# Required Art-Based Curriculum Improves Essential Qualities in Medical Students: A Three-Year Study With In-Person and Remote Art Observation Experiences

## TL;DR

A required art-based curriculum for medical students improves their tolerance for ambiguity, regardless of whether they learn in person or remotely.

## Contribution

The study demonstrates that an art-based curriculum can enhance essential qualities in medical students across different learning modalities.

## Key findings

- The art-based curriculum increased tolerance for ambiguity by 0.19 average TFA scale points.
- No significant differences were found in outcomes across in-person, emergency remote, or planned remote sessions.
- Improvements were consistent across academic years and locations.

## Abstract

Medical education is increasingly challenged to develop a curriculum that addresses ambiguity, empathy, and perspective-taking. We developed a required art-based curriculum for all first-year medical students to address this need. Within this course, students use art observation and the Visual Thinking Strategies (VTS) question framework to explore interprofessional collaborative practice, ambiguity in healthcare, and perspective-taking. The purpose of this study was to examine if the art-based curriculum was associated with changes in tolerance for ambiguity, perspective-taking, and empathy in medical students. Changes in these qualities were evaluated between in-person, emergency remote, and planned remote sessions.

From September 2018 to May 2021, 794 first-year medical students from two campuses participated in a two-hour art observation session where VTS was used to prompt discussion. All participants were surveyed in pre- and post-art observation activities in tolerance for ambiguity, empathy, and perspective-taking. A linear mixed-effects regression model was used to measure pre/post changes for each learning modality (in-person, emergency remote, planned remote).

The two-hour art observation activity using VTS was associated with an increase in tolerance for ambiguity of 0.19 (95% CI: 0.15 to 0.23) average TFA scale points. We observed no difference in outcomes across academic years, museums, emergency remote, or planned remote experiences. We did not detect significant differences in either perspective-taking or empathy.

We have developed a curriculum that improves qualities that are essential for practice in complex and evolving health systems. These improvements are observed independent of learning modality (in an art museum, emergency remote teaching, or planned remote teaching), creating an opportunity to engage with students and programs across the spectrum of health professions education, independent of location. Providing access to educational programming that addresses essential qualities and behaviors of healthcare providers has the potential to improve patient outcomes through team-based healthcare and interprofessional collaborative practice.