Having medical students participate in a museum-based art program designed specifically for patients with dementia and their caregivers can instill more positive attitudes and perceptions about the disease, new research shows.
"A day at the museum might be a wise prescription for helping students become compassionate doctors and giving them a better understanding of how patients and caregivers continue their relationships and quality of life despite their diagnosis," study author James M. Noble, MD, MS, from Columbia University Medical Center in New York City, said in a statement.
The study was published online July 29 in Neurology.
Art Therapy
Many large metropolitan areas have well-established art museum programs for patients with dementia and their carers. Dr Noble and Columbia medical student Hannah J. Roberts had 19 first-year medical students attend a single 90-minute session of one such program offered by the Metropolitan Museum of Art, the Cloisters Museum, the Studio Museum of Harlem, or the New York Historical Society.
The programs use trained staff to engage patients with dementia and caregivers in dialogue within museum galleries and in the studio while they make their own art creations. Each medical student worked with a group of patients with dementia and caregivers (6 to 10 pairs) and participated in all program activities including gallery discussions and art projects.
The students were aged 21 to 29 years, 14 were women, a little more than half had a relative with dementia, and 1 had experience caring for a relative with dementia.
All 19 students completed the Dementia Attitudes Scale (DAS) survey before and after the session. To help minimize the potential bias of repeated testing, 9 students completed the DAS twice before the program; taking the survey twice had no meaningful effect on DAS before the intervention.
Pre- and post-DAS data showed that the students experienced positive changes in their attitudes toward dementia after attending the art program with dementia patients and their carers, with the greatest gains in their comfort level. Compared with baseline, DAS scores improved by 8 to 10 points overall, with a significant 5.9-point increase in comfort scores (P < .001) and a smaller, 2.6-point increase in knowledge scores (P < .05), the researchers report.
They note that another study published recently that engaged medical students in a 4-week program led to a 16-point increase in DAS scores, again with greater changes in comfort. (Acad Med. 2013;88:837-842).
Putting the Arts to Work
"Putting the arts to work amid our aging nation's silver tsunami and a rising tide of dementia has payoffs that help us all to address a state of being that frustrates and frightens us deeply," Marcia Day Childress, PhD, and Donna T. Chen, MD, MPH, from the University of Virginia Health System in Charlottesville, write in an accompanying editorial.
"This research adds to a growing consensus about the value of museum-based arts activities in medical education," they say. "A day at the museum may well be a wise prescription, for persons with dementia and their caregivers, to be sure, but also for apprentice physicians."
In their view, some of the comments from students who participated in the study (included in the article) "dramatically speak their greater comfort in the presence of persons with dementia: their increased ease with how dementia and caregiving have recognizably human faces; their relief at seeing these individuals relate enthusiastically and meaningfully both to art and to their caregivers; their distinct pleasure at observing patients' daily lives outside medical environments; and their satisfaction at participating in activities that exercise persons' continuing capabilities rather than consign them to early social death."
Dr Childress and Dr Chen also think this study "invites further research" to see whether the positive attitude changes last and whether they lead to improved patient care and outcomes. They also wonder whether similar results can be achieved in students who do not voluntarily enroll or whose attitudes on pretest are below neutral. Students in the current study were all volunteers who started with attitudes on the "positive side of neutral" (baseline on DAS, 97.4; neutral, 80; range, 20 to 140), they point out.
More broadly, Dr Childress and Dr Chen wonder whether interacting with patients with dementia outside of clinical settings might have a positive effect not only on students' attitudes toward dementia but also on elders in general and geriatric practice.
The study was supported by Columbia University. The authors have disclosed no relevant financial relationships.
Neurology. Published online July 22, 2015. Abstract Editorial
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Cite this: A Trip to the Museum Teaches Med Students About Dementia - Medscape - Jul 30, 2015.
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