New University of Michigan startup ArtSpective, which provides implicit bias training for health care workers, was founded on the idea that a picture is worth a thousand words.

The training uses fine art photographs and guided storytelling to reduce stigma and improve patient-provider interactions. It was born of a unique partnership between researchers at the School of Nursing and U-M Museum of Art.

Clayton Shuman, assistant professor of nursing, and David Choberka, the Mellon Foundation curator for University Learning and Programs, designed the initial training for perinatal nurses who work with pregnant women or mothers with substance use disorder. Shuman founded ArtSpective, which was launched in September 2023 with the support of Innovation Partnerships, the central hub for research commercialization activity at U-M.

But the bias training can be tailored for any stigmatized group and any profession—not just health care. For instance, physicians who treat patients with obesity, or law enforcement who deal with people who are unhoused. ArtSpective provides training for small and large groups and asynchronous training for individuals, both from inside and outside the university.

Art and health care: A partnership that works

Shuman’s research focuses on improving care for peripartum patients with substance use histories. A study he co-authored in 2022 reported that more than 40% of nurses had stigmatizing attitudes about perinatal substance use. This kind of stigma hurts care, he said, and states are beginning to recognize that bias is a problem. Michigan now requires all professions licensed or registered under the state’s public health code, except veterinarians, to take implicit bias training. Shuman believes ArtSpective can meet that need.

During his research, Shuman came to believe that current approaches to employee bias training could be more effective. Most interventions addressed the clinicians’ educational deficits rather than the stigma itself. But Shuman thought stigma was a barrier to receiving and applying education, so he wanted to address the stigma first.

When Shuman heard Choberka’s presentation about using art to facilitate learning and application, he said “the lightbulb went on,” and they began working on what eventually became ArtSpective.

“Our goal was not to develop another educational intervention, but to develop an intervention that prepares the learner for education and helps them learn more about themselves and how they perceive and interact with others,” Shuman said.

Photos, narratives and group discussion changed attitudes

Keane Trautner, a nurse practitioner, was a doctoral student when he did a version of the ArtSpective bias training geared toward HIV/AIDS stigma. He said his relationship with his dad influenced how he interpreted a photo of an elderly man and a younger woman, who he described as looking somber. Others in the group interpreted the photo differently.

“It was a very interesting way for people with different thoughts and backgrounds to express where they’re coming from,” he said. “I feel like culture is really important and art is a good medium for bringing culture in.”

Employee bias training can be dry—a worker clicks through a computer module and gets a score, or listens to a lecture. ArtSpective is different because it focuses on perspective taking—adopting the point of view of another person within their context.

“It’s a pretty common practice in art museum education that gets people to notice more complexity and nuance in images, in addition to helping people to be aware of their own biases,” Choberka said. “However, the adaptation to this topic and the online platform are unique to ArtSpective.”

Choberka curated the photos from UMMA’s collection that were used for the concept testing that Trautner viewed. He said getting two perspectives on the same image is critical. Participants write about the photos from the perspective of a healthcare worker and as the photo subject.

When nursing students who took the bias training wrote as the healthcare workers, the narratives revealed assumptions and judgments. When writing as the photo subject, the students were more empathetic.

“We do not believe that this intervention will fix the problem of stigma entirely. But when we engage with artwork, it’s not a one-and-done solution, it’s a process,” Shuman said. “ArtSpective is designed to be accessed multiple times, and we learn something new each time.”

ArtSpective LLC was granted seed funding by Ann Arbor Spark and has National Institutes of Health seed funding from the National Institute on Drug Abuse to test the feasibility and effectiveness of the asynchronous version.

Shuman and U-M have a financial interest in ArtSpective.

A study on the feasibility of ArtSpective is forthcoming in the Journal of Addictions Nursing.