The Online Art Museum

This article was migrated. The article was marked as recommended. With the onset of the coronavirus-19 (COVID-19) pandemic, we transformed an in-person art museum-based course for medical students into an online format. This brought new challenges but offered unexpected advantages. The course included daily close-looking of artworks using the Visual Thinking Strategies method, group arts-based activities, reflective writing, and independent creating assignments. The virtual format allowed us to incorporate important features that were unavailable in our in-person elective: multi-media activities, access to nearly unlimited international works of art, and personal reflection from one’s private space. As instructors, the experience enlightened us on the value of online arts-based teaching.

The Online Art Museum Like medical educators across the globe, we were forced quickly to adapt our educational delivery because of the coronavirus-19 (COVID-19) pandemic.We transformed an art museum-based course for medical students to an online format, which brought new challenges but offered unexpected advantages.
During fall 2019 and winter 2020, our team designed and piloted sessions of an art-museum course for medical students.This course, part of a wave of arts-based teaching in medical education (Association of American Medical Colleges, 2020; Fancourt and Finn, 2019;Haidet et al., 2016), was designed as a month-long in-person elective at The Baltimore Museum of Art (BMA) for 4 th year medical students with the goals of exploring what it means to be a physician, to be human, and to lead a good life.We piloted 6 2-hour sessions with medical students to get feedback on different activities, as well as how they viewed the relevance of the course.These sessions were co-planned and -led with museum educators at The BMA (EB, SW).Activities centered on themes of family, community, education/work, and included both beholding and creating of art (e.g., close viewing of a paniting, sketching a sculpture from multiple perspectives) with personal reflection and small group discussion.These pilot data will help refine the course, which will launch in 2022.
In March 2020, our university ceased in-person classes amidst the COVID-19 pandemic and called upon faculty to rapidly develop online electives for medical students.This prompted our team, comprised of medical school faculty (MSC), staff (MKH), trainees (HK, KS), and art museum educators (EB, SW, PY) to adapt and condense our in-person elective into a five-day course, "The Online Art Museum: Exploring Professional Identity through Art."We ran this fulltime course twice, in April and May 2020, on the Zoom videoconferencing platform, with 10 and 8 students, respectively.
Our course required two hours of in-class time on Zoom (see Table 1 for typical schedule with examples of activities) with additional daily out-of-class assignments.Each day's in-class session began with a facilitated group discussion using the Visual Thinking Strategies (VTS) method, a pedagogical approach that involves a facilitated group discussion about a work of art that encourages close looking and holding space for multiple interpretations (Yenawine, 2013).After VTS, students shared reflections on their out-of-class assignments, which included reading and creative work.We then launched into a group activity, unique each day, adapted from previously piloted museum-based activities we had run throughout the year, many designed by educators at the BMA.For example, one group activity asked students to look at a piece of art together and write a group poem in response.We closed each day's in-class session with a reflective writing exercise and five-minute meditative exercise.Then, they reflect on the connection, sketch the piece, and select a piece of music that relates.
Group activity (varies each day) 30 minutes Group poem in smaller group.After looking at a pre-selected piece of art, each participant writes a line that a figure in the painting might think or say.Participants share their lines, assemble into a poem, and then perform the poem when the larger group reconvenes.

Reflective writing exercise 15 minutes
Students write for ten minutes in response to a prompt, then are invited to share if they wish.
Example prompts: "Write about the world within you." "Describe yourself through glasses of a different prescription than your own."

Meditative exercise 5 minutes
After a brief guided deep breathing exercise, the facilitator read a poem or played a song.For example, the first day closed with The Guesthouse by Jalaluddin Rumi (Maulana, Barks and Moyne, 2004).
We were able to include a variety of activities in our online course.We incorporated multimedia experiences of music and video in class.Some homework assignments involved finding or making objects, which students could then show to their peers over Zoom.The school-wide schedule restructuring broadened our participant base to include students across multiple class years, enhancing the diversity of student perspectives represented.The online format also expanded the content we were able to access-we selected diverse works from online museum collections around the globe and were not limited to art currently exhibited at The BMA.
Students provided feedback on a post-class survey that included both closed and open-ended questions.In response to the close ended questions, all respondents (n=11) expressed a desire for a formal arts-based program in their medical education.When queried about preferred format, over half (n=7/11) said they would prefer a mix of online and in-person activities, while two students expressed interest in an entirely online course.
Students were asked open ended questions about the pros and cons of the online format.Representative quotes are provided in Table 2. Participants commented on how they found meaning and connection despite the virtual setting.One student described the group dynamic as "a close knit and safe community."Another student commented that being able to participate from the security and comfort of home fostered a feeling of ease to reflect and share, leading to deepened introspection.
From our perspective as course facilitators, we found that students shared deeply personal stories and reflections in the virtual setting.We appreciated that students had the option to turn off their cameras during individual tasks such as writing exercises to allow for individual introspection and privacy on a different level than our in-person course could offer in the public museum space.Transforming art museum-based teaching to a virtual setting was a challenge-how would we recreate the magic of the art museum online?But with the help of technology, we were able to carry out arts and humanities-based activities in a virtual classroom.The experience opened our eyes to the potential for online arts-based teaching to bring us closer while staying physically distant.On the last day of the course, students lingered past the official end time, reluctant to leave the sanctuary we had created together.

