Professor and Vice Chair for Education, Department of Psychiatry and Behavioral Sciences
Member, Miller Coulson Academy of Clinical Excellence
In college, Margaret Chisolm set out to study film history within a broader visual arts program. Then she turned to medicine, and psychiatry. More recently, she has found an innovative way to bridge the two fields by incorporating art museum-based methods into medical education. These techniques, involving thoughtful, facilitated discussions prompted by art, can help medical trainees have a deeper appreciation for the human condition, according to Chisolm.
Chisolm tells her history in a three-part blog post on closer.org, a website hosted by Johns Hopkins’ Miller Coulson Academy of Clinical Excellence that features clinicians’ posts about clinical reasoning, connecting with patients and other topics. While studying form in college, she came across a photo-essay book by former art critic John Berger that profiled an English country doctor in the late 1960s, highlighting the man’s interactions with his patients. “It sounded like the kind of person I’d like to be, and the kind of career I wanted,” recalls Chisolm. So she turned down graduate school in cinema studies to take a year of chemistry, organic chemistry and physics to gear up for applying to medical school.
Once in medical school, when it came time to rotate through different departments, she left psychiatry for next to last, thinking she would become a surgeon. “I had absolutely no interest in psychiatry—that’s why I left it until the end,” Chisolm laughs. “Then when I did [that rotation], I found out that it brought out the best in me. I thought it played to my natural talents…and then I fell in love with the patients. I really liked working with the most vulnerable people.”
Chisolm came to Johns Hopkins in 1988 for an internship and residency in psychiatry, then completed a forensic psychiatry fellowship at the University of Maryland. She worked for Sheppard Pratt Hospital for a year, then spent time balancing part-time work as a psychiatrist at the Johns Hopkins University counseling center and private practice, which she eventually turned to a full-time career. In 2006, her co-chief resident from Johns Hopkins, Constantine Lyketsos (now chair of psychiatry at Johns Hopkins Bayview Medical Center), recruited her to join the faculty full time as director of education in psychiatry at Johns Hopkins Bayview.
Over the years, her role in education has evolved from overseeing first-year residents to mentoring learners throughout the world in educational scholarship, from undergraduates through faculty. “There are a lot of misconceptions about what it takes to succeed academically at Johns Hopkins,” says Chisolm. “A lot of people think that if they’re not scientific investigators, they don’t have a way forward.” A clinical excellence promotion track Chisolm is helping develop—that rewards faculty for innovation in teaching—may solve some of these misperceptions, she says. “What I find rewarding is showing people that if they love teaching or if they love developing educational materials for innovative new methods of teaching, they can take what they love and still succeed.”
Chisolm spent about 10 years with Johns Hopkins’ Center for Addiction and Pregnancy, where she worked with drug-dependent pregnant women and published articles about mood disorders, substance use and treatment strategies in this population. Her research efforts advanced to studying burnout in medical education trainees and helping health profession trainees treat all patients with dignity and respect. “That grew out of my addiction work,” she says, “and seeing how even some really great clinicians can have a blind spot toward their attitudes toward patients with addiction and other psychiatric illnesses.”
Now, her educational efforts are incorporating art. In 2019, Chisolm was one of 12 inaugural fellows in an art museum-based health professions education fellowship offered by the Harvard Macy Institute and Cambridge Health Alliance. Held at the museum of Fine Arts in Boston, the program explored ways to use the museum environment and art appreciation to advance health profession education goals such as honing observation and interpretation skills; team building; and examining assumptions, values and stigma. She is developing a fourth-year elective for medical students to use the local art museums to explore what it means to be human and a physician, and to live a good life. She also is taking courses to become certified as a facilitator of Visual Thinking Strategies. The efforts can help transform the way physicians think about themselves, humanity and their mission, she says.
While attending on the inpatient unit recently, Chisolm organized a Visual Thinking Strategies break, where she used art to illustrate a point that had come up in rounds regarding observations versus interpretations. “I can use this to help develop critical thinking skills of our residents and other learners, to encourage perspective-taking, empathy and other skills that are relevant to health care,” she says.