Influencing factors of art-mediated educational strategies on life attitudes of teaching hospital staff: a quantitative study

Abstract

Background

Art-mediated educational strategies are increasingly recognized for fostering transformational learning (TL), reshaping perspectives and life attitudes. This study explored how engagement frequency, professional category, and years of work experience influence the effects of participating in art creation and appreciation on healthcare providers’ (HCPs) life attitudes in a teaching hospital.

Methods

An annual art-based workshop, “Whole-Person Care Experience Sharing,” was conducted at a teaching hospital. While most participation was voluntary, some staff were assigned to create artworks, and others could choose to appreciate or not. Afterward, the Short-Form Life Attitude Inventory (SF-LAI) was distributed to all hospital staff and collected anonymously. Retrospective analyses included responses from 2020 (n = 835, 24.8%) and 2021 (n = 474, 14.9%). Respondents were stratified by engagement level: non-engaged, attendees (appreciators), participants (creators), or both. A factorial ANOVA assessed the effects of gender, engagement frequency, professional category, and years of work experience, including interaction terms, with post hoc Bonferroni tests identifying subgroup differences.

Results

Staff who both created and appreciated art exhibited the highest life attitude scores, followed by those who either created or attended, with non-engaged staff scoring the lowest (p <.001). Gender and professional category did not significantly affect scores. However, greater engagement frequency (p <.001) and more years of work experience (p <.05) were associated with higher life attitude scores. A trend toward an interaction between engagement frequency and professional category (p =.05–0.07) showed that physicians and nurses had increased scores with more frequent engagement, a pattern absent in other or non-medical professions. Considering engagement frequency, professional category, and work experience together, a significant interaction emerged between professional category and years of experience (p <.05), indicating frequent engagement was especially beneficial for early-career physicians and nurses.

Conclusions

Art-mediated educational interventions enhance life attitudes among hospital staff, with engagement frequency, professional category, and work experience as key moderators. Physicians and nurses with less experience benefit most. These findings underscore the value of integrating art-based strategies into healthcare education to foster holistic growth and well-being among HCPs, especially in the early-career stages of physicians and nurses.

Introduction

The World Health Organization (WHO) defines health as a state of complete physical, mental, and social well-being, rather than merely the absence of disease [1]. To address these multidimensional aspects of health, the “Whole Person Care” model was proposed, emphasizing holistic and person-centered approaches [2]. Within this framework, healthcare providers (HCPs) play a pivotal role, as their perspectives, values, and attitudes have been shown to significantly influence patients’ experiences and health outcomes [3, 4]. Cultivating a sense of spirituality has been identified as one way for HCPs to deepen their empathy and enhance the quality of care they provide. Art-mediated educational strategies can serve as a catalyst for such inner development by fostering self-reflection, emotional expression, and spiritual awareness. Thus, integrating spirituality—nurtured through artistic engagement—into healthcare education and practice is essential for delivering compassionate, high-quality care [5].

To support this process, Transformative Learning (TL) theory offers a valuable framework. Emerging from the field of adult education, TL is defined as a “dramatic, fundamental change in the way we see ourselves and the world in which we live” [6]. Through reflection, dialogue, critique, discernment, imagination, and action, TL encourages deeper engagement with oneself and one’s relationship to others and the world [7, 8]. In this context, art-mediated educational interventions grounded in TL can promote meaningful personal growth among healthcare professionals, aligning with the principles of Whole Person Care and advancing the humanistic goals of healthcare.

Emotion is one of the two very important biological resources necessary to ignite the engine of TL [9, 10]. Art often presents multiple interpretations and perspectives, inviting viewers to explore alternative viewpoints. By engaging with art, individuals can reflect on their emotions, values and personal experiences [11]. This emotional engagement fosters self-reflection, awareness and transformative growth [12].

To achieve and sustain true health, healthcare providers (HCPs) must recognize themselves and their patients as human beings within social contexts. This holistic understanding is essential, as it encourages empathy, self-awareness, and a deeper connection with patients. Such insights are not only fundamental for improving patient care but also for enhancing HCPs’ emotional and psychological well-being. The question of what it means to be human has long been a focus for both HCPs and patients. Teaching ‘meaning and purpose’ may require strategies that help trainees process emotions, explore perspectives, and question assumptions [13]. Studies have shown that art-mediated educational strategies can enhance self-awareness and promote behavior changes [14,15,16]. Transformational learning through art in medical education fosters critical reflection [17], emotional engagement [18], narrative construction [19, 20], meaning-making and identity formation [21], collaboration [22], and resilience [23]. Most importantly, it creates democratic spaces where both learners’ and teachers’ expertise are equally valued [24]. This is particularly important in hierarchical environments, such as hospitals.