Take Home Messages
• Art museum-based activities for medical education are possible in an online format.
• Online arts-based teaching may offer access to inclusion of multi-media activities and nearly countless works of art from online collections, as well as private opportunities for student reflection."I loved having the opportunity to take this course online and having everyone with their camera on in such a small group was almost like doing it in person." "A great way to engage from afar, the comfort of home can also facilitate reflection.Although there are benefits to being in a museum, being at home comes with unique advantages for self-reflection" "Thought the sessions went well over Zoom.Way less awkwardness than I was expecting based on previous experiences." Limitations "Easier to accidentally disengage [in online setting], for example to get an email and respond to it during the course as opposed to ignoring it, or not even knowing it came because you are not on your electronic device." "Weaknessesnot being able to meet in person, maybe a little more [of a] barrier to speak and share over video" "I wonder if some of the images were blurry for people, based on their internet connection.During one session, the photo appeared blurry for me.It may help to check in with students to confirm that they can see the image clearly." *At the end of the course, we invited students to participate in an optional, online feedback survey as part of an IRB-exempted research study.Eleven of the eighteen students filled out the survey (response rate = 61%).These are some of the responses to the item: "If you have any comments about the online format of the course (strengths and/or weaknesses), please share them here." was appreciated by participating students.The take home messages are now well supported by the main arguments and data presented in the article.Thank you.Others who are interest in the area of medical humanities will find this article thought-provoking.I hope to see a future article from this group of authors.I would be keen to read more about how this course contributes to the development of future doctors into your medical programme and how it relates to our growing understanding about the importance of the humanities in medical education.

Competing Interests:
No conflicts of interest were disclosed.

Version 1
Reviewer Report 05 September 2020 https://doi.org/10.21956/mep.19008.r27274 © 2020 Anakin M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

University of Otago
This review has been migrated.The reviewer awarded 2 stars out of 5 I read your new education method or tool article with interest because I am supervising a master's student conducting a study about medical humanities in India.The medical programme at my university has also been impacted by changes in teaching and learning practices due to the COVID19 pandemic, therefore, I was eager to learn about how your team adapted your course to an online format.Overall, I felt that this article has the potential to be useful, however, a description of the month-long in-person elective is needed to understand the comparative statements made about how well or better the online course was appreciated by students when the authors interpreted their evaluation feedback.For example, there is no evidence provided to support the statement, "The activities in our online course were more varied than we could have accommodated in an in-person incorporated multimedia experiences of music and video in class."and the other comparative statements in the fourth paragraph of the article, and the statement in the eighth paragraph (i.e., "But with the help of technology, many activities worked just as well, if not better, online").To improve the usefulness of the methods described in this new education method or tool article, the authors may wish to provide examples of the reading and creative work students completed in their out-of-class assignments and the prompts used for the reflective writing exercise and five minute meditative exercise used at the closure of each day's in-class sessions.Please describe how the evaluation feedback was analysed so the reader understand how the quotations shown in Table 2 were chosen.This explanation will help the reader to understand how the student feedback was valued in the first sentence of the seventh paragraph of the article.Please consider explaining how these evaluation findings might be used to enhance the online (or the in-person) course in the future.Please consider revising the take home messages so that they accurately reflect the evidence presented in this new education method or tool article.In the first message, please consider defining success earlier in the article and explain how success was measured or addressed by the students' evaluation feedback.In the second message, please consider revising the absolute statement about it not being possible to include multi-media activities, access to nearly unlimited international works of art, and private opportunities for student reflection in a public museum setting because the features of the month-long in-person elective were not described to the reader nor was other evidence from the literature presented to support this claim.I would be very happy to read and review a revised version of this article.
Competing Interests: No conflicts of interest were disclosed.

P Ravi Shankar American International Medical University
This review has been migrated.The reviewer awarded 4 stars out of 5 This is an interesting description of an online arts museum course for undergraduate medical students.Online teaching-learning has become important during the ongoing pandemic.AMEE MedEdPublish has published a large collection of articles on the pandemic.The authors' initiatives are important.I would like to request the authors to provide more description about the module, the learning objectives, the actual painting used and how they were selected.A description of the out-of-class assignments would also be of interest.Online courses like these will be playing an important role in medical and health professions education for some time to come.The article will be of interest to all health humanities educators.
Competing Interests: No conflicts of interest were disclosed.This review has been migrated.The reviewer awarded 5 stars out of 5 As clinical educators have had to quickly learn to adapt their curricula during the pandemic, I congratulate the authors for being brave enough to transform what would have been an in-person artmuseum course for medical students to the online format.For those of us who currently are pioneering health professions' educators in these cultural places and open spaces, we know the value of being in the sanctity of the gallery and museum and many might be tempted to think that much of the very essence of the experience would be lost in the transition.This succinct and helpful account will encourage others to be brave, to take the plunge and innovate in the current circumstances whether teaching in this realm or in other areas of medical education.What the authors detail from the students themselves, is that there was great benefit and much to be gained, often unexpectedly from this online shift.At present, arguably more than ever before, educators need to reach out to their students, be present and offer them time and space to think, reflect and make meaning and the art-museum in this virtual form offered the students exactly that, as it always does, supporting the students personal development as they start to acquire their professional identities.This form of clinical teaching is not easy and requires skilful curation, sensitive presentation and good collaboration between museum educators and their clinical counterparts, but this expert team have shown that in the right hands the art-museum builds relational and self-care 'power skills' that are becoming even more vital for this next generation of doctors.

Table 1 .
Typical daily schedule for course.

Table 2 .
Students' feedback about the strengths and limitations of online course format."Iam grateful we have tools and [are] able to adapt to still get to have meaningful conversations and activities.The online activities were meaningful... very powerful and inspiring." *Strengths "I thought this was the next best thing to an in-person course.I felt engaged and I appreciated being able to see and hear my colleagues and educators." This is an open access peer review report distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
This is an open access peer review report distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.