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Empathy and tolerance of ambiguity in medical students and doctors participating in art-based observational training at the Rijksmuseum in Amsterdam, the Netherlands: a before-and-after study
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Stella Anna Bult
, Thomas van Gulik - J Educ Eval Health Prof. 2025;22:3. Published online January 14, 2025
- DOI: https://doi.org/10.3352/jeehp.2025.22.3
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- 5 Web of Science
- 5 Crossref
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Abstract
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Supplementary Material - Purpose
This research presents an experimental study using validated questionnaires to quantitatively assess the outcomes of art-based observational training in medical students, residents, and specialists. The study tested the hypothesis that art-based observational training would lead to measurable effects on judgement skills (tolerance of ambiguity) and empathy in medical students and doctors.
Methods
An experimental cohort study with pre- and post-intervention assessments was conducted using validated questionnaires and qualitative evaluation forms to examine the outcomes of art-based observational training in medical students and doctors. Between December 2023 and June 2024, 15 art courses were conducted in the Rijksmuseum in Amsterdam. Participants were assessed on empathy using the Jefferson Scale of Empathy (JSE) and tolerance of ambiguity using the Tolerance of Ambiguity in Medical Students and Doctors (TAMSAD) scale.
Results
In total, 91 participants were included; 29 participants completed the JSE and 62 completed the TAMSAD scales. The results showed statistically significant post-test increases for mean JSE and TAMSAD scores (3.71 points for the JSE, ranging from 20 to 140, and 1.86 points for the TAMSAD, ranging from 0 to 100). The qualitative findings were predominantly positive.
Conclusion
The results suggest that incorporating art-based observational training in medical education improves empathy and tolerance of ambiguity. This study highlights the importance of art-based observational training in medical education in the professional development of medical students and doctors. -
Citations
Citations to this article as recorded by
- Understanding uncertainty and ambiguity in medicine and medical education: a narrative review with implications for training
Sarine Sarkis, Christian Raphael
Postgraduate Medical Journal.2026; 102(1207): 461. CrossRef - Observational training for surgical residents using visual arts in the museum
Thomas M. van Gulik, Stella A. Bult, Pien E.J. de Ruiter, Floortje Huizing, Alexander de Mol van Otterloo, Alexander Leijdesdorff, Sjoerd Lagarde
Surgery.2026; 190: 109843. CrossRef - Training the eye and diagnosing the canvas in the Museum ‘A perspective on art-based medical education’
T.M. van Gulik, S.A. Bult, P.E.J. de Ruiter, F. Huizing, A. Leijdesdorff, S. Lagarde, A. de Mol van Otterloo
Ethics, Medicine and Public Health.2026; 34: 101243. CrossRef - Developing a Feasible Arts and Humanities Course Using Visual Thinking Strategies and Haiku Writing: A Mixed-Methods Study
Hirohisa Fujikawa, Takayuki Ando, Junji Haruta
Medical Science Educator.2025; 35(6): 3105. CrossRef - Erb’s Palsy: Visual Diagnosis in Art before Medical History?
Pien E.J. de Ruiter, Stella A. Bult, Jeroen R. Dijkstra, Thomas M. van Gulik
Gynecologic and Obstetric Investigation.2025; 91(1): 26. CrossRef
- Understanding uncertainty and ambiguity in medicine and medical education: a narrative review with implications for training
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