The Memory Art Project: medical students and older adults

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Abstract
The humanities are increasingly recognized as an important component of medical student education. This study addresses whether early exposure to healthy older adults through the humanities may prepare medical students for positive relationships with aging patients. Few studies have presented a detailed example of a humanistic endeavor organized by medical students to facilitate student interactions with healthy older adults. To report the results of a unique art project organized to promote rapport between medical students and healthy older adults. Twelve first- and second-year students at the Medical College of Wisconsin were paired with 12 older adult residents at a local independent living facility. Participation was voluntary, and all participants were asked to complete 3 sessions over the course of 2 months. During the first session, partners met each other and formed a relationship. A professional art instructor provided a lesson and supervised practice in acrylic painting. In the second session, all student and older adult participants created a painting to represent their partner. The third session featured a reception to celebrate the artwork and new friendships. Ten medical student/older adult pairs completed the project. Reactions were positive, and the project was perceived as beneficial to both students and older adults. The Memory Art Project effectively promoted positive communication between medical students and an aging population that will need to interact meaningfully with medical professionals in the future.
311
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Author Affiliations: Medical College of Wisconsin, Milwaukee,
Wis. (Kodadek, Bettendorf); Center for Bioethics and Medical
Humanities, Institute for Health and Society, Medical College of
Wisconsin, Milwaukee, Wis. (Uihlein, Derse).
Corresponding Author: Lisa M. Kodadek, c/o MCW Center for
Bioethics and Medical Humanities, 8701 Watertown Plank Rd, PO
Box 26509, Milwaukee, WI 53226-0509; phone 414.955.8498; fax
414.955.6511; e-mail lkodadek@mcw.edu.
Wisconsin Medical Journal • 2010 • Volume 109, No. 6
dents and an aging population that will need to interact
meaningfully with medical professionals in the future.
INTRODUCTION
The humanities are increasingly recognized as an
important component of medical student education.
1,2
As broadly defined in the literature, the humanities
seek to define a better understanding of the human
condition through literature, fine arts, philosophy, eth-
ics, sociology, and history.
3,4
This type of comprehen-
sive learning is critical to the development of physicians
when one considers the fundamental basis of clinical
medicine: an encounter between people.
5
Furthermore,
students are not merely trained to be doctors, they are
educated in medicine, and education is at least as con-
cerned with the type of person—or professional—a
student will become, as with what that student can do.
2
Medical education, therefore, should address not only
the science of medicine, but also the fields that allow
students to develop as empathetic, humanistic individu-
als who communicate well with their patients.
The incorporation of humanities into medical educa-
tion is especially important, as recent studies have noted
a decrease in student empathy during medical school.
6,7
One study showed a significant decrease in medi-
cal student vicarious empathy (the visceral emotional
response to patients) following the first and third years
of medical school.
6
This finding was seen in both men
and women, irrespective of eventual specialty choice.
Many medical schools have integrated the humanities
into medical education, which may help combat this
downward trend. Almost half of all medical schools in
the United States involve arts in the curriculum and over
two-thirds offer arts-related extracurricular activities.
8
Major benefits of the arts in medical education include
enhancement of student well-being, improvement of
clinical skills, and promotion of humanism.
9
The theo-
retical and practical importance of the humanities has
been supported extensively in the medical literature,
10-13
ABSTRACT
Background: The humanities are increasingly recog-
nized as an important component of medical student
education. This study addresses whether early expo-
sure to healthy older adults through the humanities
may prepare medical students for positive relation-
ships with aging patients. Few studies have presented
a detailed example of a humanistic endeavor organized
by medical students to facilitate student interactions
with healthy older adults.
Objective: To report the results of a unique art project
organized to promote rapport between medical stu-
dents and healthy older adults.
Methods: Twelve first- and second-year students at
the Medical College of Wisconsin were paired with 12
older adult residents at a local independent living facil-
ity. Participation was voluntary, and all participants
were asked to complete 3 sessions over the course of
2 months. During the first session, partners met each
other and formed a relationship. A professional art
instructor provided a lesson and supervised practice in
acrylic painting. In the second session, all student and
older adult participants created a painting to represent
their partner. The third session featured a reception to
celebrate the artwork and new friendships.
Results: Ten medical student/older adult pairs com-
pleted the project. Reactions were positive, and the
project was perceived as beneficial to both students and
older adults.
