Perspective: acts of interpretation: a philosophical approach to using creative arts in medical education

Medical educators have used the visual arts for a variety of instrumental purposes, such as sharpening trainees' skills in observation, description, critical thinking, and communication. The arts have also served as means to more humanistic ends-that is, as a mode of self-care for house officers coping with grief and as a medium for reflecting on the meaning of illness and the nature of doctoring. More generally, art can serve as an expression of identity, as a form of social critique, and as a means to develop a sense of community of shared values. At the University of Michigan Medical School, the creation of original artwork (visual or otherwise) has been a major part of the Family Centered Experience, a longitudinal learning activity based on the stories that patient-volunteers tell of living with chronic illness. The purpose of this article is to explore how the creation of original art may serve as concrete evidence of the types of tacit learning and understanding that students gain through human interactions in medicine. The evidence of learning is not achieved via behaviorist notions of "demonstrating competence"; instead, student interpretive projects are visual or musical expressions of the affective, experiential, cognitive, and existential lessons students have learned through their long-term relationships with patient-volunteers. The overall aim of this article is to provide additional theoretical foundations, as well as practical information, that may guide the incorporation of the humanities and arts into the training of physicians.