Over the last academic year, GP teachers in the department have
been working together with our managers, admin colleagues, students and
trainees in small groups termed educational communities of practice (e-COPs).
One function of these groups has been to consider how we can improve and
develop our teaching and curricula including more of the student and crucially
the patient voice.
With this in mind, a small group of GP teachers, medical
students, trainees, managers and admin staff visited the Wellcome collection in
April for a special viewing of the works of Michele Angelo Petrone. Michele, a
professional artist, lived with Hodgkin's Lymphoma for over 10 years before he
died in 2007. He expressed his experiences as a patient living with this
disease through his artworks, many of which were painted in hospital to give
his hospital room life, colour and personality. This work formed the exhibition
Between Night and Day shown at Wigmore Hall , London in 1996.
One of the pieces that stood out for the group was a diary
Michele had kept during one hospital admission. He had written about how he
felt afraid of the other people on the ward as he saw in them his potential
future. This made us all reflect on how the patient’s environment and those
around them can have a huge impact on a patient’s comfort and emotional state.
Many of the pieces featured contrast and faceless figures. The
faceless figures were a poignant reminder to us as clinicians that too often we
can lose sight of the patient who ‘becomes’ their illness. Michele eloquently
expressed this when he said, “I need to
know that this body is my body. And I need to know everything that is happening
to my body. But most of all I need to know that you know that within my body
there is me”.
Throughout their time at medical school, students are asked
to consider the patient’s ideas, concerns and expectations (ICE). However,
despite these patient centred aspects being driven into students from the
earliest history taking sessions, it is well documented that over time empathy
declines at medical school and beyond (1,2).
Viewing these artworks and reflecting on what they seemed to be telling
us about how Michele must have felt living with his disease and going through
his treatments, highlighted just how important it is for us to help our
students to retain this quality and the important role humanities has in
helping us enrich the curriculum in this way.
We left this experience in reflective mood. Some of the
courses we offer at present (Year 3 Medicine in the Community (MICA) and the
Year 5 Integrated Clinical Apprenticeship (ICA)) give students the opportunity
to manage small case loads of patients providing continuity of care and
developing close rapport. We are also
starting to use the arts increasingly in how we ask students to understand and
reflect on patient experiences, such as on the ICA and the Health inequalities
SCM. The arts also feature in the Year 5 GP-Dermatology Course with students
interacting with works of clay, paintings and sculptures in the V+A with a view
to improving observational and tactile skills.
Now we have to consider, how else as educators, we can use
art in medicine to aid our students in remembering that our patients are human
beings, not their disease; “within my body there is me”.
It would be very interesting to hear from you about things
that you do in your teaching practice which contribute to this. Please do get
in touch: s.mountjoy@imperial.ac.uk
To view some of Michele’s works, please go to the following
link:
References:
1.
Derksen F, Bensing J, Lagro-Janssen A (2013) Br J Gen Pract, Effectiveness of empathy in
general practice: a systematic review. DOI: https://doi.org/10.3399/bjgp13X660814.
2.
Neumann M, Edelhäuser F, Tauschel D et al. (2011) Empathy decline and its reasons: a systematic review of studies
with medical students and residents. Acad
Med 86(8):996–1009.
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