Creative Arts in Humane Medicine

Cheryl L. McLean

• Publisher: Brush Education
• Year: 2014
• ISBN:
  9781550594553
• Topic: Medicine
• Subtopic: Ethics in Medicine

Creative Arts in Humane Medicine is a book for medical educators, practitioners, students and those in the allied health professions who wish to learn how the arts can contribute toward a more caring and empathic approach to medicine. Topical research and inspiring real-life accounts from international innovators in the field of humanistic medicine show how the creative arts in varied forms can contribute toward greater learning and understanding in medicine, as well as improved health and quality of life for patients and practitioners.

Section 1

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Educating for Empathy Through the Arts

1
Teaching Empathy Through Role-Play and Fabric Art

An Innovative Pedagogical Approach for End-of-Life Health Care Providers

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ANDRÉ SMITH, JANE GAIR, PHYLLIS MCGEE, JANICE VALDEZ AND PETER KIRK, MD

This chapter explores the experiences of first- and second-year medical students who participated in a learning intervention that used fabric art and role-playing to foster the acquisition of empathy skills for end-of-life care. The intervention centers on students’ engagement with artwork by renowned artist Deidre Scherer, who depicts the processes of aging, dying and grieving in her work. We collected data from qualitative interviews with students and from observations of students’ participation in the intervention. The students reported experiencing intense feelings of empathy toward the patients depicted in the artwork. Based on these experiences, they successfully formulated empathetic responses that took into account the imagined perspectives of these patients. We conclude that this learning intervention effectively cultivated empathy in the students who took part in the study.

Introduction

Caring for elderly individuals who are dying constitutes a pivotal but often largely unacknowledged aspect of the health care system. Given increases in life expectancy and the proliferation of life-prolonging treatments, the majority of deaths now occur in old age and take place in hospital or long-term care facilities (Northcott & Wilson, 2008). Palliative care in such settings focuses on reducing pain and discomfort rather than on halting or delaying the progress of disease (World Health Organization, 2007). Because older adults often experience vulnerable states, health care providers also find themselves needing to respond to older patients’ emotional needs (Roter et al., 1997; Halpern, 2003; Shapiro & Hunt, 2003; Larson & Yao, 2005). Being empathetic under such circumstances may prove demanding for health care providers, but it can also yield important benefits for patients’ quality of end-of-life care. Research on empathy in the clinical relationship suggests considerable benefits that may transfer to the context of palliative care. For example, empathetic physicians are more successful at making patients adhere to prescribed drug treatments, thus improving therapeutic outcomes such as pain management (Piette, Heisler, Krein & Kerr, 2005). Empathetic physicians also elicit more complete medical histories from their patients, thus improving diagnostic accuracy and treatment decisions (Halpern, 2003; Larson & Yao, 2005). In addition, they are less likely to be sued for malpractice (Meryn, 1998) and more likely to be perceived as trustworthy (Butow, Maclean, Dunn, Tattersall & Boyer, 1997). Finally, empathetic physicians report high levels of professional satisfaction, derive more meaning from their work and are less likely to experience burnout, which is a constant concern in palliative care (Roter et al., 1997).

Unfortunately, health care providers are often ill equipped to address the psychosocial needs of older dying patients and their families, in part because the teaching of empathetic skills is underdeveloped in medical and paramedical curricula (Halpern, 2001; Price, 2004; Nordgren & Olsson, 2004). As Kidd and Connor (2008) found in their survey of medical humanities and arts-based activities across Canada, instructors in medical humanities feel their field is marginalized in Canadian medical schools partly because instruction tends to be voluntary and rarely extends beyond the pre-clinical years. Another reason is that medical education tends to privilege scientific knowledge of body systems and diagnostics at the expense of interpersonal skills and psychological awareness (Starr, 1982; Wilkes, Milgrom & Hoffman, 2002).¹ Yet, as Garden (2007) remarks, “learning about the way an individual patient experiences and makes meaning from illness and the social context of that suffering is vastly different from the way students are tested on knowledge about the organ systems and disease” (p. 564). As a result, health care providers learn to manage patients’ physical symptoms systematically and efficiently but tend to neglect the existential and experiential aspects associated with death and dying (Kirk, 2011).

Teaching Empathy: A Brief Survey of the Literature

A strong proponent of improving empathy training in medicine is Jodi Halpern, a psychiatrist, a philosopher and Professor of Bioethics and Medical Humanities at the University of California, Berkeley. In From detached concern to empathy: Humanizing medical practice (2001), Halpern rejects outdated notions of scientific objectivity that discourage empathy training and claims that “empathy requires experiential, not just theoretical, knowing” (p. 72). According to Halpern, learning to be empathetic requires physicians to “imagine how it feels to experience something, in contrast to imagining that something is the case” (p. 85). Unfortunately, existing programs that teach empathy typically lack the sophistication needed to reflect Halpern’s pedagogical vision. Students learn about empathy primarily in the classroom, although evidence suggests that experiential learning (e.g., modeling the responses of an empathetic mentor in a clinical setting) is more effective (Henry-Tillman, Deloney, Savidge, Graham & Klimberg, 2002; Larson & Yao, 2005; Stepien & Baernstein, 2006). Didactic approaches to teaching empathy are also less effective in securing students’ enthusiastic participation than alternate approaches, such...

Table of contents

• Cover
• Title page
• Table of Contents
• Copyright page
• Foreword
• Acknowledgments
• Introduction
• Section 1: Educating for Empathy Through the Arts
• Section 2: The Arts and Practitioner Self-Care
• Section 3: Navigating with Narrative Through Life Experience
• Section 4: The Creative Arts in Action for Change in Health
• Contributors