“What does Impressionist art have to do with medical communication?”
It’s a question that Dr. Michael Flanagan often gets after telling people about “Impressionism and the Art of Communication,” the seminar he teaches to fourth-year medical students at the Penn State College of Medicine.
In the course, students complete exercises inspired by 19th-century painters like Vincent van Gogh and Claude Monet, ranging from observation and writing activities to painting in the style of said artists. Through the process, they learn to better communicate with patients by developing insights on subjects like mental illness and cognitive bias.
Dr. Flanagan’s seminar speaks to a broader trend in medical education, which has become pronounced over the past decade: More and more, medical schools in the U.S. are investing in curriculum and programming around the arts. Professors argue that engaging in the arts during medical school, whether through required courses or extracurricular activities, is valuable in developing essential skills that doctors need, like critical thinking and observational and communication skills, as well as bias awareness and empathy.
While it’s become more common in recent years, some medical schools have been incorporating the arts into their curriculum for decades. Penn State, for example, was the first medical school in the U.S. to develop its own department of medical humanities, which launched with the school in 1967. And many schools have long required students to take reflective writing courses or interdisciplinary classes that tap into social sciences or the arts as part of graduation requirements. This coursework is meant to address a wide swathe of real-world scenarios, from medical decision-making to ethics. And within this framework, there’s room for the performing arts, music, literature, and visual arts, as vehicles to deliver lessons.
Medical students at Columbia University’s College of Physicians and Surgeons, for example, are required to take humanities seminars in their first year, which range in subject from dance to poetry. And in the past few years, more schools, including Harvard Medical School and the University of Texas at Austin’s Dell Medical School, have developed their own arts and humanities programs.
“It’s not just a nice idea to incorporate humanities into medical schools to make the education more interesting,” Dr. Flanagan says of such programs. “It’s protecting and maintaining students’ empathy so that by the time they go off to practice medicine, they’re still empathetic individuals.” He notes that while medical students traditionally enter their first year with very high levels of empathy, after three years, research has shown, the exposure to content around death and suffering can cause those levels to plummet. Engagement in the humanities can rectify this problem.
Dr. Delphine Taylor, associate professor of medicine at Columbia University Medical Center, emphasizes that arts-focused activities are important in training future doctors to be present and aware, which is more and more difficult today given the pervasiveness of technology and media.
One of the most popular programs, adopted at schools including Yale, Harvard, and UT Austin, involves students meeting at art museums to describe and discuss artworks. At the most basic level, these exercises in close observation help to improve diagnostic skills—priming students to identify visual symptoms of illness or injury in patients, and (hopefully) preventing them from making misguided assumptions. But it’s also about delving beneath face value.
“It’s a richer experience than just, ‘Check, I know how to observe now,’” says Dr. Taylor, regarding the courses Columbia offers, where students visit museums like the Metropolitan Museum of Art. She notes that by verbally reacting to the art they see, and developing hypotheses around factors like what the artist was thinking or why they used a certain shade of red, students can prepare for future scenarios with patients and colleagues that will be uncomfortable and uncertain. These classes, which are most often led by museum educators, also serve to engender curiosity, to encourage students to ask questions, and, importantly, to consider the perspectives of others.
One of the oldest courses of this type was begun at Yale in the late 1990s by dermatology professor Dr. Irwin Braverman and curator Linda Friedlaender, who created a class that takes place at the Yale Center for British Art, and continues to be taught today. After taking that course in 2013, current Yale med student Robert Rock, who studied art history as an undergraduate, took the initiative to develop his own art tour of the Yale Center for British Art.
“The point is to create a critical consciousness,” Rock explains. “I think in medical culture there’s a deference to authority that holds people back from asking important questions about things that can mean life or death.” He notes that the museum is neutral territory where students, who often don’t have much experience with art, can feel comfortable voicing opinions or asking questions. His tour, called “Making the Invisible Visible,” has since been incorporated into the Yale curriculum.
Beyond looking at and discussing art, students are also making it. At Columbia, students can take a comics course taught by Dr. Benjamin Schwartz, assistant professor of medicine and chief creative officer at Columbia’s Department of Surgery, who is also a contributing cartoonist to The New Yorker. In his classes for first- and fourth-years, students learn to create their own comics and, in the process, gain insights into the different vantages from which to see and understand real-life situations. Perhaps most importantly, they learn to practice effective storytelling.
“When you become a doctor, you train really hard to learn another vocabulary and it really is almost like its own language,” says Dr. Schwartz. “You become so well-versed in it that you can forget that you’re speaking it and words that are common to you might be confusing jargon to the person you’re speaking with.” Making comics, he explains, can help to prevent these types of scenarios, and engender mindfulness.
Efforts to better communicate with patients also drive much of Dr. Flanagan’s Impressionism course. One particularly original exercise sees students partner up to paint. One student is given a postcard with a famous Impressionist painting on it, while the other student, who cannot see the card, stands at a canvas with a paintbrush in hand, and must ask their partner questions about the painting in order to reproduce it. “The painter becomes like the physician who’s taking a history and trying to get information from the patient,” Dr. Flanagan says. “They experience firsthand how much easier it is to gain information when you ask open-ended questions, when you stop and let that patient tell their story.”
At many schools, programming around the arts is also happening outside of the classroom. Yale has its Program for Humanities in Medicine, which promotes interaction among the medical school and other schools at the university, while also supporting student-run organizations and events—like Rock’s art tour and a series of drawing sessions started by one of his classmates, Sue Xiao.
Yale med student Nientara Anderson says her involvement in an on-campus interdisciplinary group and other artists initiatives has helped widen her perspective on important issues—perspective that will ultimately make her a better doctor.
“I noticed in my first year of medical school that we were talking about things like race, mental health, sexuality, and we weren’t really reaching outside of medicine and asking people who really study these things,” Anderson says. “I see art as a way, especially art in medicine, to bring in outside expertise.”
Rock agrees, stressing that a sense of “criticality, more than anything, is what I would hope that the arts and the humanities bring to the medical profession.” He points to incidents of unconscious bias, where preconceived notions about things like how a certain disease presents or where an individual lives can negatively affect a doctor’s decision making. “There are a lot of apparent assumptions in Western society that can be extremely problematic and very dangerous when aligned with the power that a physician has in the clinic, operating room, or emergency department,” he adds.
Dr. Taylor notes that at Columbia, students are similarly receptive to taking humanities courses. “The application to medicine is very obvious, we don’t have to tell our medical students why they’re doing this,” she says. And visual art, it seems, has a special role to play.
Dr. Schwartz suggests that visual art is somewhat unique in what it can offer to medical professionals. “For me, the greatest asset with visual art in particular, when it comes to teaching medical students, is just that it gently takes us out of our comfort zone,” he says. “It gives us a great opportunity to have these stop and think moments.” Doctor or not, we could all stand to have more moments to stop and think.