Building on these insights, the concept of “attitude towards life”—encompassing one’s sense of meaning, purpose, values, and approach to challenges and relationships—is closely tied to these humanistic qualities. In healthcare, a positive life attitude has been linked to greater empathy, resilience, and a stronger commitment to holistic, patient-centered care [25]. Moreover, studies suggest that interventions aimed at enhancing life attitudes can improve both provider well-being and patient outcomes [26, 27]. Accordingly, this study sought to assess and promote life attitude among hospital staff.

While many studies explore the role of art in medical education [22], most focus on undergraduate students [28,29,30,31,32] or specific groups within teaching hospitals, such as residents or nurses [33,34,35,36]. Research on various roles within hospitals is limited, and gaps remain in understanding the efficacy, influencing factors, and clinical implications of arts-based courses. This study addresses two key research questions: (1) Does an arts-mediated educational strategy, involving art creation and appreciation, positively affect the life attitudes of teaching hospital staff? (2) What factors influence life attitudes following art creation and exhibition workshops? The aim is to evaluate the effectiveness of the ‘Whole-Person Care Experience Sharing’ art workshops in promoting positive life attitudes among hospital staff and identify the factors contributing to this effect.

Although TL is often employed in the context of faculty development, this study applies TL principles more broadly to support personal growth and humanistic reflection among hospital staff of various professional categories—including physicians, nurses, administrative personnel, and allied health professionals. The workshops were not limited to teaching staff but were designed to foster self-awareness, empathy, and meaning-making across disciplines and hierarchies, in alignment with the principles of Whole Person Care.

Methods

Setting and procedures

This study was conducted at Kaohsiung Veterans General Hospital, a teaching hospital located in southern Taiwan, which has approximately 1,500 beds and 3,000 employees. The hospital provides clinical training for undergraduate medical students and related professionals, as well as postgraduate and continuing medical education for healthcare providers. As part of its effort to implement whole-person care education, the hospital introduced an art-mediated TL program through a series of workshops titled “Whole-Person Care Experience Sharing”, aimed at fostering self-awareness among staff.

The workshops were designed in accordance with TL theory, which emphasizes experiential learning, critical reflection, and perspective transformation. In this context, art creation was employed not merely as a form of expression but as a structured educational strategy to evoke reflection on personal values, emotional engagement, and existential meaning. Through the processes of creating and presenting their artworks, participants engaged in deep self-inquiry and meaning-making, reflecting the core elements of transformative learning—including heightened self-awareness, identity reconstruction, and shifts in worldview. These characteristics positioned the program as a structured arts-mediated educational intervention grounded in TL principles.

The workshops were conducted as follows:

• One year of artwork creation: HCPs at the teaching hospital were invited to create a piece of free-form artwork reflecting their interpretation of life’s meaning, based on experiences from the past year. These experiences could stem from significant moments in clinical practice, insights from literature or end-of-life care, or meaningful encounters with patients and colleagues. The aim of the workshop was not to teach artistic techniques but to facilitate reflection and personal expression. Participants were encouraged to use their preferred modes of expression—including poetry, prose, painting, photography, or music—depending on their own comfort and strengths. Postgraduate physicians were required to participate, with at least one participant from each other medical profession. Participation for other staff members was voluntary. Artworks could be created individually or collaboratively, respecting personal emotional expression and the needs of vulnerable individuals.

• Week-long exhibition of humanistic artworks: To enhance visibility and encourage reflection, the exhibition was held in the teaching hospital’s gallery space, located at the commuter entrance.

• At the end of the week-long exhibition, participants were invited to deliver oral presentations about their artworks. These presentations, which took place in June for postgraduate physicians’ artworks and in December for the other staff members’ artworks, each lasted approximately half a day. During these sessions, participants shared the inspiration behind their ideas and the messages they aimed to convey. These presentations fostered peer feedback and deepened participants’ insights into the meaning of life.

• After the activity, an email with a link to the Short-Form Life Attitude Inventory (SF-LAI) [37] was distributed to all hospital staff. The responses were collected and analyzed anonymously. The SF-LAI was employed based on its established validity and reliability in measuring individuals’ perspectives on meaning, goals, and attitudes toward life among hospital staff. Prior studies have reported satisfactory model fit (CFI = 0.955, TLI = 0.952, RMSEA = 0.071, SRMR = 0.038) and high internal consistency (Cronbach’s alpha and McDonald’s omega > 0.9) [38], supporting its appropriateness for this context.

• To evaluate the factors influencing transformative learning in this educational program on the life attitudes of HCPs, several factors were selected: frequency of attending (or appreciating) and participating (or creating) in workshops, gender, professional category, and years of work experience. These factors were chosen because they most effectively describe hospital employees, and it is reasonably inferred that they could influence life attitudes [39, 40]. A between-subject ANOVA was used to assess the main and interaction effects of these independent variables. The independent variables included the following levels:

• Frequency of participating or attending the workshop (frequency): 0, 1, ≥2.

• Gender: male, female.

• Category of profession: physician, nurse, other medical professions and non-medical staffs.

• Working years: ≤5 years, 5- <10 years, 10- <20 years, ≥ 20 years.

