Can the simple act of really looking at and discussing a painting help medical students and trainee doctors build empathy? UWA is involved in a pilot program to find out.

As soon as you lay eyes on a patient you start thinking, ‘how are they holding themselves, are they limping, why are they holding their arm like that’ – it’s all very clinical. I was curious to see how observational skills work in a different setting, in an artistic environment you are concentrating on the emotive side of things

When 25-year-old Dhanushke Fernando is on Surgery or Emergency Medicine rotation at Sir Charles Gairdner Hospital as part of his med student placement, the light, colour and construction of a particular painting are the last things on his mind.

“I’m immediately into thinking about the black and white of what’s wrong with this patient, based on what I’ve been taught,” Dhanushke says frankly.

And in the complex, frenetic and often difficult world that makes up an Emergency Medicine Department, you can hardly blame him.

However there is a growing train of thought that interpreting and reflecting on art might help students understand the complexities of a diagnosis based on more than just physical symptoms in not only emergency medicine, but also dentistry, audiology, physiotherapy and optometry.

“It’s about developing an understanding and appreciation of the many layers in a patient’s story – including their background, family and other issues,” says Dr Janice Lally, Academic and Public Programs Curator at UWA’s Lawrence Wilson Art Gallery (LWAG) where the ‘Object based learning’ (Art in Medicine) sessions are being held.

“Studying medicine isn’t only about science but about developing ways to interact with and gain information from patients and colleagues and exploring ways to observe and communicate confidently in new situations.

“Ethics, difficult conversations, assessing and navigating cultural differences and preconceptions – all are challenging topics to explore and areas we believe can be helped in an environment like an art gallery where judgement is suspended and where there is no right answer.”

In one Art in Medicine workshop held at LWAG, Emergency Medicine trainees and their mentors held group discussions around pieces from the UWA Collection which featured images of people, such as Yosl Bergner’s The pie eaters and Women in a sitting room by Iris Francis.

“We asked participants to think about their own dining tables and what they looked like, both when dining alone and when they had friends over; and when next at work to think about the first patient they see and  to consider ‘What does their dinner table look like?’ ” Dr Lally says.

Then we’d ask them to imagine the waiting room and reflect ‘How does that patient feel when sitting in the waiting room?‘ While the workshops usually only run for an hour and a half, they’re a chance for observation and reflective discussion in small groups.

Emergency Medicine Registrar and keen photographer Dr Kavinda Senasinghe, who’s also doing placement at Sir Charles Gairdner, says while art 'isn’t his thing’, he ‘forced himself to get involved’ in the program, finding it enlightening.

“It gave me a chance to focus on something different, to learn that there isn’t only one viewpoint,” the 28-year-old self-confessed ‘adventure nut’ says.

“I’m usually either reading and learning or I’m in the madhouse that is the ED (Emergency Department) or I’m out sky-diving, spear-fishing or wake-boarding," he says.

To take time out from the craziness to observe art has taught me to look beyond my initial first impression and to take other factors into consideration. It’s about empathy really.

UWA’s Dr Gabrielle Brand, a Senior Lecturer in Health Profession Education, says integrating arts and humanities-based pedagogy into the curriculum is of growing interest to medical educators.

Dr Brand was lead researcher in a study where a short film, ‘The Art of the ED’ was shown to UWA medical students before their first clinical placement in emergency, with overwhelmingly positive results.

‘While I was watching the film, I felt like I was the patient and doctor all at once, in that I was living the experience both from within and as an observer’ was one comment.

Another student wrote: ‘…the older gentleman in the suit, hat, sitting down alone… the empty area seemed to represent to me some loss or empty space within (him).’

“The film created a safe, non-threatening space to access, experience and process emotion around emergency medicine,” Dr Brand says.

Despite the study being small and exploratory, the results offer some in-depth insights into how educators may begin to teach reflective processes that integrate the ‘art’ and ‘science’ of emergency medicine.

Co-Director of Emergency Medicine training at Sir Charles Gairdner Hospital Dr Ioana Vlad, who has worked alongside Dr Lally in co-ordinating the trial workshops, says in a world like the ED where alarms are constantly sounding and there is very rarely time to stop, the chance to ‘teach’ or encourage empathy is important.

“We want to ensure students pay attention to the whole person and not just the condition of the patient,” she says. “I’ve been very encouraged by the number of trainees wanting to get involved and then come back again. I think we are on to something.”

Dr Senasinghe agrees. “I’m definitely going to go again, I want to attend as many sessions as I can,” he says.