In 2019, the AAMC commissioned a scoping review of how arts and humanities were being used in medical education. The resulting paper, How Are The Arts and Humanities Used in Medical Education?: Synthesis Results of a Scoping Review of Published Literature, was published in Academic Medicine in August 2021. The article provides a descriptive and statistical review of 769 publications and noted "a persistent gap in evaluation and assessment." Only 50% of the arts and humanities programs appeared to have been evaluated, and the majority of those programs reported only on learner satisfaction.
In Fall 2020, the AAMC released a request for proposals to design new methodology–or enhance existing methodology–to evaluate the impact of existing integrative arts and humanities programs or curricula across the developmental spectrum (undergraduate, graduate, continuing medical education, and interprofessional settings).
In January 2021 eight grants of $25,000 were awarded to U.S.-based AAMC member medical schools and teaching hospitals whose proposals laid out promising plans for evaluation of arts and humanities programs in their institutions. Priority was given to programs that serve veterans and groups that are traditionally underrepresented in medicine. The FRAHME grant program was made possible in part by a grant from the National Endowment for the Humanities (Federal Award ID Number: AH-268665-19).
Below find a complete list of the awardees and more information about their projects.
Baylor College of Medicine
Title: Tinctures of the Arts: Measuring the Effect of Medical Humanities Activities on Empathy, Burnout, and Communication in Students and Other Learners
Principal Investigator: Ricardo Nuila, MD
Team: Andrew Childress, PhD; Larry Laufman, EdD
Project Description: The Baylor College of Medicine (BCM) Narrative Medicine Program sponsored and facilitated a range of interactive and educational activities, including creative writing and narrative medicine workshops, storytelling events, and a speaker series.
As part of these activities, medical students, residents, and other health care professionals learned to elicit and write patients’ stories, as well as their own stories of caring for patients. Learners were introduced to vulnerable patient populations, including veterans and patients from underresourced backgrounds who bore the brunt of the COVID-19 pandemic. Learners also had opportunities to reflect on how to incorporate the humanities into their clinical practice.
Using a variety of quantitative and qualitative research methods, BCM studied how increased exposure to medical humanities activities correlates with learners’ attitudes toward empathy, burnout, emotional intelligence, and communication with patients.
Project Results: The team published their results in the article "Using Narrative Medicine Workshops to Improve Empathy and Emotional Intelligence and Address Burnout Among Medical Students" in Academic Medicine in 2022.
Case Western Reserve University School of Medicine
Title: Learning to Care for Dying Patients: A Multi-Outcome Study of Humanities Interventions
Principal Investigators: Erin Gentry Lamb, PhD; Ryan Jenkins, MD
Project Description: Recognizing the need for physicians to be comfortable and competent when working with dying patients, the Case Western Reserve University (CWRU) School of Medicine sought to measure effectiveness of both the existing medical curriculum and a humanities intervention on student preparedness for death and dying.
Drawing on guidance from both students and palliative care specialists, researchers developed and implemented an elective humanities course for a portion of M2 students consisting of four weekly one-hour discussion sessions. Co-taught by a physician and a humanities scholar, the course’s literary and artistic works (stories, poems, plays, memoirs, visual art, etc.) and discussions invited students to explore emotional reactions to death and dying, critique medical responses to dying patients, hear diverse patient and family perspectives, and consider health equity in relation to death and dying. All M2 students then took an objective structured clinical examination (OSCE) designed by the investigators to simulate an in-depth interaction with a dying patient, and retook the death anxiety measure, providing a robust qualitative assessment of the effectiveness of existing curriculum and the impact of the humanities intervention.
Project Results: The team presented their results in a session titled "Claiming Space for Health Humanities in MedEd: The Challenge of Translating Value" at the March 2022 Health Humanities Consortium Conference.
