Medicine as Art: The Development of Reflective Practitioners through an Arts-based Curriculum Author: Dr. Joyce Zazulak and Nicole Knibb Date:

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1 Medicine as Art: The Development of Reflective Practitioners through an Arts-based Curriculum Author: Dr. Joyce Zazulak and Nicole Knibb Date: September 30, 2016

2 I do not have an affiliation (financial or otherwise) with a pharmaceutical, medical device or communications organization. Je n ai aucune affiliation (financière ou autre) avec une entreprise pharmaceutique, un fabricant d appareils médicaux ou un cabinet de communication. 2

3 Outline and objectives for today Define and explore visual literacy and evidence-based looking Describe the Art of Seeing Program Reflective writing in response to work of art PhotoVoice Research findings 3

4 What is visual literacy? The ability to interpret, negotiate, and make meaning from information presented in the form of an image. I am going to see my patient 4

5 Teaching Visual Literacy Foundation in Visual Thinking Strategies (VTS): Abigail Housen (cognitive psychologist) and Philip Yenawine (former director of MoMA) Principle: Formal analysis/guided observation/facilitated discussion/evidencebased looking Practice: Group problem solving Outcome: Fosters critical thinking 5

6 The Art of Seeing Visual Literacy for Family Medicine Residents 6

7 Empathy: Can it be taught or is it lost? 7

8 Loss of Empathy Medical schools select for empathy and compassion. Medical students have average or aboveaverage levels of empathy and compassion at the beginning of medical school. Several studies report a decline of empathy throughout medical school. Hojat 2005,2009; Dehning

9 Why are the arts important to medicine? Good medicine is more than technical knowledge and decision-making Demands identification of another s suffering Nurturing of empathy may be stewarded by the arts More than tick box exposure 9

10 Arts and Humanities Another s illness and suffering Cost of caring 10

11 Why learning to look at art? Art Is a world that runs constant and parallel to ours where we imagine different futures millions of them and try them on for size. Art is, basically, a visual means of communication. Art is a necessary way for humans to understand themselves and the universe. Art captures the significance of both the individual and the cultural. Humans have a vital and persistent need to create art and is an ever-present part of human experience. Our imaginations function as a survival mechanism. 11

12 Interpretation and evidence-based looking What s your interpretation of the image you see? What specifically do you see that influences your interpretation? Remember to keep looking. 12

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15 Imagine the story behind the painting Remember to start with formal analysis. Remember to use evidence-based looking and make interpretations based on what you see. 15

16 PhotoVoice Voicing Our Individual and Collective Experiences Participatory action research method using photos Enables participants to: Share experiences (about your life as residents) Develop critical consciousness: a critical understanding of what impacts and influences your understanding of your world 16

17 Foundational Components Taking a picture with a specific goal or intention Individual reflection and narrative writing Group dialogue 17

18 PhotoVoice Examples Broken Heart Diet: Type 2 DM 18

19 PhotoVoice challenge: Take a photo of a part of your body or clothing that tells us something about you. 19

20 What to consider before taking your photo 1. Narrative description (suggestions!) 2. Supporting details of the photo (describe the photo) Why you choose this particular image or images? What does this photo let us about you? What did you find challenging? What did you learn? 3. Share your narrative 20

21 Photography Prompts 1. Why I chose to be a physician. 2. What it means to be a physician. 1. Something that makes being a physician hard. 2. Something that makes being a physician rewarding. 1. The suffering I am part of. 2. The healing I am part of. 21

22 Culminating Activity 22

23 Interesting Outcomes Improved observation and descriptive skills. Overall improvement in patient questioning. Discomfort at not being the experts. Empathy and concern for how patients feel. Increased tolerance for ambiguity. Learn to avoid immediate judgments. Recognize bias. Collaboration and multiple viewpoints. 23

24 Outcomes Increase in descriptive observational skills (Dolev et al 2001, Naghshineh et al 2008) Student descriptions were richer and more accurate (Bardes et al. 2001) Better pattern recognition and improved emotional recognition (Shapiro et al 2006) Awareness of health problems across different cultures (Inskeep et al 2001) Increased understanding of the complex nature of human beings (Boisaubin 2000) Empathy (Zazulak et al 2010) And more.. 24

25 THANK YOU! DR. JOYCE ZAZULAK ASSOCIATE PROFESSOR MCMASTER DEPARTMENT OF FAMILY MEDICINE NICOLE KNIBB EDUCATION COORDINATOR MCMASTER MUSEUM OF ART 25

26 Help us improve. Your input matters. Download the ICRE App, Visit the evaluation area in the Main Lobby, near Registration, or Go to: to complete the session evaluation. Aidez-nous à nous améliorer. Votre opinion compte! Téléchargez l application de la CIFR Visitez la zone d évaluation dans le hall principal, près du comptoir d inscription, ou Visitez le afin de remplir une évaluation de la séance. You could be entered to win 1 of 3 $100 gift cards. Vous courrez la chance de gagner l un des trois chèques-cadeaux d une valeur de