Art-making in a Family Medicine clerkship: how does it affect student empathy?

Abstract

INTRODUCTION: To provide patient-centred holistic care, family doctors in particular must possess interpersonal and empathic skills. Medical schools typically adopt a skills-based approach to such training. A novel arts-based approach may also help medical students develop empathic understanding of patients. METHODS: This was a mixed-method quantitative-qualitative study. In the 2011-12 academic year, all 161 third year medical students at the University of Hong Kong were allocated into either an art-making workshop or a problem solving workshop during the Family Medicine clerkship. Students in the art-making workshop wrote a poem, created artwork and completed a reflective essay while students in the conventional workshop problem-solved clinical cases and wrote an essay about the principles of family medicine. The Jefferson Scale of Empathy (JSE) (student version) measured the level of empathy of students at the start and end of the clerkship. Within subjects ANOVA was used to compare the change within and between groups. Qualitative data were thematically analysed using a grounded theory approach. RESULTS: The quantitative results showed a decrease in JSE scores over time within groups but no statistically significant difference between groups. Qualitative analysis of creative work produced by students in the art-making group revealed understanding gained in relation to self, patients, pain and suffering, and the role of the doctor. DISCUSSION: Consistent with the literature, empathy declined over time in medical school. However, the arts-based approach enabled medical students to reflect on the caring aspect of medicine which contributes to empathic understanding. It also seemed to promote self-awareness, which can help them to recognize the potential for emotions to influence judgment which is of vital importance in clinical practice.