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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  
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
  • 1,026 View
  • 133 Download
AbstractAbstract PDFSupplementary 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.
Comparison of the level of cognitive processing between case-based items and non-case-based items on the Interuniversity Progress Test of Medicine in the Netherlands  
Dario Cecilio-Fernandes, Wouter Kerdijk, Andreas Johannes Bremers, Wytze Aalders, René Anton Tio
J Educ Eval Health Prof. 2018;15:28.   Published online December 12, 2018
DOI: https://doi.org/10.3352/jeehp.2018.15.28
  • 20,216 View
  • 213 Download
  • 11 Web of Science
  • 11 Crossref
AbstractAbstract PDFSupplementary Material
Purpose
It is assumed that case-based questions require higher-order cognitive processing, whereas questions that are not case-based require lower-order cognitive processing. In this study, we investigated to what extent case-based and non-case-based questions followed this assumption based on Bloom’s taxonomy.
Methods
In this article, 4,800 questions from the Interuniversity Progress Test of Medicine were classified based on whether they were case-based and on the level of Bloom’s taxonomy that they involved. Lower-order questions require students to remember or/and have a basic understanding of knowledge. Higher-order questions require students to apply, analyze, or/and evaluate. The phi coefficient was calculated to investigate the relationship between whether questions were case-based and the required level of cognitive processing.
Results
Our results demonstrated that 98.1% of case-based questions required higher-level cognitive processing. Of the non-case-based questions, 33.7% required higher-level cognitive processing. The phi coefficient demonstrated a significant, but moderate correlation between the presence of a patient case in a question and its required level of cognitive processing (phi coefficient= 0.55, P< 0.001).
Conclusion
Medical instructors should be aware of the association between item format (case-based versus non-case-based) and the cognitive processes they elicit in order to meet the desired balance in a test, taking the learning objectives and the test difficulty into account.

Citations

Citations to this article as recorded by  
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JEEHP : Journal of Educational Evaluation for Health Professions
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