MACPMegan S. Lemay, M.D., Assistant Professor of Internal Medicine, and John E. Nestler, M.D., Professor Emeritus and Former Chair of Internal Medicine and inaugural VCUarts physician-scientist in residence, have partnered with Sara Wilson McKay, Ph.D., Associate Professor of Art Education, VCUarts, to help illuminate the humanity in medicine through expression in the arts. The Medicine, Arts and Humanities curriculum was developed in 2019 and has been offered as an interprofessional and cross-community elective in the School of Medicine since that time. Students in the elective course participate in eight, three-hour sessions; for example, students attend a session at Six Points Innovation Center in the historically black Richmond neighborhood of Highland Park led by community leader Free Egunfemi Bangura. Students discuss the history of VCU’s racism and violence against Black Richmonders, role-play a scenario of discrimination in medicine based on true events, and discuss intent versus impact using clay sculpture. At another session, Narrative Medicine: Living Histories, students obtain a “living history” from patients and created a narrative about the patient. In a living history, patients are interviewed about their lives and what they wish their medical team to know about them. Art Communication students have also participated in this session, sketching patients during the encounter.
For “Visual Art and Medicine”, students meet at the Virginia Museum of Fine Arts and complete guided dialogic observations of visual art preceded by instruction on cognitive bias in healthcare. Other sessions touch on teamwork, improvisation, reflection, and resilience and mindfulness. Capstone projects allow students to present their creative works reflecting on the questions: “What makes you a better doctor? What makes you a more resilient person?” using dance, painting, original music, poetry, embroidery, and other arts.
The results of the curriculum are already impressive. After engaging in the curriculum, students experienced a decrease in implicit racial bias and reported an awareness of course impact on implicit bias. All students reported that they would recommend the course to others, This work has been presented at the VCU Health Sciences Education Symposium and at the National Society of General Internal Medicine.
Among other projects, working with Dr. Catherine Grossman (VCU SOM), and Dr. Aaron Anderson (VCUarts), Dr. Lemay and Dr. Nestler helped create an improvisational theater workshop for students entering their third year of medical school. Participants in the workshop demonstrated improved empathy with standardized patients. Dr. Nestler, in collaboration with Professor Stephen Alcorn of VCUarts, has also created an elective in the Communication Arts Department of VCUarts to expose art students to examples of illness, healing and death. The objective of the elective is to heighten the art students’ appreciation of the human condition to which few have been exposed. The art students visit MCV Hospitals, a retirement home, a maternity ward, a cemetery, interview a patient with Stage 4 cancer, and create art based on those experiences.
“(This) ongoing work is a large part of why VCU is now internationally recognized as a leading institution for Arts + Healthcare collaborations,” states Aaron D. Anderson, Ph.D., Associate Chair and Professor, VCUarts, Health Liaison, School of Arts/School of Medicine, Founding Director, Standardized Patient Program, VCU.
The students who participate agree:
“This course helped illuminate some implicit biases I hold by bringing up what ideas I connect subconsciously in our appreciation of art and what assumptions I make about people based on diagnosis, etc.”
“Reminded us to practice mindful listening and accept that as we come from different backgrounds, we have to continually think about cultural humility when approaching different individuals.”
“Every session pushed me out of my comfort zone and challenged my preconceived notions about what it means to be a good physician.”