The Power of Perspective: Palliative care physicians Gordon Wood and Joshua Hauser on teaching with museums

Since its January 2022 exhibition, A Site of Struggle: American Art against Anti-Black Violence, The Block Museum has partnered with Feinberg School of Medicine palliative care physicians Gordon Wood and Joshua Hauser in an interdisciplinary collaboration that foregrounds the use of art in educating medical professionals. Following their June gallery talk, Perspectives on Art, Medicine, and Palliative Care in “The Heart’s Knowledge,” we sat down with Drs. Wood and Hauser to explore their partnership with The Block and the capacity of art to teach scientifically-minded professionals things that standard classroom learning cannot.

 How did you come to incorporate art museum teaching into your instruction of medical professionals?

Dr. Wood: I went to a training through the Harvard Macy Program for Educators in Health Professions, and they had an optional session at the Museum of Fine Arts in Boston. They had been doing work in the museum with their medical students in the Harvard program for a little while. I went to that session, was very interested in it, and met with the teacher afterwards to think about how they were doing the instruction and how I might try it, because I thought it would really resonate with the trainees that I work with who are learning to be palliative care physicians.

I came back home and experimented with our trainees who are learning to be palliative care physicians, and found it really powerful. I decided I wanted to learn more about how to do this teaching. They were starting the Art Museum-based Health Professions Education Fellowship through the Harvard Macy Program and I was a Design Partner Fellow.  There I met some collaborators and we have since formed a sort of collaborative of palliative care educators from Northwestern, Harvard, Yale and Emory as the core group, who all do this type of teaching and have published about it and presented about it at our national meetings.

Dr. Hauser: My colleague, Gordon Wood, has been working in museum-based education for quite a few years now, with colleagues from Harvard Medical School, Yale School of Medicine, and Emory School of Medicine. And through Gordon, I’ve had the chance to engage in a number of activities using museum-based education for medical professionals: physicians, nurses, social workers, chaplains and our fellowship trainees. These activities have a couple of goals: One is to help us think about observational and perspective-taking skills. Number two is thinking of museums as a vehicle to help build teamwork and empathy.

And so, with Gordon, we designed a number of activities for our fellows (physicians who have just finished residency training) and other colleagues here in Chicago at the MCA, the Museum of Contemporary Art. We’ve also done this several times for an even broader audience through a national conference called the American Academy of Hospice and Palliative Medicine in Boston and a couple other cities as well.

We got in touch with The Block about a year-and-a-half ago in connection with the exhibit A Site of Struggle: American Art against Anti-Black Violence. We used the occasion of that exhibit to have a retreat for our palliative care team, in which the Block team helped facilitate a reflective conversation with us about the impact of this art on ourselves and on our work.

It might seem counterintuitive, why teach scientifically-minded people with art?

Dr. Wood: So for me, there are things that people practicing in palliative care need to learn that are hard to teach in a classroom. In a classroom, it’s easy to teach how to dose a medication or something like that, but it’s harder to teach an appreciation for multiple perspectives or the importance of stopping and reflecting – both for your own self-care and for the care of the patient.

Our fellows work in teams with social workers, chaplains, nurses, advanced practice providers, doctors and other professionals and they do that because patients with a serious illness may be suffering not just physically, but emotionally, practically and spiritually. The risk is that they see a patient with this sort of complex suffering and they only see the physical pain, and they have sort of premature closure where they assume they know what’s going on with this patient and think that they will be better if they just change the dose of their pain medicine. But if they can slow down and get input from their other team members, and understand the multidimensional nature of the patient’s suffering, they can care for them better.

So, in the museum, by looking at a piece of art in a group and having other people notice things in the piece of art and having their understanding of the piece of art evolve over a discussion, they come to these insights. “Wow, I had one idea when I started looking at this that grew as I heard from other people and we spent a long time looking at this piece of art, and now I understand it much better.” They can make analogies from that to their practice where they learn that they need to slow down and get input from their team to truly understand what’s going on with their patient and how they can best help them.

