Empathy and cultural competence remains stable for medical students: do the humanities have an effect?

There is a paucity of rigorous longitudinal data regarding the relationship between humanities and their effect on multiple psychometrics. Using an observational art course, we assessed pre- and post-course metrics and longitudinal impacts with 120 preclinical medical students taking the "Art of Observation" between 2016 and 2019. Jefferson Scale of Empathy (JSE) and Jeffreys Transcultural Self-Efficacy Tool (TSET) were assessed annually for four years. Budner Tolerance of Ambiguity (TOA) Scale was administered before and after the course. The JSE showed no drop in empathy as students progressed from first to fourth year (p = 0.374). The TSET showed statistically significant increases in cultural self-efficacy (p < 0.001) in the cognitive and practical components but no change in the affective component of the scale. After the art course, TOA significantly improved on two [solubility (p = 0.009) and complexity (p = 0.21)] of the three subscales, but not novelty (p = 0.62). Empathy and cultural self-efficacy remained consistently high throughout medical school and did not decrease during the clinical years in an institution prioritizing the humanities and community engagement. Comfort with cultural competency generally improved throughout training. After taking an art course that emphasizes cognitive flexibility and a multiple perspectival approach, students demonstrated greater tolerance for ambiguity.