Arts-based training for staff
As well as arts programmes aimed at supporting patients and the general public, arts in health also includes programmes specifically developed to support staff. In some cases, this includes the arts being embedded into the initial training of doctors or other healthcare professionals. In other cases, it involves the arts being integrated into the day-to-day practice of staff or being offered as an additional opportunity to support their health and wellbeing. Examples of arts programmes for staff could include:
- ? Creative relaxation workshops to reduce burnout
- ? Photography to improve diagnostic skills
- ? Music in theatre to help surgeons concentrate
- ? Role play sessions to improve patient communication
- ? Expressive poetry to improve job satisfaction
- ? Staff choirs to enhance teamwork
Arts-based training within healthcare has arisen as part of a larger global movement of applying arts-based methods in business. The aim of this work is to use the arts, especially participatory arts, as an instrument for team-building, leadership development, problem-solving, and communications training. The field began to grow in particular in the late twentieth century, primarily in the UK and USA, and has since spread all over the world. One of the most famous examples of this is the ‘Serious Play’ concept developed by the LEGO company, by which teams are encouraged to strategize, communicate, and problem-solve through the use of 3D LEGO modelling.
Within healthcare, arts-based training arose through a growing awareness of the needs for development of the interpersonal skills of healthcare professionals to enable respectful and understanding care. In 1927, a history of medicine programme was established at the University of Zagreb in Croatia as part of a move to integrate the humanities into the medical programme to broaden the perspectives of students and support the demands of life as a practising doctor. This was followed by others, such as the National University of La Plata in Argentina, which launched a medical humanities programme in 1976, and Dalhousi University and the University of Manitoba in Canada. In the 1990s, the number of medical schools offering similar programmes suddenly burgeoned, with programmes in the USA flourishing, including at Stony Brook University, the University of California, and the University of Missouri-Kansas City.
In 1996, the University of Oslo developed a course entitled ‘Medicine and the Arts’, which covered visual arts, architecture, literature, and music, and explored their role as sources of personal and professional development and sources of insight into patients’ experiences.(25) Following suit in 1997, in response to a publication from the General Medical Council in the UK entitled Tomorrow’s Doctors: recommendations on undergraduate medical education (1993), three Scottish medical schools proposed a special study module in medicine and literature, which they explained was adaptable to other art forms too. They cited the importance of the module in broadening ‘the intellectual armamentarium of tomorrow’s doctors’, as well as promoting the ability to tackle challenges, adapt to changes, develop a critical and questioning attitude, and stimulate interest and education.(26) The module included creative writing workshops, reading groups, performances of short plays, magazine designs, field visits to theatres, and poetry readings. The sample bibliography focused on books that were related to health and medicine, such as scientific experiments in Mary Shelley’s Frankenstein and Virginia Woolf’s study of mental illness in Mrs Dalloway.
Since then, a whole range of modules and training programmes have developed in an attempt to support the training of doctors and, more broadly, the continuing professional development of healthcare professionals. Many of these programmes are focused on the development of interpersonal skills, including supporting empathy and communication, but many also tackle issues such as coping with the physical and emotional demands of healthcare work with aims to improve wellbeing and reduce burnout, and others have specific aims to enhance clinical skills such as critical thinking in diagnostics and visual awareness in imaging.
Title: Performing Medicine
Aims and objectives: A major concern for medical students in the UK is their performance in their Objective Structured Clinical Exams (OSCEs). These exams are designed to test competency in skills such as clinical examinations, medical procedures, and communication. The exams are hands-on either with real or simulated patients (either actors or electronic patient simulators), with candidates rotating through ‘stations’ assessed by different examiners. The Guys’ King’s and St Thomas’ School of Medical Education in London (GKT) identified that many students who failed a year and had to retake attributed failing to their performance in these exams. Consequently, GKT wanted to identify a way of supporting these students.
The project: An Academic Support Programme was designed by theatre company Clod Ensemble and delivered to students in their third, fourth, or fifth years at GKT. It ran for a day a week and included 10 taught, practical study days, delivered by Performing Medicine Associate Artists. The programme used exercises and methods drawn from dance, theatre, and live art practices, which addressed areas such as non-verbal communication, voice, teamwork, reflective practice, power and status, ways of seeing, care and compassion, and difference, with sessions run by Clinical Faculty focusing on learning styles, effective patient history-taking, and application of clinical knowledge.
Research: An impact study from King’s Learning Institute of the pilot (2013-2015) found that 87% of the Year 4 students felt the programme had directly improved their OSCE skills. In addition, 90% felt it had improved their communication skills and learning techniques and 94% felt they could manage stress better. The variety of the artistic forms involved and the multi-disciplinary perspective on medicine were found to be strengths of the programme. Further information: A video of student responses to the programme is available via the Performing Medicine website along with further information on the programme: www.perform- ingmedicine.com. Further information on Clod Ensemble is available at www.clodensemble.com.
For further information on the use of arts-based methods in business, Steven S Taylor and Donna Ladkin explore four processes by which arts-based methods can contribute to the development of managers and leaders.(27) ‘The effectiveness of arts-based interventions in medical education: a literature review’ in the journal Medical Education summarizes the evidence base to date.(28) Artful Creation: Learning- Tales of Arts-in-Business by Lotto Darso maps international involvement in arts-based training, replete with case studies and interviews with visionary business people alongside methods and guidelines for arts organizations and businesses planning on working together.(29) For more information about medical humanities in medical programmes, the journal Academic Medicine hosted an open-access special edition in October 2003 (volume 78 issue 10), which gave overviews of some of the leading programmes around the world.