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The arts may make med students better doctors — and help protect against burnout, study suggests

Many universities have begun to incorporate courses in the performing arts, music, literature and the visual arts into their medical school curriculum.

Medical students who are significantly engaged in the arts during their spare time, either as an active or passive participant, tend to have higher levels of empathy, emotional intelligence, tolerance of ambiguity and other traits considered positive in a doctor, according to a study published earlier this year in the Journal of General Internal Medicine.

Those students also tend to have lower levels of the kinds of negative traits associated with burnout, such as physical fatigue, emotional exhaustion and cognitive weariness, the study also found.

“The humanities have often been pushed to the side in medical school curricula, but our data suggests that exposure to the arts are linked to important personal qualities for future physicians,” said Dr. Marc Kahn, the study’s senior author and an associate dean at the Tulane University School of Medicine, in a released statement. “This is the first study to show this type of correlation.”

As Kahn and his colleagues point out in their paper, “Medicine today finds itself caught in a paradox. It has undoubtedly enjoyed many successes, and yet it is also the profession with the highest rate of suicide, a burnout rate greater than 50%, rampant depression, dwindling empathy, a negative view by the public, and a disturbing tendency for physicians to quit.”

“This conundrum has prompted a search for a more balanced way to train healing physicians who can maintain their ideals and better cope with the challenges of medical practice,” they add. “It has also led to a revisiting of the relationship between medicine and the humanities.”

Indeed, many universities have begun to incorporate courses in the performing arts, music, literature and the visual arts into their medical school curriculum. And ever-greater numbers of students with a humanistic undergraduate background are applying to — and being accepted by — medical schools. Research has shown that such students perform as well academically in medical school as their peers with undergraduate degrees in the sciences.

The positive and the negative

For the current study, Kahn and his colleagues surveyed 739 students at five medical schools across the country. (None was in Minnesota.) The survey, which took 45 minutes to complete, included questions designed to measure the students’ “active” and “passive” involvement in the arts, specifically painting (or other forms of visual arts), singing, playing a musical instrument, listening to music, dancing, writing for pleasure, reading for pleasure, attending theater, going to museums/galleries and attending concerts. 

It also included questions that are well-established measurements of positive personal qualities (wisdom, empathy, self-efficacy, tolerance for ambiguity and emotional appraisal) and negative qualities associated with well-being (physical fatigue, emotional exhaustion and cognitive weariness).

An analysis of the questionnaires’ data revealed a significant correlation between engagement in the arts and all five of the positive personal qualities. The strongest link was with wisdom, followed by appraisal of others’ emotions. The analysis also found a significant inverse correlation between engagement in the arts and all three negative components of burnout.

Basic components of professionalism

The study comes with many caveats. Most notably, it was an observational study, so it can identify only a correlation between the humanities and the traits measured, not a direct cause-and-effect. Also, the survey had a 24 percent return rate — double the average for external surveys, the authors point out, but still relatively low. The students who responded to the surveys may have differed from those who didn’t in ways that biased the study’s results.

“Nevertheless, our results suggest that the humanities do correlate with important physician qualities,” write Kahn and his colleagues. “Of interest, the three personal qualities that correlated most strongly with exposure to the humanities were tolerance of ambiguity, empathy, and wisdom. This is intuitive considering that the humanities are not only a way to teach compassion and tolerance, but also represent the wisdom of those who came before us. In fact, wisdom might very well be the single trait that encompasses all of those other traits which define a well-rounded doctor: empathy, openness to possibilities, emotional resilience, mindfulness, humility, altruism, a knack for learning from life, plus a cathartic sense of humor.”

“One could argue,” they add, “that some of the qualities we measured (tolerance for ambiguity, empathy, emotional appraisal of self and others, resilience) are, together with wisdom, fundamental components of professionalism. Hence, if we wish to create wiser, more tolerant, empathetic, and resilient physicians, we might want to reintegrate the humanities in medical education.”

It’s not a new concept, they point out. More than 100 years ago, the German physician and renowned public health advocate Rudolf Virchow encouraged his medical students to cultivate the humanities to avoid what today we call professional burnout.

“You can soon become so engrossed in study,” Virchow told the students, “then [in] professional cares, [then] in getting and spending, you may so lay waste your powers that you find too late with hearts given away that there is no place in your habit-stricken souls for those gentler influences that make life worth living.”

FMI: You can read the study on the Journal of General Internal Medicine’s website.

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