October Art Museum Challenge

This is the tenth in a series of monthly reflections by Dr. Flora Smyth Zahra, a dental educator from King’s College London (Twitter @HumanitiesinHPE; Instagram @clinicalhumanitiestoolbox) and Dr. Margaret “Meg” Chisolm (Twitter and Instagram @whole_patients). Drs. Smyth Zahra and Chisolm are participating in an Art Museum-based Health Professions Education (AMHPE) fellowship. Feeling inspired and uplifted by the program, they pledged to spend at least a half-day every month looking at art. This is the story of what they did in October.

Dr. Chisolm

In October, Drs. Kamna Balhara, Sarah Clever, Elizabeth Ryznar, and I led a “Night at the Museum” event for the Student Wellness Initiative at the Johns Hopkins School of Medicine. At the students’ request, the two-hour event took place in the evening and—of course—had a wellness focus. We met at the Walters Art Museum and over the course of the evening participated in four activities. The first three took place in the Museum’s 4^th floor galleries, and we concluded the evening with a contemplative exercise in one of the Asian galleries.

We started the evening with a quotation from Camus to make it clear we were opening ourselves up to a different kind of educational experience:

“A man’s work is nothing but this slow trek to rediscover, through the detours of art, those two or three great and simple images in whose presence his heart first opened.” -Camus

 

We then moved to the galleries to the first of the evening’s activity: an open-ended facilitated discussion about one painting, using the Visual Thinking Strategies (VTS) pedagogical method.

VTS was first developed by Philip Yenawine and Abigail Housen for use in museum education. But because it supports the development of skills integral to the practice of medicine, such as critical thinking, perspective-taking, and collaboration, it has been adopted by health professions educators. I’ve written about the VTS method in more detail in a previous CLOSLER post, if you want to learn more.

VTS begins with a moment of silent looking together at a work of art, and we had pre-selected a painting with the evening’s theme of wellness in mind. This painting provided the “third thing” that was the focus of the VTS discussion.

Following the discussion, the group engaged in a reflective “debrief” focused on the students’ observations and feelings about the experience. The students shared how the activity  allowed them to “tap into the artistic, slow, contemplative portion” of their minds, encouraged “a new mode of thinking” and “patience,” helped them learn to “pay attention to small details” about patients, and “understand multiple perspectives.”

Next, we broke into two groups for our second activity of the evening: the creation of ‘group poems.’ First, one group viewed a painted portrait of a woman together and the other group, a sculpture. In both groups, each student was then asked to write down—on a horizontal strip of paper—a phrase or sentence that they imagined the figure in the painting or sculpture to be thinking or saying. Next, each person shared with their group the phrase they’d written down and together each small group decided how to arrange all of the lines into a poem, which they then performed for the other group.

The third activity of the evening was a Personal Responses Tour. We had prepared the specific prompts for this Tour ahead of time (with the help of my research coordinator Margot Kelly-Hedrick), keeping the evening’s wellness theme in mind. We used some prompts previously described by others, but we created different prompts specifically for this evening, such as “Find a piecework of art that has depicts something that your future self might need;” “Find a work of art that inspires you;” “Find a piece work of art that embodies wellness, whatever that means to you;” “Find a work of art that gives you energy.” After each student (and faculty) had selected their prompt, each person walked through the galleries to find the work of art that best spoke to that prompt. Once identified, each person closely looked and reflected upon their selection. Then, the entire group reconvened to take a tour together of everyone’s selections. Each person shared their prompt in front of the work of art they had chosen and explained the reason they selected it.  At the end of the Tour, each student was invited to keep their prompt as a reminder of the evening.

Finally, we walked together to the 3^rd floor Asian galleries for our closing, contemplative activity. We encouraged the students to spend 10-15 minutes walking through the galleries on their own, mindful of what they were noticing. We asked each student to reflect on the prompt “And I noticed…” and to write on an index card what they noticed. We then gathered in a circle and each of us read from our cards: “And I noticed….”

We concluded the evening by reading Mary Oliver’s poem “Lead,” which we then distributed to each participant, another memento of the evening. The students were then welcome to spend the remaining half-hour, before the museum closed, enjoying the sanctuary of the art museum, which many of them did.

Students overwhelmingly appreciated the opportunity to engage with one another in this special setting. As one student said: “It’s wonderful to engage our minds in different ways. Also [it was] a very good bonding experience….”

Dr. Smyth Zahra

I have written previously that since the education of clinicians follows a transformational model of professional development; it is therefore incumbent upon us as faculty to curate learning environments where transformational learning is most likely to occur. Fundamental to the theory is the premise that learners need to be able to risk their vulnerability and be open enough to challenge previously held assumptions. This can obviously only occur in an atmosphere of trust between teacher and learner. The art museum affords humanistic, experiential learning environments, away from the usual clinics and seminar rooms that when properly curated flattens traditional hierarchies and provides learners the necessary psychological safety for dialogue, debate, slow-looking, deep learning, self-care and higher level emancipatory levels of reflection.

For some years, I have been researching the benefits of integrating arts and humanities epistemologies in clinical curricula. A dissertation submitted in part fulfilment of a Masters in Clinical Education which explored a Humanities teaching intervention in dental undergraduate education surfaced five main themes:

1.Ambiguity and uncertainty

2.Permission and protection

3.Storytelling

4.The bigger picture and the importance of context

5.New ways of knowing and being

The theme of permission and protection was recurrent in the data. The students frequently stated in their written and verbal reflections that they were “grateful to have had the opportunity” to consider their clinical learning from very different perspectives in these non-traditional classroom spaces. At the time, in my field notes I recalled that “whenever we had finished in the art gallery the students had the option to leave, however, without exception they stayed, split into smaller groups and spent time either wandering through the rooms or just sitting, enjoying the space.”

The free writing exercise that day, which most had never tried before, surprised and delighted quite a few with some finding it “difficult to stop.” It seemed that they felt that they had been given permission and freedom to consider their dental studies within the context of free writing, exploring a gallery and collaborating on art-based problem-based learning. One student was “amazed how much we extrapolated,” while another “loved the discussion that day” and was only sorry she hadn’t “spoken up more.”

Relating back to the first theme of learning to embrace ambiguity and uncertainty, over half the students at this time noted that they enjoyed the subjectivity in art appreciation and that “the fact that there was no right or wrong answer gave them confidence to voice opinions.” These liminal spaces; the museums, their galleries and gardens are wonderful resources for dialogic, transformational learning that also support wellbeing and that is why as a UK Clinical Senior Lecturer in Interdisciplinarity and Innovation, in my home faculty we are now integrating these approaches longitudinally through the five years of our curriculum.

Caveat to the above:

Curating such experiential learning is far from easy and colleagues wishing to adopt these approaches are well advised to have undergone sufficient training and have the educational background to be able to lead these activities or collaborate with and be advised by museum curators who are experts in this area and have experience of working with clinical students.

Stay tuned for what we learn during next month’s art museum challenge…