C L O S L E R
Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

December Art Museum Challenge

Photograph by Dr. Margaret Chisolm.

Takeaway

The art museum is an emerging informal educational space for the health professions. Here, transformative learning theory provides educators with a model to understand how, through systematically challenging learners’ preconceived beliefs, assumptions, and values, students can grow in their developing professional role.

This is the twelfth and final 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 participated in the inaugural class of the 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 of 2019 looking at art. This is the summative reflection of their experience.

 

Dr. Chisolm

On January 11, 2019, a dozen health professions educators from around the world came together for the first time at the Boston Museum of Fine Arts (MFA) to learn how to use the art museum as an educational space. Prior to that day, I had received no training in art museum-based education at all. I had been part of a Visual Thinking Strategies (VTS) discussion in 2014 at the same museum as part of the Harvard Macy Institute Program for Educators. And, true to the “See one, do one, teach one” mantra of medical education, after that one experience I even developed a course based on VTS for the first year psychiatry residents at Hopkins, which I then described in a peer-reviewed publication. But I had no exposure to any formal training in this field until one year ago. To say that the fellowship changed my life would be an understatement.

 

I had just been officially promoted to the rank of Professor at Hopkins and was looking for the next “challenge.” And I found it in the museum. This is a new and relatively wide open field with many more questions than answers. How does one use the art museum to teach medical learners? What teaching methods are used? How does one learn these methods in way that ensures effective teaching and learning? What does effective learning look like and how are these outcomes measured?

 

It’s been a year of discovery for me filled with lots of practice at looking—which I’ve described in these posts—and skill building. In addition to the fellowship, I’ve taken two courses taught by the VTS research-based education nonprofit, and just yesterday returned from a workshop taught by one of the VTS co-founders, Philip Yenawine. And I’ve practiced, practiced, practiced. I’ve practiced at the Boston MFA with members of the Association for Academic Psychiatry. I’ve practiced at the Walters Art Museum with medical students from the Hopkins Student Wellness Initiative. I’ve practiced at the Baltimore Museum of Art (BMA) with pre-health students from the Homewood campus (funded by the Hopkins Ten by Twenty Challenge grants). I’ve practiced at the Boston MFA, the Smith College Museum of Art, the Harvard Art Museums, and the Institute of Contemporary Art/Boston with the VTS courses and workshop participants. I’ve practiced—using projected images—with first year psychiatry residents at Johns Hopkins Bayview Medical Center at their academic seminar, with Hopkins psychiatry department at their Grand Rounds, with the Bayview internal medicine faculty at their Grand Rounds, and with the broader Hopkins community at the AfterWards program at Johns Hopkins Hospital. And I’ll be practicing via a AAMC webinar later in February and with emeritus faculty at Hopkins in March, and with other faculty (the latter funded by a Hopkins Institute for Excellence in Education/CME small grant for which Dr. Kamna Balhara is PI).

 

And the future looks bright for more opportunities to practice doing what I love: teaching in the art museum! For the past four months, I’ve been working with two BMA museum educators to develop a four-week elective for fourth-year medical students, which we’re hoping to launch in February 2021. The elective will be focused on using the art museum to explore the big questions in medicine: what it means to be human, to be a physician, and to lead a good life (for ourselves and our patients). Over four weeks, students will participate in eight two-hour museum educator-led sessions held in the BMA galleries; eight two-hour sessions led by me held at the BMA and other Baltimore and DC-area art museums; and four two-hour close observation sessions held in clinical care settings; interspersed with art-making and written reflection sessions held in an innovator’s space near the BMA. The elective’s goal? Transformation. Just as I was transformed by the art museum-based fellowship, I’m hoping the students will be transformed by the art museum-based elective. As they cross the threshold between medical student and physician, I’m hoping they will enter their residency training with a renewed sense of the meaning and purpose of medicine, and with a deepening of their professional identity formation as humanistic physicians. And, like I, be eager to take up a new challenge throughout their medical careers.

 

Dr. Smyth-Zahra

It has been a wonderful experience to have participated in the inaugural cohort of the Harvard Macy  Art Museum-based Health Professions Education (AMHPE)fellowship and subsequently to have written this series of posts for CLOSLER with my friend and colleague Dr Chisolm.

 

Museum and art gallery-based education provides an almost infinite resource for health professions’ educators. Much has already been written regarding the instrumental value of art in nurturing the observational skills of clinical students. In my own experience of teaching medical and dental students this has certainly proven to be the case, however, I have found that the real merit in integrating these museum activities into the curriculum is in providing a liminal space for learners to explore and embrace the non-linear, the complexity and ambiguity of 21st century clinical practice that a traditional, positivistic syllabus does not provide. Professional identities develop in tandem with personal development within communities of practice. With regulatory emphasis on safe, collaborative team working, preparation for real life practice, and the ever-increasing realisation that clinician well-being is directly related to patient care, the art museum affords vital reflective space with opportunities for participatory and object-based learning. Carefully curated experiential sessions, delivered jointly by clinician and museum educators, allow for both team and self-reflection, promote an appreciation for the cultural determinants of health (particularly as evidence of the effectiveness of social prescribing increases), and help nurture critical consciousness.

 

As a restorative dentist with a degree also in literature, and in my role as a senior clinical lecturer in interdisciplinarity and innovation within dental education, I am acutely aware that in order to become the leaders and clinicians society needs our students have to be both, creative, and critical thinkers, with a clinical entrepreneur’s mindset, change agents equipped for global problem solving. I continue to advocate that it is therefore fundamental for these students to have a basic understanding of: ontology, philosophy of science, and epistemologies from the humanities to improve their metacognitive and analytical skills and promote cultural agility. Dialogic learning and higher level critical reflection in the liminal space of the art museum is key to the belonging and becoming of this 21st century clinician. In my home institution, under the leadership of the dean of education, Professor Kim Piper, we continue to develop a signature pedagogy for flourishing in an age of uncertainty, integrating a five-year longitudinal arts and humanities curriculum, the most recent addition to which is “Thriving in Cultural London,” which we are currently in the process of evaluating.

 

Thank you CLOSLER and good luck to the new cohort of AMHPE Harvard Macy Fellows!

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