Conclusion: The Memory Art Project effectively pro-
moted positive communication between medical stu-
Lisa M. Kodadek, BS; Brittany A. Bettendorf, BA; Julia A. Uihlein, MA; Arthur R. Derse, MD, JD
The Memory Art Project:
Medical Students and Older Adults
WISCONSIN MEDICAL JOURNAL
Wisconsin Medical Journal • 2010 • Volume 109, No. 6
312
students with older adults, with the focus of under-
standing medical student attitudes toward aging and
geriatrics practice; this program used art appreciation
and discussion to facilitate interactions. The Memory
Art Project is a unique rendition of the NIH program
with emphasis on communication skills and creation
of positive relationships with older adults. The free-
dom to have a broad focus was possible because the
Memory Art Project pilot was sponsored by a grant
from a private philanthropic foundation (The Harry
G. and Charlotte H. Slater Family Fund of the Greater
Milwaukee Foundation).
METHODS AND MATERIALS
The Memory Art Project consisted of 3 sessions during
which medical students were paired 1-to-1 with older
adults. Twelve first- and second-year medical students
from MCW were paired with 12 residents from St.
John’s on the Lake in Milwaukee, Wisconsin. St. John’s
is a combined care facility offering independent and
assisted living, as well as skilled nursing; all of the older
adult participants were from the independent living
community. This facility was chosen for its proximity
to MCW and because of the artistic interests of the resi-
dents. All older adult and medical student participants,
hereafter referred to as all participants, volunteered to
complete the project. All participants committed to
attending 3 sessions at the St. John’s facility over the
course of 2 months. The Medical College of Wisconsin/
Froedtert Hospital Institutional Review Board (IRB)
approved this study.
During the first session, all participants completed a
preliminary survey, met their partners, and were given
a painting lesson. All participants were asked to bring
meaningful items to the session. These items included
photographs, books, and other possessions of personal
significance. All participants were introduced to their
partners and used the objects they had brought with
them as a foundation for discussion of memories and
interests. This interaction facilitated the formation of
new friendships and also allowed participants to gener-
ate ideas for the artwork they would create at the second
session. Painting was used as a creative conduit to estab-
lish relationships and provide a task-oriented forum for
meaningful conversation and genuine exchange of life
stories. The latter part of the session included an art les-
son provided by a professional instructor covering basic
skills needed to complete an acrylic painting. Art sup-
plies were provided for all participants to practice their
new skills, and they were encouraged to plan the piece
to be created at the second session.
and the incorporation of humanities programs in medi-
cal education has been increasingly significant over the
past 30 years.
14
In parallel with an increasing emphasis on the human-
ities, geriatrics training has become a focus for improve-
ment in medical school curricula as well. Demographic
shifts in the population continue to require a larger work-
force to care for the increasing number of older adults.
As the American Geriatrics Society announced in 2000
with its core competencies, “In general, it is important in
student training to include discussions of healthy as well
as non-healthy elders, since referring only to ill elderly
people perpetuates many of the myths and stereotypes
associated with aging and may promote ageism.”
15
It is
important to understand the lives and needs of healthy
older adults, as medical students possess negative atti-
tudes toward aging even before starting medical school;
16
curricular efforts can correct these negative attitudes
and better prepare students to care for older adults.
17-20
This study presents an overview of a humanistic project
designed to bring medical students together with healthy
older adults to facilitate positive interactions.
BACKGROUND
The Medical College of Wisconsin (MCW) has both
a rich program for medical humanities and an innova-
tive curriculum for geriatrics education. In the 1990s,
MCW became one of the first medical schools to com-
bine medical ethics, principles of palliative care, and
literature (required poetry and non-fiction readings) in
a course for second-year students.
21
Other MCW cur-
ricular highlights include The Art of Medicine through
the Humanities, a well-received elective course available
to fourth-year students,
22
and The Healer’s Art course,
23
offered to first-year students. Additionally, an annual
literary journal titled Auscult features the photography,
poetry, and prose of students and staff.
24
MCW received
the Association of American Medical Colleges (AAMC)
John A. Hartford Foundation Grant Award in 2000 for
the advancement of geriatric and gerontology studies
through improved curricula. This award has allowed
for improved student exposure to geriatrics, including
the formation of a Senior Mentor Program offered to
first-year medical students to gain early exposure to
geriatrics.
20
The Memory Art Project was created on the
existing institutional foundation to further these efforts
in both medical humanities and geriatric education.
The idea for the Memory Art Project stemmed
from the Vital Visionaries Program developed by the
National Institute on Aging at the National Institutes
of Health (NIH).