The other piece of this is this idea of a “third thing” in medical education, which a physician named Liz Gaufberg has written about. The idea there is that you can also use art to talk about hard things, because it can be difficult to have a student and say, for example, “Let’s talk about death and dying. What are your thoughts on that?” But if you have a piece of art that speaks to that, and you can speak about it through a discussion about the piece of art, that third thing makes it easier to broach some of these more difficult subjects like their own experiences caring for people facing the end of their lives.

Dr. Hauser: An answer – but not necessarily the answer – is that there’s so much that is non-scientific that goes into patient care, especially in the setting of serious illness, which is the setting in which we take care of patients in palliative care. We consider topics of how we connect with this person in front of us, how we develop empathy and how we appreciate very diverse perspectives. We must consider someone who’s suffering from an illness, their family members, and even the  physicians,  nurses, and others caring for them.

This ability to help create new perspectives and reflect is also true, I think, of other humanities, and we work a lot with some of the written humanities. We work with poetry in medicine and narrative in medicine, for example. Our experience is that the use of those media, visual arts and narrative, can be a way to help cultivate different viewpoints and a tool to help us reflect in ways  that a more focused scientific approach can’t be.

Of course, those things go together: It’s important to understand, and to know, and to be well-versed in the science of the work we do in medicine. But, for some of the connective elements of what we do, some of the empathic elements and some of the more ephemeral elements, I think, the visual arts and the written arts can be really important ways to do that.

Can you tell me a bit about your partnership with The Block?

Dr. Wood: Our first partnership with the Block Museum came around A Site of Struggle: American Art against Anti-Black Violence. We were trying to think about how to teach about racism and bias and its impact on patients’ healthcare and healthcare experiences. We became aware of this exhibit at The Block, and worked with the team to plan how we could use A Site of Struggle to think about these topics. We brought our team of doctors, nurses, advanced practice providers, social workers, and chaplains, and spent some time in the museum, and found it was a helpful way to open a discussion about these topics.

Based on that experience, we have had subsequent partnerships. We brought members of our team up for The Heart’s Knowledge: Science and Empathy in the Art of Dario Robleto. We had the opportunity to work with Dario, the artist, to think about his exhibit and what it has to teach us about our role and the intersection of art and medicine. That was a really powerful experience to have the artist there. And that led to a gallery talk that Josh Hauser and I did with that same exhibition, which was a nice opportunity to engage with the community and think about the role museums could play and helping us all think about these issues.

Dr. Hauser: We’ve always tried to think of how we at the medical school can connect with other parts of Northwestern. I think what is really remarkable about it for me, and I think for Gordon as well, and for all of us, is how open, and innovative, and generous Erin Northington and others at The Block have been with this partnership.

Last summer, we had a several hour retreat for members of our team with Dario, using his art to help us reflect on the work that we do as physicians and healthcare professionals. Erin also invited Gordon and I to be do a gallery talk. And so, Gordon and I as two physicians, and two real neophytes, got to reflect a little bit at a gallery talk with an even broader audience of the general public.

We do a lot of our education in the hospital. We do a lot of our education in the classroom. To be in a museum was a special treat for us.

There’s a parallel in your own practice and Dario’s in the way that they bridge a gap between art and science that, to many, might seem unbridgeable – can you speak to your experience with Dario’s work and its similarity to your own?

Dr. Wood: Dario’s work thinks about science and the questions that it raises about the human experience. I think he does a lot of work to think about what something scientific, like an EKG rhythm, has to tell us about what it means to be human, and the issues that it raises and questions that we should grapple with. I think similarly, while a lot of what we do in palliative care is about science and treatments for illnesses, there is also a lot of attention to larger questions. “What does this all mean for the patient as a person and their family and their experience and their legacy?” I think that’s where I see the overlap with Dario’s work. We’re both thinking about science, but also what does this mean about people, human experiences, how do we grapple with all that?

Dr. Hauser: One of the things that I saw in Dario’s work is an artistic version of “evidence” that parallels what we often call “medical evidence” – for example, an EKG tracing or a sound recording of a heartbeat – some piece of evidence or manifestation of something that’s really abstract and ephemeral, i.e., a heartbeat. And, what’s interesting is that that’s what medicine does all the time: it tries to make something concrete that’s really ephemeral.

