Takeaway
Understanding the patient's experience and concerns deepens when we listen to understand rather than to respond. This builds trust and can result in better patient-centered care.
Lifelong learning in clinical excellence | August 4, 2026 | 2 min read
By Carolina Musri, MD, Johns Hopkins Medicine
I recently completed the training to become a Visual Thinking Strategies (VTS) facilitator. VTS is an inquiry-based teaching method that uses art and other visual images to build critical thinking, observation, and communication skills. I’d attended a class previously to learn about VTS, and valued the emphasis on cultivating close observation, empathy, respect, and openness to ambiguity. It taught me that our first interpretation is rarely our only one, and that listening carefully to others often changes the way we see.
Training as a facilitator, however, revealed a completely different challenge. Rather than experiencing the discussion as a participant, I was learning how to create the conditions for others to experience it. That required a level of discipline and leadership I hadn’t fully appreciated.
As a physician, I’m accustomed to tolerating uncertainty. Clinical encounters often require sitting comfortably with silence while patients gather their thoughts. Facilitating VTS exposed another kind of uncertainty—resisting the impulse to guide participants toward an answer. The facilitator’s role is not to resolve ambiguity but to protect it long enough for collective meaning to emerge.
The facilitator is also responsible for the image selection. The artwork must invite multiple plausible interpretations without leading participants toward a single narrative. The ambiguity isn’t a flaw—it’s what makes genuine inquiry possible.
I also came to appreciate how demanding active listening really is. Paraphrasing isn’t repeating someone’s words verbatim—it’s distilling the essence of their observation while preserving the original meaning, and expressing it in language that invites further exploration rather than closure.
The training left me with questions that I’ll keep in mind while caring for patients:
1. How often do we mistake our first impression for the truth?
2. How does shared evidence gradually reshape individual perspectives?
3. How often do we truly listen to understand rather than to prepare our response?
Becoming a VTS facilitator has shown me that these aren’t only questions about looking at art. They’re questions about how we learn, communicate, and make sense of the world together. So . . . what more can we find?
Click here to learn more about VTS.
This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.