25
The NIH program paired medical
313
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Wisconsin Medical Journal • 2010 • Volume 109, No. 6
a unique opportunity for medical students and older
adults in the community to build relationships based on
positive communication. The richness of these interac-
tions was manifested creatively in the art pieces pro-
duced during the project. All participants were asked
to write a paragraph about their art piece to explain
how the painting represented their partner. Below are 2
examples of medical student paragraphs:
I made this for [my partner] because we both love lakes,
and I thought the curves of color reflected waves. I com-
At the second session, all participants began to create
a painting for their partner. The objects shared at the
first session provided inspiration for the paintings and
served directly or indirectly in generation of the final
product. The art instructor provided individual instruc-
tion as needed. All participants were asked to complete
their paintings before the third session.
The third session showcased the artwork and allowed
for recognition of the relationships formed. Dinner was
provided, and ample time was allowed for discussion
and sharing of the paintings. Surveys were distributed
to all participants to assess the project’s impact. The
paintings were displayed publicly at St. John’s on the
Lake for 2 weeks following the final session. After dis-
play, all participants kept the painting their partners had
created for them.
RESULTS
Surveys were administered to all participants before
and after the project. Demographics of medical student
participants and older adult participants are reported in
Tables 1 and 2, respectively. Although 12 partner pairs
(24 people) were enrolled in the project originally, only
10 pairs (20 people) completed the project. One older
adult could not participate due to illness; an additional
participant could not be recruited and the correspond-
ing medical student opted not to participate. One part-
ner pair chose to complete the project on their own
time, as the group setting was uncomfortable for the
older adult. The remaining 20 participants attended all
3 sessions. Data are reported for those participants who
completed the project.
The mean age of the medical students was 24 years
(range 23 - 25 years old); 90% were female. Sixty per-
cent were first-year medical students, and 40% were
second-year medical students. Eighty percent of the
student participants had never worked or volunteered
in a setting allowing regular contact with adults aged
65 and older. Fifty percent of medical students reported
interest in the project primarily for the opportunity to
interact with older adults, while 50% were attracted to
the opportunity for painting instruction. The mean age
of the older adults was 81 years (range 77 - 86 years).
Forty percent of the older adult participants were male,
and 60% were female. All of the older adult participants
had at least some college education, and 50% held a
graduate degree. All older adults (100%) reported inter-
est in the project primarily for the opportunity to inter-
act with medical students as opposed to the opportunity
for painting instruction.
The goal of the Memory Art Project was to provide
Table 1. Characteristics of Medical Student Participants
a
Variable Percent (N)
Gender
Male 10 (1)
Female 90 (9)
Year in Training
Year 1 60 (6)
Year 2 40 (4)
Experience with older adults
b
Yes 20 (2)
No 80 (8)
Feature of interest
c
Art/painting instruction 50 (5)
Interaction with older adult 50 (5)
Mean (SD)
Age (years) 24.1 (0.6)
a
Data reported for student participants who completed project.
b
Student participants were asked, “Have you ever worked or
volunteered in a setting that brought you in regular contact
with individuals aged 65 and over?”
c
Student participants were asked prior to starting project,
“What feature of this program MOST interested you: art/paint-
ing instruction or interaction with older adults?”
Table 2. Characteristics of Older Adult Participants
a
Variable Percent (N)
Gender
Male 40 (4)
Female 60 (6)
Education
Some college 10 (1)
Bachelor degree 40 (4)
Graduate degree 50 (5)
Feature of interest
b
Art/painting instruction
Interaction with medical student 100 (10)
Mean (SD)
Age (years) 81.1 (3)
a
Data reported for older adult participants who completed
project.
b
Older adult participants were asked prior to starting project,
“What feature of this program MOST interested you:art/paint-
ing instruction or interaction with medical students?”
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314
helped me feel more like a human with these interac-
tions rather than [viewing the interactions as] clinical.”
Others stated, “I made a great connection with my
partner,” and, “I thought the program was a good way
to introduce people to the geriatric population.” Some
students have continued to spend time with their older
adult partners, even after conclusion of the project. Two
student participants in the pilot study are currently
leading efforts to continue the Memory Art Project
annually.
The older adults also had positive experiences. One
stated, “I am very favorably impressed with the medical
students.” Another noted the “good energy” associated
with the project. One adult said, “I loved meeting the
students—so vibrant and so bright and so much energy,”
while another said, “It was interesting to get to know
my ‘partner’ and to see her enthusiasm for becoming
a physician. Our sharing was such that I think we will
always be friends.”
Pre- and post-project surveys were distributed to all
participants to assess the effectiveness of the Memory
Art Project in achieving its educational goals. Medical
student participants were asked to respond to the state-
ment, “I feel comfortable around people aged 65 and
over” on surveys given both before and after the project.
