title: A guiding framework to maximise the power of the arts in medical education: a systematic review and metasynthesis.
abstract: BACKGROUND
  A rich literature describes many innovative uses of the arts in professional education. However, arts-based teaching tends to be idiosyncratic, depending on the interests and enthusiasm of individual teachers, rather than on strategic design decisions. An overarching framework is needed to guide implementation of arts-based teaching in medical education. The objective of this study was to review and synthesise the literature on arts-based education and provide a conceptual model to guide design, evaluation and research of the use of the arts in medical education.
  
  
  METHODS
  A systematic literature review using the PubMed and ERIC databases. Search terms included humanism, art, music, literature, teaching, education, learning processes, pedagogy and curriculum. We selected empirical studies and conceptual articles about the use of creative arts, imagery and symbolism in the context of professional education. Data synthesis involved a qualitative content analysis of 49 included articles, identifying themes related to educational characteristics, processes and outcomes in arts-based education.
  
  
  RESULTS
  Four common themes were identified describing (i) unique qualities of the arts that promote learning, (ii) particular ways learners engage with art, (iii) documented short- and long-term learning outcomes arising from arts-based teaching and (iv) specific pedagogical considerations for using the arts to teach in professional education contexts.
  
  
  CONCLUSIONS
  The arts have unique qualities that can help create novel ways to engage learners. These novel ways of engagement can foster learners' ability to discover and create new meanings about a variety of topics, which in turn can lead to better medical practice. At each of these steps, specific actions by the teacher can enhance the potential for learners to move to the next step. The process can be enhanced when learners participate in the context of a group, and the group itself can undergo transformative change. Future work should focus on using this model to guide process design and outcome measurement in arts-based education.
authors.affiliation: Office for Scholarship in Learning and Education Research, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA.|Department of Medicine, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA.|Department of Humanities, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA.|Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Haidet
authors.affiliation: Office for Scholarship in Learning and Education Research, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA.
authors.forename: Jodi
authors.initials: J
authors.lastname: Jarecke
authors.affiliation: George T Harrell Health Sciences Library, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA.
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Adams
authors.affiliation: Department of Medicine, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA.|Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA.
authors.forename: Heather L
authors.initials: HL
authors.lastname: Stuckey
authors.affiliation: Department of Medicine, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA.|Department of Humanities, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Green
authors.affiliation: Department of Humanities, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Shapiro
authors.affiliation: Office of Undergraduate Medical Education, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Cayla R
authors.initials: CR
authors.lastname: Teal
authors.affiliation: Department of Medicine, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA.|Department of Humanities, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA.
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Wolpaw
mesh_terms: D001154:Art; D002983:Clinical Competence; D003479:Curriculum; D004501:Education, Medical / Q000379:methods*; D006808:Humanism; D007858:Learning; D009146:Music