Perspective: Acts of Interpretation: A Philosophical Approach to Using Creative Arts in Medical Education

University of Michigan Medical School, Ann Arbor, MI 48109-0726, USA.
Academic medicine: journal of the Association of American Medical Colleges (Impact Factor: 2.93). 06/2012; 87(8):1138-44. DOI: 10.1097/ACM.0b013e31825d0fd7
Source: PubMed


Medical educators have used the visual arts for a variety of instrumental purposes, such as sharpening trainees' skills in observation, description, critical thinking, and communication. The arts have also served as means to more humanistic ends-that is, as a mode of self-care for house officers coping with grief and as a medium for reflecting on the meaning of illness and the nature of doctoring. More generally, art can serve as an expression of identity, as a form of social critique, and as a means to develop a sense of community of shared values. At the University of Michigan Medical School, the creation of original artwork (visual or otherwise) has been a major part of the Family Centered Experience, a longitudinal learning activity based on the stories that patient-volunteers tell of living with chronic illness. The purpose of this article is to explore how the creation of original art may serve as concrete evidence of the types of tacit learning and understanding that students gain through human interactions in medicine. The evidence of learning is not achieved via behaviorist notions of "demonstrating competence"; instead, student interpretive projects are visual or musical expressions of the affective, experiential, cognitive, and existential lessons students have learned through their long-term relationships with patient-volunteers. The overall aim of this article is to provide additional theoretical foundations, as well as practical information, that may guide the incorporation of the humanities and arts into the training of physicians.

Download full-text


Available from: Arno Kumagai, Jul 30, 2014
  • [Show abstract] [Hide abstract]
    ABSTRACT: This is a commentary in which a fourth-year medical student argues for the relevance of the arts and humanities and the need to sustain medical students' exposure to these through the medical curriculum. She writes that the point of incorporating the visual arts, literature, music, and other arts into the curriculum is not necessarily to "teach" professionalism but, rather, to offer students a viable, lifelong tool to reorient themselves as they move along in their training. The advantages that the humanities offer are multifactorial: They offer a space for discussion about topics such as death and dying-and coping with dying patients-such that students can feel safe and objective in sharing thoughts; they remind students of the patient experience; they eloquently distill muddy feelings into nuanced words; and they serve as an anchoring point for a state of mind that nurtures reflection over the disdain encouraged by the "hidden curriculum" of the wards. The author closes the commentary with excerpts from literature.
    Academic medicine: journal of the Association of American Medical Colleges 07/2013; 88(7):921-923. DOI:10.1097/ACM.0b013e3182956017 · 2.93 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To learn what medical students derive from training in humanities, social sciences, and the arts in a narrative medicine curriculum and to explore narrative medicine's framework as it relates to students' professional development. On completion of required intensive, half-semester narrative medicine seminars in 2010, 130 second-year medical students at Columbia University College of Physicians and Surgeons participated in focus group discussions of their experiences. Focus group transcriptions were submitted to close iterative reading by a team who performed a grounded-theory-guided content analysis, generating a list of codes into which statements were sorted to develop overarching themes. Provisional interpretations emerged from the close and repeated readings, suggesting a fresh conceptual understanding of how and through what avenues such education achieves its goals in clinical training. Students' comments articulated the known features of narrative medicine-attention, representation, and affiliation-and endorsed all three as being valuable to professional identity development. They spoke of the salience of their work in narrative medicine to medicine and medical education and its dividends of critical thinking, reflection, and pleasure. Critiques constituted a small percentage of the statements in each category. Students report that narrative medicine seminars support complex interior, interpersonal, perceptual, and expressive capacities. Students' lived experiences confirm some expectations of narrative medicine curricular planners while exposing fresh effects of such work to view.
    Academic medicine: journal of the Association of American Medical Colleges 12/2013; 89(2). DOI:10.1097/ACM.0000000000000098 · 2.93 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Ways of exploring the related acts of thinking and reflection are not just confined to expository prose. Following Heidegger's (1966) model of a conversation that gradually reveals deeper meanings of the concept of thinking, the following is a record of a conversation during a walk in the country on a summer's evening. Three individuals, a Doctor, a Philosopher, and a Poet, revisit the topic of reflection from a variety of different perspectives in hopes of understanding its place in the practice of medicine. In particular, they explore an area of reflection where medicine is often silent: during times of great suffering and loss. Along this country path, as night gradually falls, they attempt to capture the complex meanings of reflection that culminate in that intimate "open space" where medicine is practiced and where fundamentally important human events occur.
    Perspectives in Biology and Medicine 12/2013; 56(3):362-70. DOI:10.1353/pbm.2013.0025 · 0.48 Impact Factor
Show more