My journey from the hospital to the museum is a short one, likely an insufficient distance to meet any daily exercise goals. It is a familiar path. Through green spaces. Near historical landmarks. Down the hot streets of Birmingham, Alabama. Over the first 5 years that I had taught UAB’s Art in Medicine course to undergraduate medical students, I found I could shorten that journey if I took it at a brisk pace, head down, thinking about the curriculum. A curriculum I knew that I knew. Or so I thought.
Five years into teaching the course, unease crept into my familiar routine. In 2011, I had set out to use museum-based medical education to teach observational skills. On a surface level, I thought I had succeeded. Students’ course comments suggested they loved learning about art at the Birmingham Art Museum. They seemed to breathe deep in the gallery’s air. They learned how to look. They practiced observation. And then, they moved on to their next rotation. In my view, I had reached an educator’s dilemma: I knew I was teaching the course I set out to teach, but I felt I was not teaching the course the students needed.
I responded by adding new partners. The curator at the University’s medical collections offered to share historical wax models used by Alabama’s first medical college. Directors at the University’s Art Museum, AEIVA, suggested their rotating collection of local and national artists. And educators at the Birmingham Civil Rights Institute saw connections to the course I had missed. In all, we added new stops at 4 locations, each following my suggestions to help teach observation to medical students.
Next, we re-branded the course. The new name, Prescribing Art, intended to convey the necessity for the material. COVID-19 concentrated our goals as we hopped from remote learning to hybrid education. I knew what emerged from those changes began to feel different from the original idea. More inclusive. More impactful. And perhaps, more sustainable.
Then, the opportunity arose to become a Fellow at the Harvard Macy Art-museum based Health Professions Education Fellowship. Only then did I see that what I was trying to teach was not just observation but also about ways of knowing.
Knowing has many faces in medicine. Knowing the pattern of an ominous rise on an EKG can signify a threat to a patient’s heart. Knowing that some diabetic medications can cause abdominal pain can indicate an opportunity for treatment changes. Knowing the signs of stroke can prompt an urgent call that can be life saving.
But other ways of knowing exist in medicine. Knowing how your horizons can contract when the doctor says the PET scan suggests cancer. Knowing how your pre-school daughter will react when it is time to check her blood sugar to control the new diagnosis of diabetes. Knowing that your fixed income may mean choosing between paying the pharmacy bill or paying the rent.
As a medical educator, I feel more comfortable teaching the first type of knowing. For my students, that type of knowing requires diligence and study, reading and repetition. I often feel less comfortable trying to teach the second type of knowing. For my students, that type of knowing requires lived experience and listening intently, paying attention and practicing curiosity.
The Harvard Macy Art Museum-based Health Professions Education Fellowship taught me to use museum-based health professions education to cultivate a sense of curiosity for clinical spaces. Because of the Fellowship, the curriculum changed.
The Birmingham Museum of Art became our home base. We looked at a painting of an 18th Century medical scene to make sense of our common experiences. We realized that if we looked closely and asked “What is going on here?” we could practice critical thinking to get to a possible answer. A familiar way of knowing.
The University’s medical collection allowed us to understand how our ancestors learned about medicine. Reading labels on some of the wax models, we realized that knowing is not a static concept. One model that was labeled “Gout” held tell-tale features of Rheumatoid Arthritis.
The University’s art museum helped us see our State through the eyes of a vernacular artist. He knew what it was like to live in a rural part of the country with a long history of poverty and inequity. We saw how he used familiar objects to represent, and then to understand, the world around him.
The Birmingham Civil Rights Institute helped us wonder what it was like to know our city in the mid-twentieth century. We began to know some of the historical roots of inequity in education, entertainment, public accommodations, and civic life. We began to know how those historical roots still manifest in the health of our patients, and the health of our country, today.
Returning to home base, we ended the week wondering what it might be like to observe the world from a different perspective. We learned that if we closed our eyes, we could call on other senses to know a work of art. And we asked what it must be like for others to experience the world in this way.
Ways of knowing involve asking the right questions. Ways of knowing also involve listening—and having a plan to gain knowledge when what we think we know changes. When asked to reflect on what students learned about themselves as observers during the course, reflections included sentiments such as, “I learned that perspective changes the interpretation of what one sees,” and, “Now I notice the benefit of asking ‘how’ and ‘why’ as I interact with the world around me.” My educator’s dilemma resolved when the Fellowship taught me to approach situations with a sense of curiosity.
Perhaps the biggest lesson for me was that at the end of the week leaning about ways of knowing, students had new skills to feel comfortable saying to their patients, and to one another, “I do not know…but maybe we can find out together.”
*Cover photo used with permission from the Birmingham Art Museum.
Credit: “Benjamin West (American, 1738-1820), Erasistratus the Physician Discovers the Love of Antiochus for Stratonice, 1772, oil on canvas, Collection of the Birmingham Museum of Art.”
Did you know that the Harvard Macy Institute Community Blog has had more than 335 posts? Previous blog posts have explored topics including museum based medical education in clinical care, striking a chord, and can art reframe medicine?
Stephen W Russell