CUNY School of Medicine
Title: The Role of Narrative Medicine in the Development of Equity-Focused and Culturally Humble Professionalism
Principal Investigator: Lynn Hernández, PhD
Team: Erica Friedman, MD; Samantha Barrick, MS
Project Description: Professionalism is a lifelong, developmental, context-specific process which can be fostered and shaped over the course of a medical student’s training and career. Reflection, both self and group, is one of the most valuable tools in medical education for teaching professionalism. However, for reflections to be effective, students must feel safe and opportunities must be developmentally appropriate. The objective of this project was to examine whether a Narrative Medicine (NM) curriculum at the CUNY School of Medicine (CSOM) had the potential to create these safe spaces for students by offering multiple opportunities for students to engage in both self and group reflections through guided activities. Using a mixed-methods experimental design, this project evaluated the effects of a NM curriculum in fostering the development of professionalism among a diverse sample of students enrolled in our BS/MD program. Given that cultural sensitivity is an important component of professionalism, we also examined whether our NM curriculum led to a greater willingness and ability for engaging in cultural sensitivity.
Project Results: This study is ongoing.
Georgetown University School of Medicine
Title: Evaluating an Integrated Cross-Campus Medical Humanities Initiative
Principal Investigators: Lakshmi Krishnan, MD, PhD; Daniel Marchalik, MD, MA; Nicoletta Pireddu, PhD, MA
Project Description: The Georgetown Medical Humanities Initiative, a cross-campus collaboration among Georgetown University Medical Center, College, and School of Medicine Literature and Medicine Track, arose in response to the multifaceted challenges facing these fields, including disciplinary siloes in undergraduate, pre-health, and medical school education and a burnout epidemic among health professionals. Drawing on faculty and community expertise across the main and medical campuses, it has piloted integrated and team-taught undergraduate, nursing, and medical student classrooms, supported opportunities for cross-campus research and mentorship, and developed a Medical Humanities speaker series.
This grant supported a multidisciplinary team including clinicians, faculty, medical and graduate students, statisticians, and web developers in evaluating program outcomes and impact. The program was assessed quantitatively and qualitatively, including thematic content analysis of student research, evaluation of faculty and student satisfaction, well-being, and longitudinal reflections.
Project Results: This study is ongoing. When it is complete, outcomes, as well as educational materials, will be made available via an open-resource platform.
Johns Hopkins University School of Medicine
Title: Simulation to Assess Impact of a Health Equity-Focused Health Humanities Track in GME
Principal Investigator: Kamna S. Balhara, MD, MA
Team: Margaret S. Chisolm, MD, FAMEE; Richard Greene, MD, MHPE; Nathan Alex Irvin, MD, MSHPR, FACEP; Amanda J. Kirkpatrick, PhD, RN; Nicole L. Mollenkopf, PharmD, MBA, BCPS, BCPPS; Philip M. Reeves, PhD; Rachel Marie E. Salas, MD, MEd, FAAN; Antoinette (Toni) S. Ungaretti, PhD
Project Description: An interdisciplinary team of clinicians and educators at Johns Hopkins University developed and implemented simulation-based scenarios to evaluate the impact of a health equity-focused health humanities track in graduate medical education (GME). Efforts to advance health equity require physicians to identify and navigate bias, practice cultural sensitivity, work with interprofessional teams, and engage in continuous self-reflection.
There is increasing evidence that integrating arts and humanities curricula into health professions education may be effective in helping learners develop these key relational and reflective skills. The project team applied its synergistic expertise in GME, curricular evaluation, humanities, simulation, and health equity to implement and evaluate this year-long longitudinal health humanities GME track grounded in narrative medicine, visual thinking strategies, and social medicine. Curriculum effectiveness was evaluated using simulation scenarios as surrogates for clinical environments, permitting preliminary evaluation of skill translation to clinical encounters.
The grant supported the development and implementation of two novel simulation scenarios to evaluate the impact of participation in the track on learners’ ability to 1) navigate sources of biases; 2) demonstrate cultural sensitivity; 3) engage in collaborative practice; and 4) develop avenues for self-reflection on their role in advancing equal access to health care for all patients. These outcomes were evaluated by triangulating input from multiple evaluators (faculty, interprofessional colleagues, standardized patients, and self-evaluations) via a combination of validated scale-based measures and qualitative analysis of written reflections.
Project Results: The team presented their results in a session titled "Claiming Space for Health Humanities in MedEd: The Challenge of Translating Value" at the March 2022 Health Humanities Consortium Conference.
