A Visual Arts Activity to Support Residents as They Care for "Difficult Patients"

Background Certain patients significantly challenge the care team, increasing the risk of burnout as clinicians struggle to perform their best work while meeting the needs of their patients. Imagining another's perspective, a clinical empathy skill, can increase compassion and lower distress when interacting with these patients. Objective To evaluate the effectiveness of an art-based perspective-taking activity on clinicians' feelings of discomfort when anticipating encounters with challenging patients. Methods This museum-based session was conducted from 2017 to 2022 (virtual sessions in 2020) by faculty trained in using arts-based methods to teach. Residents (n=142) in a university-based internal medicine residency program along with health professionals, trainees, and faculty (n=12) attending an international conference were invited to participate. Participants recalled a challenging patient, chose a piece of art that might be meaningful to this person, and discussed their choice and insights gained. Participants completed pre-post ratings of anticipated discomfort. Inaugural participants submitted written reflections on these ratings. Data were analyzed using paired t tests and content analysis. Results Five 90-minute sessions were conducted with 65 internal medicine residents and 12 faculty; 75 of 77 total participants completed pre-post discomfort ratings (response rate 97.4%). Anticipated discomfort decreased after sessions (mean pre=5.38; post=4.13; P<.01). Open-ended responses aligned with a transition from self to other focus in perspective-taking. Costs were minimized by using art from a campus museum, paper and pencil surveys, and faculty academic time. Conclusions This innovative visual arts-based activity to increase empathy for challenging patients is simple, feasible, self-contained, and cost-effective.