May 6, 2016

The Art of Medicine: Penn GSE Med Ed visits the Philadelphia Museum of Art

Twenty-four physicians and health care providers from some of the nation’s best teaching hospitals walk through Philadelphia Museum of Art. For the last two years, these practitioners have been learning how to better educate the next generation of medical professionals in Penn GSE’s Medical Education Master’s program. 

This is the students’ last extended weekend session in the program, and CHOP physician leader Don Boyer wants them to engage in a day of experiential education. Boyer, the Med Ed program’s faculty advisor and Assistant Professor of Clinical Anesthesiology, Critical Care, and Pediatrics at the Perelman School of Medicine, has worked with program co-director and Penn GSE Senior Fellow Annie McKee to build a day where students will “question how we have arrived at our current level of understanding about medical education and think about the next steps forward.” Allison Ballantine, also a physician leader, is the program’s co-director and Associate Professor of Clinical Pediatrics at the Perelman School of Medicine. She, too, is excited for a day where students can “see what teaching looks like in different contexts.”

Matthew Palczynski, the art historian teaching them today, leads the students up the stairs to the modern art wing. He begins with an invitation to let go of their preconceived notions for the day, to be open and curious, to remember the feeling of going to a museum as a child, perhaps. I want you to embrace this experience.” 

The Med Ed cohort gathers around Manet to start their exploration into modern art history

As they gather around Manet’s 1864 painting “The Battle of the Kearsarge and the Alabama,” Palczynski explains that art historians unlock history and context for viewers. So, what to make of this painting of a battle between two ships?

Palczynski compares the avant garde in art with the vanguard in medicine. He explains the 19th century French Academy system, in which artists were trained in five genres, then given an official stamp from the government, denoting them as artists. Around the group, there are nods of recognition – the comparisons to their own profession more real than they might have imagined. Manet, he explains, was a system changer. “Manet is reminding you that what you’re looking at isn’t the battle,” he says, pointing out brush strokes and detail work in the painting. “He wants you to see what’s here, not what you think you’re looking at.”

Palczynski unpacks this in the context of medicine, as he explains how we bring cognitive bias whenever we examine an object – or a patient. “We push onto an object all sorts of things we expect or want to see,” he says. “Be careful, Manet reminds us, not to project onto something or someone, convincing yourself you’re seeing something that’s not there.”

<> <> <>

This may not seem like a traditional graduate class experience. But Annie McKee said it’s a critical component of expanding students’ understanding of the many ways people learn. The program’s structure, she explains, emphasizes experiential and non-traditional learning environments. 

When Boyer met Palczynski and heard about the work he did with Wharton’s executive programs, using art to teach about creativity and innovation, he immediately thought of bringing him to Med Ed. “We spend two years in the Med Ed program giving leaders in medical education the tools necessary to expand their skills in medical education, largely sharing proven strategies and using established methods,” he said. “The idea of aiding them in thinking creatively and helping them think ‘outside the box’ was very appealing to me to round out their other class experiences.”

McKee echoes Boyer’s sentiments. “The in-depth exploration of the evolution of modern art enables us to see how emotion, intellect, and societal norms all impact what we perceive and what we believe,” she said. “We’re discovering that ‘facts’ are sometimes deceptive and truth is relative. This is an important lesson for our students, who are physicians or health care providers charged with educating in a diverse and rapidly changing environment.” 

<> <> <>

As the group moves to a junction in the hallways, where the focal piece is Cézanne’s 1905 painting “The Bathers,” Palczynski asks the group to sit on the floor, looking up at the large painting. Throughout the morning, his lecture is sprinkled with pro tips on understanding art, and here, he notes that museum architecture is deliberate – this painting is at a literal junction, situated at the end of a hall on an artery of the wing. 

Palczynski asks students to describe what they see in Cézanne's "The Bathers"

Museums and collectors, he explains, are always on the lookout for the leaders in the field. Where Manet left off, Cézanne picks up the torch, pushing modernism a step further from realism. “What are you doing in your field to make sure you’re keeping up with innovations?” he asks. “Stay aware. We don’t practice Renaissance medicine anymore, do we?” The group laughs. 

He asks the group to describe what’s happening in the painting, where it appears a group of nude women are bathing by a lake. As they talk about what they see, and how viewers of the painting may be peeping on a private scene, Palczynski questions the gaze of the viewer. It’s a perfect opportunity to introduce Michel Foucault’s The Birth of the Clinic: An Archaeology of Medical Perception, the French philosopher’s concept of the medical gaze.

“When a patient enters the clinic, the patient becomes an object, subject to the gaze of the doctor, who holds the power,” Palczynski explains. “You, as the physician, are looking at that patient with a through the lens of a power relationship, which makes it all the more important that you are aware of the biases you bring into the room. How quickly are you making an evaluation, and what are you seeing—or believe you are seeing—that’s influencing the judgment you’re making?” Ultimately, as he explains Foucault’s theory, the physician holds tremendous authority in this relationship. “When you see a patient, you might sense that something’s not right,” he says, “but how are you figuring out, mindful of the power you hold, the context your patient is in, and how your own biases might influence your interpretation?”

The group moves on, looking at the transition from Cézanne to Picasso, Picasso to Mondrian, and so on. Just as in scientific research, they learn, art is all about innovation, about finding ways to do something that hasn’t been done before.

In the afternoon, the group returns to Penn’s campus, where the experiential learning of the field trip to the museum gives way to a classroom lecture and group discussions. Palczynski introduces Andy Warhol and the advent of identity in art. They learn about the cultural structures art addresses and critiques, from race to gender to sexuality. And they discuss many overlapping historical connections between science and art, from collections of specimens to phrenology and genotyping.

Back in the classroom, the students discuss new directions in art

Med Ed student Lisanne Hauck, an Attending Physician in Pediatrics at Hackensack University Medical Center in New York, was so appreciative of Palczynski’s expertise. “This day opened me up to seeing so much more than I ever had,” she said.

Throughout the day, this cohort of medical educators experienced a variety of learning structures, from collaborative and experiential discussion in the museum to traditional lecture to developing examples and questions in small groups.

Boyer hopes these soon-to-be graduates take away a series of questions at the end of their program. “What is working in our field, in medical education? What is not working in our field?” he asks. “How do we build on what is working and optimize (or abandon) what’s not working? What are the next big questions to answer in medical education? And how can each student play a role in the evolution of our field?”  

The executive-style Med Ed program means students continue to work during the program, meeting at Penn for select long weekends throughout the year, participating in online sessions from home, and continually applying learning into practice. This cohort graduates in May, and after spending a day with an expert art historian and master teacher, they’ll leave Penn GSE with a new perspective on art and their profession.