In medicine, many pieces of evidence, such as an EKG tracing, an echocardiogram, i lab values, for example, all help us diagnose an illness and ultimately treat an illness.   Those are all pieces of evidence that we derive in medicine to help us understand what’s happening in a body. Dario was doing a parallel thing with his pieces of art. His versions of recorded heartbeats were reflective of the more human experience of illness. Those were pieces of art, but they were attempts to make something that’s very ephemeral, a little bit more real and able to connect with, which is what doctors do.

What do you think the future of this work looks like for you?

Dr. Wood: What I hope we can do is look more at the impact of this work on our trainees. Earlier this week, we actually brought a group of trainees to the museum. And at the end, we asked them one thing they’re going to do differently afterwards. They have amazing insights and things that I think that they’ll do to slow down, hear from their colleagues, reflect on their practice, and avoid premature closure on their assessments. I think people take these messages into their practice, but it would be incredibly powerful to show, in a more rigorous way, that they carry these aspirations forward.

Museum-based education has already been shown to be impactful in multiple areas for medical trainees and I think there’s an opportunity to add to this body of knowledge by examining how this teaching affects the practice of our particular population of learners in Palliative Care.

Dr. Hauser: I’m open and optimistic. This is an area of a lot of interest in this topic in medicine nationally. There are colleagues at Harvard Medical School who do a lot of this work – they have been teachers of mine and teachers of Gordon’s. I’ll be part of a course that they’re doing this fall and winter about the use of the visual arts, and medicine, and museum-based education. As part of that course, participants develop a project to do at their home institution, and I hope to work again with The Block.

I could imagine continuing what we’ve already done, which is a yearly retreat for our fellows and our palliative care team, but then, expanding that to include medical students, who are an important population whom we teach. I could imagine including other colleagues who are not in palliative care: colleagues in internal medicine,  pediatrics, surgery, psychiatry and other fields

I’m not sure exactly what the future holds, but I know based on the strength of our partnership, there will be a number of things that we will continue to do together.

Joshua Hauser, MD, Palliative Medicine Fellowship Director

Joshua Hauser is Associate Professor of Medicine and Medical Education and Palliative Medicine Fellowship Director at Northwestern Feinberg School of Medicine. He practices clinically at Northwestern Memorial Hospital and the Jesse Brown VA Medical Center, where he is section chief for palliative care. Dr. Hauser has had a career-long interest in palliative care education and directs the Education in Palliative and End of Life Care (EPEC) Program, a 20-year-old train-the-trainer program designed to teach primary palliative care skills to clinicians of all disciplines and backgrounds. In addition to general palliative care education, Dr. Hauser has educational interests in medical humanities and bioethics and overall professional development for medical students and trainees of all levels. The Poetry for Veterans project he started has led to a medical humanities seminar at Northwestern, a joint staff-patient poetry discussion series at the Jesse Brown VA, a paper in Journal of Palliative Medicine and was featured in an article in the Wall Street Journal.

Gordon Wood, MD, Palliative Medicine Fellowship Associate Director

Gordon J. Wood, MD, MSCI, FAAHPM is Associate Professor of Medicine and Medical Education in the Section of Palliative Medicine at Northwestern University Feinberg School of Medicine. He is Associate Program Director for the Northwestern University fellowship in Palliative Medicine and serves as Associate Director of the Education in Palliative and End-of-Life Care (EPEC) Program. He is also a Strategic Partner with VitalTalk, a nonprofit at the forefront of improving serious illness communication. In collaboration with a group of educators from across the United States, Dr Wood has helped pioneer the use of museum-based education (MBE) in Hospice and Palliative Medicine (HPM) training. He was a design partner fellow for the Harvard Macy Museum-based Health Professions Education Fellowship and has used MBE techniques to help teach Chicago-area HPM fellows over the last 9 years.  He has published on the use of MBE in HPM education and presented this work nationally and internationally. 

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