Ohio State University College of Medicine
Title: Traveling on Time, the Next Horizon for Health: Journeys to Equity, Inclusiveness, and Transformation of Racism to Humanism
Principal Investigator: Jennifer Garvin, PhD, MBA
Team: Jeff Barbee DMA, MA; Leslie Burrs; Linda Stone MD, MA
Project Description: As part of the Humanism in Medicine program, this project implemented a series of virtual presentations to juxtapose racism with concepts of humanism. The process for this series was to integrate arts and humanities, using segments from the opera VANQUI, with reflection questions, humanistic concepts and possible solutions based on the dynamics of racism illustrated in the opera. Each module served as a springboard to address specific areas of concern.
The project team provided commentary and posed questions to contrast threats to health from racism, with humanistic concepts and values. The team and invited speakers also provided didactic lectures about humanism, racism, action plans to address racism, and training in expressive arts, communication, and advocacy to accompany the opera pieces. Participants included faculty, students, clinicians, patients, and the Columbus community. The series used VANQUI as a focal point for participants to develop a digital portfolio of expressive arts renderings and journal entries, culminating in a personal and professional action plan to build equity.
Project Results: The team presented their results at a session titled "Claiming Space for Health Humanities in MedEd: The Challenge of Translating Value" at the March 2022 Health Humanities Consortium Conference. They also presented at the "Friends of FRAHME" session during Learn Serve Lead: The AAMC Annual Meeting in 2022.
Virginia Commonwealth University School of Medicine
Title: Applied Improv to Impact Homelessness
Principal Investigators: Elizabeth Byland; Alan Dow, MD, MHSA
Team: Cherie Edwards, PhD
Project Description: This program sought to use techniques of improvisational theater to decrease homelessness. The program had two intertwined goals: 1) strengthening skills of self-advocacy and problem-solving among individuals impacted by homelessness, and 2) reducing the stigma of and engendering advocacy about homelessness among health care practitioners. During community-based sessions in transitional housing settings, individuals impacted by homelessness and medical students, residents, and faculty collaborated in exercises that explored the challenges facing unhoused individuals. Unhoused individuals developed strategies for negotiating the barriers to housing while health care practitioners and students realized their role in supporting people to overcome challenges to stable housing. As these groups collectively learned together, they developed insights into each other and themselves as they worked toward eliminating housing instability and its impact on health and well-being.
Project Results: The team presented their results at the "Friends of FRAHME" session during Learn Serve Lead 2022: The AAMC Annual Meeting.
Wayne State University School of Medicine
Title: Using Visual Thinking Strategies to Enhance Observation Skills Through Art and Imaging
Principal Investigator: Jennifer Mendez, PhD
Team: David Amponsah, MD; Holly Feen-Calligan, PhD; Grace Serra, CFPCA
Project Description:
The Wayne State University School of Medicine established a cross-disciplinary study with the university’s Art Therapy and Arts Administration programs on the use of formal art observation, using the university art collection to learn and practice Visual Thinking Strategies (VTS) to enrich medical students’ and art therapy students’ visual literacy, with the ability to translate and interpret imaging important in the understanding of the patient perspective in relationship to their health.
While medical students readily mastered the technical skills required for reviewing patient ultrasound images, interpretation of the images was a challenge and an unmet curriculum need. Through this interprofessional collaboration, medical students overcame difficulty in translating two-dimensional ultrasound monitor images to three-dimensional anatomical structures in patients. The pilot study involved 30 medical students, 30 art therapy students, and 10 arts administration students. Data on the frequency of accurate reading and observations on ultrasound visual skills examination pre- versus post-training was collected and evaluated.
Project Results: Faculty were so happy with this program that they have implemented the VTS Ultrasound session for all students starting with the incoming class of 2024. The team published their results in an article titled "Using Visual Thinking Strategies to Enhance Observation Skills" in Art Therapy in October 2023. They also presented about this project at the following conferences:
- Learn Serve Lead 2022: The AAMC Annual Meeting
- American Art Therapy Association Annual Conference, 2022
- Health Humanities Consortium Conference, 2022
- Nexus Summit 2021: Working Together in the Nexus, 2021
- International Conference on Communication in Healthcare, 2021
- Wayne State University Humanities Center, 2021