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The art of medicine: arts-based training in observation and mindfulness for fostering the empathic response in medical residents
  1. Joyce Zazulak1,
  2. May Sanaee2,
  3. Andrea Frolic3,4,
  4. Nicole Knibb5,
  5. Eve Tesluk6,
  6. Edward Hughes2,
  7. Lawrence E M Grierson1,7
  1. 1 Department of Family Medicine, McMaster University, Hamilton, Ontario, USA
  2. 2 Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, USA
  3. 3 Department of Anthropology, McMaster University, Hamilton, Ontario, USA
  4. 4 Office of Clinical and Organizational Ethics, Hamilton Health Sciences, Hamilton, Ontario, USA
  5. 5 McMaster Museum of Art, McMaster University, Hamilton, Ontario, USA
  6. 6 Department of Medicine, McMaster University, Hamilton, Ontario, USA
  7. 7 Program for Educational Research and Development, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, USA
  1. Correspondence to Dr Lawrence E M Grierson, Department of Family Medicine, McMaster University, David Braley Health Sciences Centre, 100 Main Street W., Hamilton, Ontario, L8P 1H6 Canada; griersle{at}


Empathy is an essential attribute for medical professionals. Yet, evidence indicates that medical learners' empathy levels decline dramatically during medical school. Training in evidence-based observation and mindfulness has the potential to bolster the acquisition and demonstration of empathic behaviours for medical learners. In this prospective cohort study, we explore the impact of a course in arts-based visual literacy and mindfulness practice (Art of Seeing) on the empathic response of medical residents engaged in obstetrics and gynaecology and family medicine training. Following this multifaceted arts-based programme that integrates the facilitated viewing of art and dance, art-making, and mindfulness-based practices into a practitioner-patient context, 15 resident trainees completed the previously validated Interpersonal Reactivity Index, Compassion, and Mindfulness Scales. Fourteen participants also participated in semistructured interviews that probed their perceived impacts of the programme on their empathic clinical practice. The results indicated that programme participants improved in the Mindfulness Scale domains related to self-confidence and communication relative to a group of control participants following the arts-based programme. However, the majority of the psychometric measures did not reveal differences between groups over the duration of the programme. Importantly, thematic qualitative analysis of the interview data revealed that the programme had a positive impact on the participants' perceived empathy towards colleagues and patients and on the perception of personal and professional well-being. The study concludes that a multifaceted arts-based curriculum focusing on evidence-based observation and mindfulness is a useful tool in bolstering the empathic response, improving communication, and fostering professional well-being among medical residents.

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  • Contributors JZ and MS led the study, facilitated data collection and wrote the manuscript. AF, EH, ET and NK participated in the critical formation of the research design. EH facilitated the participation of obstetrics and gynaecology residents. AF facilitated the dance portions of the programme. ET and NK facilitated the art observation portions of the programme. LEMG supervised all aspects of the project. All authors contributed to the critical revision of the paper, approved the final manuscript for publication, and have agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work were appropriately investigated and resolved.

  • Funding This project was generously supported through the Associated Medical Services (AMS) Phoenix Project Call to Caring Grant.

  • Competing interests None declared.

  • Ethics approval Hamilton Integrated Research Ethics Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.