Survey results showed a trend toward increased student
comfort around older adults. A similar trend was seen
when older adult participants were asked to respond to
the statement, “I feel at ease around medical profession-
als.” One survey item asked all participants to respond
to the statement “I have benefited from this program.”
All participants either agreed or strongly agreed with
the statement. Medical students and older adults rated
their overall experience highly. The project was a ben-
eficial and positive experience for all who participated.
One spontaneous result of the project highlighted the
quality and trust of the relationships formed: follow-
ing the third session’s conclusion, the older adult resi-
dents of St. John’s on the Lake organized an open house
tour of the facility and their individual apartments. All
students were welcomed to visit each resident’s home,
where the older adults revealed hobbies including quilt-
ing, collecting hand-blown glass, and photography.
Students were particularly impressed by a portrait of
Marilyn Monroe photographed by a St. John’s resident.
This open house gave medical students an accurate view
of the high activity level these adults maintain.
DISCUSSION
The Memory Art Project is an example of a humanistic
project organized by medical students that successfully
mitted to the broad strokes at her brave suggestion. She is
vibrant, charming, and most simply stated: lovely. I hope
my painting reflects some small measure of these qualities.
This [portrait of my partner] was inspired by the tribal
masks worn in the wedding ceremony from one of [my
partner’s] favorite books…I dedicate this painting to the
discovery of new friendships and the celebration and
color that they bring with them.
Some students saw their painting as an abstract repre-
sentation of the relationship formed:
Through my meetings with [my partner] and with our
growing friendship, I’ve learned to further think of the
beauty of mind-body healing and the power of the spirit.
This painting is a gift of thanks of helping me along my
growth as a humanistic physician, and to promise that I
will not forget the importance of caring!
One older adult combined a particular art style with the
varied interests of his student partner:
[My partner’s] interest in promoting the little used let-
ter Z…influenced my painting. Her profession, interests
and activities are part of the theme. The odd background
is influenced by my favorite abstract artist, Wassily
Kandinsky. The painting’s title is obviously “Z.”
Other older adults captured people and places impor-
tant to their student partners:
[My partner] was inspired to study medicine by a young
girl who was born deaf. The child in the picture has no
ears to show she cannot hear…[My partner] is a strong
young woman breaking loose from the traditions of her
patriarchal society and entering a field still dominated by
men. The chrysanthemums symbolize long life and the
people whose lives will be extended through [my part-
ner’s] medical skills.
I wanted to give you: The Rocky Mountains—bare rock
pushing up through rich green forests and topped with
snow…Lake Michigan and its deep blue vastness at the
eastern edge of the city where you have come to study
medicine. Instead I give you: blocks of color to repre-
sent the places, objects and ideas important to you. I
loosely borrowed from Piet Mondrian who used verti-
cal and horizontal black lines to create spaces filled with
‘momentary visual perceptions’ of color.
While the true results of the project were newfound
friendships, the paintings produced were just as rich,
inspiring, and memorable.
In surveys administered at the project’s final session,
medical students were enthusiastic about the experi-
ence and valued the opportunity to form a relationship
with a healthy older adult. One student admitted, “It’s
true that I haven’t worked with seniors before, so this
315
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Wisconsin Medical Journal • 2010 • Volume 109, No. 6
student participants in a project like the Memory Art
Project have an increased likelihood of involvement in
future medical humanities activities compared with their
peers who shared similar initial interest in the humani-
ties but did not participate in the project. Of interest, 9
female medical students completed the project and only
1 male student, which may indicate a stronger prefer-
ence among women for interacting with older adults or
participating in medical humanities projects. Although
1 study has found that women entering medical school
have more favorable attitudes toward older persons
than do men,
16
further research is needed to understand
these gender differences.
Additionally, further studies could identify the long-
term effects of research like the Memory Art Project
on young physicians and their interactions with geri-
atric patients. A longitudinal study following the part-
nerships formed in a project such as this may allow
researchers to determine the impact of longstanding
relationships versus those that are not maintained. One
final avenue to explore is whether those who partici-
pated in this project are more likely to choose a pri-
mary care specialty that encompasses a geriatric patient
population.
CONCLUSION
The Memory Art Project contributed positively to both
humanities and geriatrics education at MCW. It exposed
medical students to the fine arts, and it allowed students
to improve communication and empathy skills through
the development of relationships with healthy older
adults. Of note, the project increased both the ease felt
by older adult participants around medical profession-
als and the comfort level medical students felt around
people aged 65 and over. Medical students and geriat-
ric patients must overcome the largest age gap present
in hospitals and clinics in order to engage in produc-
tive interactions. It can be difficult for the developing
physician to maintain respect for the autonomy of the
geriatric patient, while simultaneously negotiating the
differences in medical knowledge and status within the
medical culture. Relationships such as those formed
in the Memory Art Project may provide a meaningful
foundation for both medical students and older adults
to build on to develop positive future interactions.
