{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:09:54Z","timestamp":1772168994483,"version":"3.50.1"},"update-to":[{"DOI":"10.12688\/mep.20112.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T00:00:00Z","timestamp":1724284800000}}],"reference-count":22,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T00:00:00Z","timestamp":1724284800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["mededpublish.org"],"crossmark-restriction":false},"short-container-title":["MedEdPublish"],"abstract":"<ns3:p>Background One recent trend in medical education is the integration of humanities into the curriculum, including viewing works of art in museums, with analysis of short-term, but not long-term, impact. We developed a course for medical students, trainees, and faculty at the Icahn School of Medicine at Mount Sinai co-taught by an art historian and a physician\/medical historian that features images of great works of art to make connections between art and medical history with the following goals: 1. To encourage the students to make careful and systematic observations, describe what they see to others in the group, and exchange their views respectfully, 2. To sensitize students to the patient\u2019s experience of illness by discussing artists\u2019 depictions of patients and the impact of their illness on family and friends, and 3. To highlight milestones in medical history by focusing on artworks that epitomize the state of medical care and science at a defined point in time. We have taught the course for more than a decade and so wanted to assess whether participating in the course had a long-term impact. Methods We created and deployed a five-question survey to 167 students and received responses from 35 of those students. Results 97% of respondents answered that they still think about the course, and large majorities of the respondents indicated that the course, had an impact on how they viewed works of art (91%), their appreciation of the history of medicine (89%), and their observational skills (80%). More than half the students responded that the course sensitized them to the patient\u2019s perspective of illness (63%) and had an impact on how they viewed their role as a physician (51%). Conclusions Our course has had a long-term impact on the respondents across a wide range of professional and personal characteristics.<\/ns3:p>","DOI":"10.12688\/mep.20112.2","type":"journal-article","created":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T06:57:27Z","timestamp":1724309847000},"page":"51","update-policy":"https:\/\/doi.org\/10.12688\/mep.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Long-Term Impact of a Medical School Course on the Intersection of Art and Medical History"],"prefix":"10.12688","volume":"14","author":[{"given":"Bobbi G.","family":"Coller","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel","family":"Slamovits","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9078-7155","authenticated-orcid":false,"given":"Barry S.","family":"Coller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2024,8,22]]},"reference":[{"key":"ref-1","article-title":"The humanities and medical education.","volume":"51","author":"V Medvei","year":"1947","journal-title":"St Bartholomews Hosp J."},{"key":"ref-2","doi-asserted-by":"publisher","first-page":"1378-1383","DOI":"10.1097\/ACM.0b013e3181dbf22a","article-title":"Challenging traditional premedical requirements as predictors of success in medical school: the Mount Sinai School of Medicine Humanities and Medicine program.","volume":"85","author":"D Muller","year":"2010","journal-title":"Acad Med."},{"key":"ref-3","doi-asserted-by":"publisher","first-page":"1015-1019","DOI":"10.1097\/00001888-200310000-00015","article-title":"The medical humanities program at the university of Manitoba, Winnipeg, Manitoba, Canada.","volume":"78","author":"B Magwood","year":"2003","journal-title":"Acad Med."},{"key":"ref-4","doi-asserted-by":"publisher","first-page":"1006-1009","DOI":"10.1097\/00001888-200310000-00013","article-title":"Medical humanities at the university of Texas medical branch at Galveston.","volume":"78","author":"A Jones","year":"2003","journal-title":"Acad Med."},{"key":"ref-5","doi-asserted-by":"publisher","first-page":"1039-1042","DOI":"10.1097\/00001888-200310000-00021","article-title":"The humanistic medicine program at the Karolinska Institute, Stockholm, Sweden.","volume":"78","author":"R Ahlzen","year":"2003","journal-title":"Acad Med."},{"key":"ref-6","doi-asserted-by":"publisher","first-page":"973-976","DOI":"10.1097\/00001888-200310000-00006","article-title":"The program in medical humanities at the university of Missouri-Kansas city school of medicine.","volume":"78","author":"M Sirridge","year":"2003","journal-title":"Acad 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communication programs improve physician wellness and mitigate physician suicide?","volume":"34","author":"J Genovese","year":"2016","journal-title":"J Clin Oncol."