The Intersection of Arts, Dementia and Training Tomorrow’s Empathetic Health Care Providers

Jefferson believes that for healthcare trainees, clinical practice is an art as well as a science and that empathy is a process of authentic dialogue and relationship building that cannot be taught through textbooks. Over the years, Jefferson has been deeply committed to exploring innovative, arts-based methods for growing and sustaining empathy in our students.

The majority of medical and other health professions students begin their training with altruism and empathy. But research has shown that by the third year of training, students’ empathy significantly declines. Healthcare providers' lack of empathy can lead to patients who mistrust their physicians, disregard instructions vital to treatment and feel profoundly uncared for. People living with dementia, in particular, can often feel misunderstood, unheard and invisible.

That’s where ARTZ at Jefferson comes in. The collaboration between Jefferson and ARTZ Philadelphia pairs student volunteers with mentors living with dementia-related diseases and/or their caregivers for six to eight weeks. Through this initiative, students spend extended time with their mentors—observing and discussing artwork at local museums and more—while simultaneously learning from them what it means to live with dementia—not as patients, but as people.

Because of the symptoms associated with dementia—memory loss, difficulty communicating and confusion—patients often become voiceless and marginalized by society. ARTZ at Jefferson reverses the traditional provider-patient hierarchy and enlists people with dementia as the teachers and mentors.

“The focus on the program’s mentor-student relationship is completely unique in this context of arts-centered engagement that grows into an extended relationship between health professionals and people living with dementia over time,” says Susan Shifrin, founding director of ARTZ Philadelphia and director of ARTZ at Jefferson. “We are truly honored to be partnering in this very meaningful, rich way with Jefferson.”

The program also engages caregivers as mentors, amplifying the voices of those in roles too often under-recognized by society. The structure of ARTZ at Jefferson creates a safe space for them to enjoy creative respite and serves as validation that they are helping to shape the emotional skills of the next generation of healthcare providers.

During an interview, Bill—who was a long-time ARTZ at Jefferson mentor living with dementia and now lives in a long-term care community—expressed how the program helped him and his wife, Nora.

“If we didn’t have [ARTZ at Jefferson], I don’t know what I would have done,” Bill says. “Dementia is terrible, but you have to do something with it, and the program has helped me tremendously.”

“At the first meeting, we didn’t know what to expect,” Nora says. “But we felt comfortable right away and really looked forward to sessions and wanted to come and participate. That’s a big step for someone with dementia.”

For student volunteers, the program serves as an “inoculation” against that future loss of empathy that sometimes occurs when they enter the clinical setting. It also offers an opportunity to stay connected with the interpersonal part of medicine that drew them into choosing a career in health care to begin with.

"After my time with ARTZ at Jefferson, I realized that the faces of dementia are not always the ones you imagine,” says Lydia Huang, a volunteer and third-year Sidney Kimmel Medical College student. “Being able to explore dementia in an open setting allowed me the opportunity to let my professional and emotional walls down. I built a rapport with those living with dementia without having to make the conversation so narrowly focused on the clinical topic of dementia itself. My experience with the program has equipped me with the awareness that human stories about dementia come in all shapes and sizes and that the ability to connect with others depends on your ability to find a shared humanity."

Research has linked greater empathy to fewer diagnostic errors, reduced patient symptoms and increased satisfaction, and greater professional fulfillment among doctors. For health professions educators, how best to train students in practices of empathy to counteract the decline of this critical skill is an urgent national question with implications for the wellness of both patients and providers. Jefferson has remained at the forefront of researching and benchmarking the clinical value of teaching empathy and embedding this training in our curriculum and student organizations.

ARTZ at Jefferson falls under Jefferson Elder Care—a subdivision of the Jefferson College of Rehabilitation Sciences—which is committed to improving the lives of individuals who have memory loss, Alzheimer's disease or other dementias and intellectual disabilities.

The one-of-a-kind program has gained recognition nationally—and by other universities. In fact, Harvard Medical School is currently working to launch an elective based on ARTZ at Jefferson.

In 2017, ARTZ Philadelphia received the Rosalinde Gilbert Innovations in Alzheimer's Disease Caregiving Legacy Award from the Family Caregiver Alliance in the category of policy and advocacy in recognition of the first full year of ARTZ at Jefferson.

“We emphasize the importance of a thoroughly interprofessional student cohort, including medical, nursing, occupational therapy, public health, pharmacy, radiology, trauma counseling and physician assistant students and pre-professional health sciences undergraduates,” Shifrin says. “Plus, we focus on what students can learn about the lived experiences of dementia when those with the illnesses and their care partners are understood as the only real authorities we have regarding those lived experiences.”

Learn more about ARTZ at Jefferson. Those interested in becoming student volunteers or mentors can contact Susan Shifrin.