Authors’ Contributions: LMK and BAB contributed equally to the
development and implementation of the Memory Art Project with
advisement from JU and ARD. LMK and BAB each drafted different
sections of the manuscript while LMK took the primary role in man-
uscript development. All authors were involved in revision of the
manuscript and approved the final draft as submitted. ARD served
as the Principal Investigator for the study.
promoted positive communication between medical
students and healthy older adults. The project made use
of instruction in the fine arts and an informal task-ori-
ented setting. Eighty percent of the student participants
had never worked or volunteered in a setting allowing
regular contact with adults aged 65 and over, so this
project was a novel experience for most of the student
participants.
Painting served as a creative conduit for promoting
positive interactions between students and older adults.
Whereas the Vital Visionaries project used art apprecia-
tion to facilitate student and older adult relationships,
25
the Memory Art Project was innovative in allowing
all participants to create their own works of art. The
opportunity to create a painting at structured sessions
provided a tangible goal in a task-oriented setting. The
larger goal—to improve communication skills and com-
fort among medical professionals and older adults—was
facilitated by the intimate exchanges required to paint
a picture of another person’s life. As evidenced in the
paragraphs written by all participants about their work,
the paintings demonstrate profound insight and touch-
ing revelations revealed in the context of open, positive
relationships.
All student participants volunteered to complete the
project. Therefore, the successful results of this study
may not be generalized to all medical students. A self-
selection bias may exist among the students, with those
participating possibly being more interested in interac-
tions with older adults and recognizing the value of the
humanities in medical education even before the proj-
ect’s onset. As one author has noted, “Medical practice
consists of a wide range of different jobs requiring many
different sorts of people and the educational benefits of
the humanities may not be appropriate for them all.”
2
Perhaps exposure to the humanities may benefit only
those who actually enjoy the endeavor or expect to ben-
efit from it. Regardless, the project benefited those who
participated and added to the rich culture of humanities
at MCW.
The older adult participants of the Memory Art
Project were well-educated, active members of the St.
John’s and Milwaukee communities and were very
interested in interacting with medical students. As the
project was advertised to all St. John’s residents, and
individuals voluntarily signed up to participate, a simi-
lar self-selection bias may exist: those who chose to par-
ticipate may look more favorably on the medical pro-
fession or the incorporation of humanities into medical
education.
Further investigation is needed to determine whether
WISCONSIN MEDICAL JOURNAL
Wisconsin Medical Journal • 2010 • Volume 109, No. 6
316
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Acknowledgments: The authors wish to thank The Harry G.
and Charlotte H. Slater Family Fund of the Greater Milwaukee
Foundation (Milwaukee, Wis); Kathy Eilers and the St. John’s on
the Lake community (Milwaukee, Wis); Ernest Gonzales, MSSW,
Washington University (St Louis, Mo); Joshua Hauser, MD,
Northwestern University Feinberg School of Medicine (Chicago,
Ill); Jessica Belich, Art Instructor (Milwaukee, Wis); Diane Kramer,
Medical College of Wisconsin (Milwaukee, Wis); and all participants
in the Memory Art Project.
Funding/Support: We received funding from The Harry G.
and Charlotte H. Slater Family Fund of the Greater Milwaukee
Foundation.
Financial Disclosures: None declared.
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  • Full-text · Article · Dec 2010
  • [Show abstract] [Hide abstract] ABSTRACT: This chapter describes a community-based participatory research project that embraces opportunities to augment the skills necessary to excel in an increasingly diverse workforce, especially in terms of proficiency in communication, social interaction, and technology. The Intergroup Communication Intervention (ICI) provides needed technology skills training to older adults in a community setting to improve intergroup relationships, foster positive civic attitudes and skills, and reduce ageist attitudes of younger adults. Participants build workforce skills necessary for future success as the project advances group and interpersonal communication skills across generations using technology pedagogy to bridge the divide. The ICI approach is systematic and grounded in theory. Analyses across the project’s last three years demonstrate how communication processes ignite the powerful bonding that can occur over technology. This chapter encourages future research with similar goals of using longitudinal, communication studies to enhance community, competencies, and the future workforce.
    Full-text · Chapter · May 2016 · WMJ: official publication of the State Medical Society of Wisconsin