},{"key":"ref-21","article-title":"National plan for health workforce well-being.","year":"2022"},{"key":"ref-22","article-title":"Healing arts New York launch event: the arts and wellbeing."}],"container-title":["MedEdPublish"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/mededpublish.org\/articles\/14-51\/v2\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/mededpublish.org\/articles\/14-51\/v2\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/mededpublish.org\/articles\/14-51\/v2\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T05:40:10Z","timestamp":1724910010000},"score":1,"resource":{"primary":{"URL":"https:\/\/mededpublish.org\/articles\/14-51\/v2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,22]]},"references-count":22,"URL":"https:\/\/doi.org\/10.12688\/mep.20112.2","relation":{"has-version":[{"id-type":"doi","id":"10.12688\/mep.20112.1","asserted-by":"subject"}],"has-review":[{"id-type":"doi","id":"10.21956\/mep.22059.r38505","asserted-by":"subject"},{"id-type":"doi","id":"10.21956\/mep.22059.r38506","asserted-by":"object"},{"id-type":"doi","id":"10.21956\/mep.22059.r38505","asserted-by":"object"},{"id-type":"doi","id":"10.21956\/mep.22059.r38504","asserted-by":"object"}]},"ISSN":["2312-7996"],"issn-type":[{"value":"2312-7996","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,22]]},"assertion":[{"value":"Indexed","URL":"https:\/\/mededpublish.org\/articles\/14-51\/v2#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.21956\/mep.22059.r38505, Vincenza Ferrara, Sapienza University of Rome, Rome, 29 Aug 2024, version 2, indexed","URL":"https:\/\/mededpublish.org\/articles\/14-51\/v2#referee-response-38505","order":0,"name":"referee-response-38505","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/mep.21537.r38112, Ian Sabroe, The University of Sheffield, Sheffield, England, 09 Aug 2024, version 1, 3 approved with reservations","URL":"https:\/\/mededpublish.org\/articles\/14-51\/v1#referee-response-38112","order":1,"name":"referee-response-38112","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Barry Coller<\/b>; \n<i>Posted: 16 Aug 2024<\/i>; We thank Dr. Sabroe for the review and for supporting our desire to evaluate the impact of our course. I applaud the desire to evaluate their course, and am interested to read the results.  \n<b>Reviewer\u2019s comment:<\/b> I wish the authors had not used leading questions in their survey to the extent that they have. Although the questions are open and inviting comment, they do have a leading nature by directing the respondents to consider the course and then their observational skills, physician role, etc. The questions could have focused more on lasting aspects without tying them to specific parameters, in order to generate a more open, unstructured reflection.  \n<b>Response:<\/b>&nbsp;We did not intend for our questions to be \u201cleading,\u201d and we appreciate Dr. Sabroe\u2019s acknowledging that the questions are \u201copen and inviting comment.\u201d Dr. Sabroe suggests that we could have focused more on \u201clasting effects without tying them to specific parameters in order to generate more open, unstructured reflection.\u201d We agree that an open request for \u201clasting effects\u201d would allow for broad reflection, but we were specifically interested in knowing whether we achieved our goals and so we tried to obtain this information by asking questions that we thought were presented in a neutral fashion. We balanced this by providing respondents an opportunity via open text to express unstructured thoughts and reflections. We also were concerned that fully unstructured questions would present significant analytical challenges. &nbsp;  \n<b>Reviewer\u2019s comment:&nbsp;<\/b>I am also concerned about one line in the methods, where \u2018students who answered yes\u2019 to a question were invited to add free text to explain their answers. If people answered \u2018no\u2019, their reflections on the course and question would be equally valid and useful or important to capture.  \n<b>Response:<\/b>&nbsp;We appreciate Dr. Sabroe\u2019s comment, but we didn\u2019t think that, for example, people who do not still think about the course would be interested in explaining why they no longer think about it. In addition, we did provide an opportunity for free text about anything they would like to add.  