotional experience; and personal growth. Reflections written at the end of the course engaged significantly with art - including literature, poetry, lyrics, and film. One student disclosed a mental illness in their reflection. CONCLUSIONS: Our qualitative analysis of reflections written during a visual arts-based course found several themes related to professional identity formation. Such arts-based courses can also enrich learners' reflections and provide a space for learners to be vulnerable. PRACTICE POINTS: (five short bullets conveying the main points) Arts-based courses can support learners' professional identity formationReflection themes related to professional identity formation included entering the physician role, fulfilling clinical work, and personal growthAt the end of the course, learners' reflections included significant engagement with artReflective writing in small, arts-based learning communities can provide space for learners to be vulnerableThe Role of Arts-Based Curricula in Professional Identity Formation: Results of A Qualitative Analysis of Learner's Written Reflections.

Facilitating difficult conversations through art: creating an anti-racism digital image library for health professions education.

Racism has been recognised as a threat to patient outcomes, public health, and the healthcare workforce, and health professions (HP) educators and learners alike are seeking effective ways to teach anti-racism in HP education. However, facilitating conversations on race and racism in healthcare contexts can be challenging. Integrative arts and humanities approaches can engage learners in the critical dialogue necessary to educational interventions focused on anti-racism. Discussions of works of visual art, for instance, can leverage visual art as an avenue for indirection to balance introspection and revelation with psychological safety. Structured pedagogical frameworks that emphasise the perspectives and experiences of participants, such as the Visual Thinking Strategies approach, can lead to open-ended and collaborative discussions where participants can safely explore their assumptions in a space that encourages productive discomfort. Visual arts-based programs on anti-racism in HP are limited, though, in part because no collection of images exists to support HP educators in this endeavour. This paper describes the process of developing a digital image library to support HP educators seeking to generate discussions on race and racism as part of anti-racism curricula. We also highlight common themes, best practices, and potential pitfalls associated with use of the image library.

Visual thinking Strategies and the peril of 'see one, do one, teach one'.

Visual Thinking Strategies is an arts and humanities pedagogical intervention increasingly incorporated into medical education. As a straightforward method that appears easy to use, its nuances are often overlooked or-less frequently-improperly implemented entirely. Such haphazard use can lead to lessened impact for learners, and result in inconsistent and non-generalizable findings in studies in the nascent field of arts and humanities medical education. Critical and often glossed-over components of Visual Thinking Strategies include choosing the appropriate artwork, adhering to the specific 3-question language of the method, facilitating dialogue with effective paraphrasing, framing and linking of participant comments, intentionally utilizing non-verbal communication, and carefully setting up the environment. These components can be systematically taught by strengthening Visual Thinking Strategies training for faculty and adopting faculty development techniques from the K-12 education realm, namely peer and video feedback, where VTS has been used and fine-tuned for decades. It is an opportune time to begin rigorous faculty coaching for Visual Thinking Strategies facilitation and set the standard for art and humanities interventions in medical education.

The Role of Online Arts and Humanities in Medical Student Education: Mixed Methods Study of Feasibility and Perceived Impact of a 1-Week Online Course.

BACKGROUND: The arts and humanities have been integrated into medical student education worldwide. Integrated arts and humanities courses have been found to serve four primary functions: mastering skills, perspective taking, personal insight, and social advocacy. To what extent and how arts and humanities programs achieve these educational outcomes remain unclear. OBJECTIVE: In this study, we aimed to explore how the arts and humanities may lead to perceived benefits in clinical skills development, professional identity formation, and self-care, and to evaluate the feasibility of delivering an arts and humanities-based course online. METHODS: We developed and delivered a 1-week online arts and humanities course to second- through fourth-year medical students. A total of 18 students enrolled in the course across its 2 offerings in Spring 2020. The course was primarily visual arts based but also included activities based in other arts and humanities, such as literature, reflective writing, dance, film, music, philosophy, and religion. Using a mixed methods approach, daily polls assessed student engagement in and perceptions of the various activities, and a postcourse survey assessed student perceptions of the course as a whole. RESULTS: At least 93% of poll respondents (14/15 to 17/18) across the 2 cohorts rated each type of activity as good or excellent. Qualitative analysis of student responses to the postcourse survey revealed themes concerning both the form (overall course design and online format) and the function of the course (skills development, appreciation of new perspectives, and personal inquiry). CONCLUSIONS: Results suggested that the arts and humanities may support the development of clinically relevant skills and attitudes. A more unique finding was that integrative arts and humanities courses delivered online-including those that are primarily visual arts based-engage students and may yield personal and professional benefits.

The Online Art Museum.

This article was migrated. The article was marked as recommended. With the onset of the coronavirus-19 (COVID-19) pandemic, we transformed an in-person art museum-based course for medical students into an online format. This brought new challenges but offered unexpected advantages. The course included daily close-looking of artworks using the Visual Thinking Strategies method, group arts-based activities, reflective writing, and independent creating assignments. The virtual format allowed us to incorporate important features that were unavailable in our in-person elective: multi-media activities, access to nearly unlimited international works of art, and personal reflection from one's private space. As instructors, the experience enlightened us on the value of online arts-based teaching.