J Educ Eval Health Prof.  2025;22(1):3. 10.3352/jeehp.2025.22.3.

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

• Bult SA
• van Gulik T

• KMID: 2567147
• DOI: http://doi.org/10.3352/jeehp.2025.22.3

Abstract

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.

Keyword

Cohort studies; Empathy; Medical education; Medical students; Surveys and questionnaires; Netherlands