Regarding the data generated, as the authors note the numbers of responses are relatively small. Surveys were sent to 167 students (which would appear to be all\/most of those taking the course over 10 years) and responses were from 35 students. The limitations of this small sample size are clearly acknowledged, and the limitations of the study appropriately discussed. We, of course, would also have preferred a high response rate, but we felt that the 35 responses provided sufficiently valuable information to justify reporting our results. We appreciate Dr. Sabroe\u2019s acknowledgement that we were transparent in reporting the response rate and noting the limitations of our study.  \n<b>Reviewer\u2019s comment:&nbsp;<\/b>Of those who responded, there are warm responses towards the aims of the course and positive recollections of it presented. (I note again that the survey did have somewhat leading questions, which provide a potential bias.) A series of \u2018selected quotes\u2019 are presented, without being clear how such quotes were chosen. Whilst it\u2019s clear that the course had a very positive impact on some respondents, there\u2019s a risk of selection bias in the choice of quotes presented in the main paper.  \n<b>Response:&nbsp;<\/b>The only \u201cselection\u201d of the quotes was based on whether the respondent did or did not give permission for the publication of their de-identified comment. The table and spreadsheet uploaded to Zenodo contains all of the responses that the respondents agreed to allow to be published. The following sentence has now been added under \u201cData analysis\u201d describing the compilation of the statements. All free text statements added by respondents who agreed to allow their responses to be published were compiled and are reported in Table 4. The discussion of the data generated acknowledge the positive results gained and some of the limitations of the study.  \n<b>Reviewer\u2019s comment:&nbsp;<\/b>It would perhaps also be useful to set the discussion of this course a bit more in the overall offering of the School, and the importance it attaches to humanities-based options. Students who took this module may have also been influenced in how they viewed this particular module by participation in other courses, e.g. in narrative medicine. It\u2019s too late to explore whether there were any mutual interdependencies\/reinforcements between courses in the survey, but briefly discussing the School\u2019s overall humanities offerings and attitudes to them might add value.  \n<b>Response:&nbsp;<\/b>&nbsp;We have now added the paragraph below into the Discussion in response to Dr. Sabroe\u2019s suggestion. We did not assess mutual interdependence\/reinforcements between courses with questions in the survey, in part because we did not consider this possibility, but also because we wanted to keep survey as short and simple as possible so as to increase the response rate while trying to obtain the most information. The Icahn School of Medicine has been a pioneer in integrating Humanities in Medicine through a rich set of offerings to medical students. The school also created a \u201cHumanities and Medicine\u201d admissions process under Dean Nathan Kase\u2019s leadership in 1987 to better enable students with a strong interest in the humanities to become physicians. Currently, the humanities offerings are under the auspices of the Academy for Medicine &amp; the Humanities. In addition to the Pulse of Art, the Academy offers a number of courses in creative writing, music, history, the social sciences, and the visual arts. The Academy also sponsors mentored research opportunities, which include students creating courses for other students. The school also allows students to fulfill their research graduation requirement by participating in a Medical Humanities Scholars Track.  \n<b>Reviewer\u2019s comment:&nbsp;<\/b>A minor point, but in the supplemental materials, one link (reading and misreading faces) needs a proper link direct to the source material.  \n<b>Response:&nbsp;<\/b>Thank you for letting us know. We have fixed the link.  As a point of discussion, the final paragraph of the discussion causes me to wonder how we present the importance and benefit of such courses.  \n<b>Reviewer\u2019s comment:&nbsp;<\/b>I cannot conceive of a future in which the practice of medicine will be easy. It will always be challenging, acutely and over a lifetime. I am all in favour of all wellness programmes. I support approaches that can positively impact on the lifetime stress of our career, as well as those that offer diverse ways of learning about illness. I think we should be incorporating humanities-based learning, knowledge and wisdom into training and practice as part of a standard to support clinician learning, practice, identity formation and wellbeing, for the benefits of our patients, societies, and ourselves. But\u2026 I believe the work of addressing clinician distress and burn-out requires deep reforms of working practice, clinician support etc, and that the work of creating more sustainable, survivable careers is to some degree an independent (and great) problem.  \n<b>Response:&nbsp;<\/b>We share Dr. Sabroe\u2019s view that clinical distresses and burn-out requires structural reforms of many aspects of medical training and practice, and that much of this is independent of courses like ours. At the same time, even though we did not explicitly provide questions about burn-out or wellness, several spontaneous comments indicated that at least for some of the respondents, the time in our course provided an antidote to the stresses of their medical responsibilities, and we were struck by similar comments about humanities courses in the literature. Thus, since we recognize the need for a holistic approach to physician well-being, we think it worth exploring how courses like ours can contribute to that goal.","URL":"https:\/\/mededpublish.org\/articles\/14-51\/v2#referee-comment-3558","order":2,"name":"referee-comment-3558","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/mep.21537.r38111, Amanda Swain, Department of Family Medicine & Community Health, University of Pennsylvania, Philadelphia, 09 Aug 2024, version 1, 3 approved with reservations","URL":"https:\/\/mededpublish.org\/articles\/14-51\/v1#referee-response-38111","order":3,"name":"referee-response-38111","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Barry Coller<\/b>; \n<i>Posted: 16 Aug 2024<\/i>; We thank Dr. Swain for the careful review and appreciate her identifying the need for data on the longitudinal impact of medical humanities as a strength of our manuscript. I have a few comments\/suggestions below for the authors:  \n<b>Reviewer\u2019s Comment:<\/b> I recommend an editor review the piece. There are many run-on sentences that make sections hard to read.  \n<b>Response: <\/b>We would be pleased to review any sentences that Dr. Swain or an editor thinks needs revision. &nbsp; \n<b>Reviewer\u2019s Comment:&nbsp;<\/b>The very first sentence is misleading. Medical humanities education is not a recent trend, it has been used in US medical education for 20+ years and much longer in European medical schools. I suggest this sentence is adjusted to reflect this fact.&nbsp;&nbsp;&nbsp;&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp; \n<b>Response: <\/b>We thank Dr. Swain for the suggestion. We have modified the sentence accordingly. It now reads as indicated below. &nbsp; Calls for integration of the humanities into medical education go back at least to the 1940s, but judging by PubMed citations, there has been a dramatic increase in interest and scholarship in this area during the past two decades. &nbsp; \n<b>Reviewer\u2019s Comment:&nbsp;<\/b>&nbsp;I think the questionnaire to alumni would have benefited from a Likert scale. The yes\/no questions limit the utility of the information collected. I realize this data has already been collected, but in a methods section it would be helpful to discuss why they decided on yes\/no vs something more detailed. I think this deficit could have been made up for by a content analysis of the answers (if there had been more of them).  \n<b>Response: <\/b>Dr. Swain makes a good point. In reflecting on our choice of yes\/no answers, we believe it derived from our sense that most of the answers to the questions would be binary, such as whether they still think about the course. We acknowledge that some of the others may have lent themselves to Likert scale assessment and will consider this for future research. &nbsp; &nbsp; \n<b>Reviewer\u2019s Comment:&nbsp;<\/b>If the authors are going to comment on burnout it makes more sense to do so earlier in the article and then circle back to it in the discussion section.  \n<b>Response:&nbsp;<\/b>We thank the reviewer for the suggestion, and we have now added the sentence below in the Introduction. Although not one of our stated goals, in the course of our analysis we noted that a number of respondent comments touched on the issue of physician burnout and wellness, a subject that has been a focus of recent attention, and so we briefly discuss the potential of courses like ours to contribute to physician wellness. &nbsp; \n<b>Reviewer\u2019s Comment:&nbsp;<\/b>Curious if the authors plan to use any of the data collected for this article to make changes to their current course.  \n<b>Response:&nbsp;<\/b>Based on the comments related to wellness, we are thinking about how to modify our course or create a related course that focuses more on this important issue. We now plan to ask specifically about wellness in our course survey.","URL":"https:\/\/mededpublish.org\/articles\/14-51\/v2#referee-comment-3559","order":4,"name":"referee-comment-3559","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":5,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}