Statistical analysis

Descriptive statistics are presented as means and standard deviations for all variables. A t-test and one-way ANOVA were used to examine the impact of each independent variable on life attitude scores. Given that four main independent factors were considered and their three-way interactions on life attitude scores were to be explored, four sets of hypotheses were formulated. Based on the number of independent variables and the levels of each, a factorial ANOVA was used to analyze their effects on life attitude scores.

Table 1 presents the set of hypotheses, the independent variables and their number of levels, the null hypotheses, and the corresponding ANOVA designs. P values < 0.05 were considered statistically significant. All statistical analyses were conducted using SPSS version 28.0 for Windows (SPSS, Chicago, IL, USA).

Table 1 Description of hypothesis of influential factors

Results

Response rate

Because we used anonymous surveys, it was not possible to identify individuals who completed the survey in both years. To avoid duplicate counting, we conducted a year-by-year analysis. In 2020, we received 835 valid responses (response rate = 24.8%). As the online system required all items to be completed, responses with uniform or patterned answers indicating inattentive responding were excluded. In 2021, due to the COVID-19 pandemic, the oral presentation sessions—where participants shared the inspiration and meaning behind their artworks—were conducted via online meetings, resulting in a lower response rate of 14.92%, with 474 valid responses. Participants included staff from all hospital professions. Men, physicians, and new staff (with less than five years of experience) had significantly lower response rates in both years, as did younger employees in 2021. Demographic data are shown in Table 2.

Table 2 Demographic characteristics of respondents of SF-LAI in 2020 (n = 835, total employees 3591) and 2021 (n = 474, total employees 3288)

The effects of frequency of participating or attending the workshop

The descriptive statistics of the variables are presented in Table 3. Results of the ANOVA showed that the life attitude score of the non- attending, non- participating group (M = 5.236, SD = 0.851 in 2020; M = 5.178, SD = 0.814 in 2021) was significantly lower than that of both the attending and participating group (M = 5.519, SD = 0.799 in 2020; M = 5.447, SD = 0.835 in 2021) and the attending or participating only group (M = 5.412, SD = 0.803 in 2020; M = 5.511, SD = 0.756 in 2021), F (2, 832) = 6.838, p =.001, η_p² = 0.016 in 2020, F (2, 471) = 8.902, p <.001, η_p² = 0.036 in 2021 (Fig. 1). The effects of the frequency of attending or participating in the workshop showed that the group with a frequency of ≥ 2 had significantly higher scores than the 0 group (p <.001 for both 2020 and 2021) and the 1 group in 2020 (p =.004) (Fig. 2). The 1 group also had significantly higher scores than the 0 group in 2021 (p =.003). Although in 2020 the 1 group did not show a significant difference compared to the 0 group, it exhibited an increasing trend.

Table 3 Descriptive statistics of the variables

Fig. 1

Comparison of the effect of attending or participating the workshop. The life attitude score of non- attending, non- participating group is significantly lower than that of the attending and participating group and the attending or participating only group in both 2020 and 2021. ***: p <.001. **: p <.01. *: P <.05

Fig. 2

Comparison of the effects of frequency of participating or attending the workshop (0, 1, ≥ 2). The life attitude score of ≥ 2 group is significantly higher than that of the frequency of 0 and 1 group.in 2020. The life attitude score of ≥ 2 group is significantly higher than that of the frequency of 0 group, and 1 group is significantly higher than that of the frequency of 0 group in 2021. ***: p <.001 **: p <.005

The effects of gender and category of profession

For other independent variables, our results showed that there was not a significant difference in life attitude scores between male (M = 5.366, SD = 0.873 in 2020; M = 5.361, SD = 0.885 in 2021) and female (M = 5.364, SD = 0.815 in 2020; M = 5.378, SD = 0.790 in 2021) in both years (t(833) = 0.026, p =.979 in 2020 and t(472) = − 0.176, p =.860 in 2021), and between professional category.

The effects of working years

The life attitude scores of working years ≥ 20 years (M = 5.541, SD = 0.794 in 2020; and M = 5.534, SD = 0.809 in 2021) were significant higher than that of working years < 5 years (M = 5.320, SD = 0.803 in 2020; and M = 5.388, SD = 0.777 in 2021), 5–10 years (M = 5.330, SD = 0.856 in 2020; and M = 5.275, SD = 0.793 in 2021), and 10–20 years (M = 5.235, SD = 0.852 in 2020; and M = 5.230, SD = 0.823 in 2021). (F (3, 831) = 4.965, p =.002, η_p² = 0.018 in 2020, F (3, 470) = 3.467, p =.016, η_p² = 0.022 in 2021).

The 3-way ANOVA analysis of frequency, gender, category of profession and working years

Table 4 shows the summary results of a three-way ANOVA. Significant main effects of frequency were found in all models (H₁₁, H₂₁, H₃₁). The main effect of working years was significant (H₂₃) in one model (the model including frequency, gender, and working years), F(3, 811) = 2.767, p =.041, η_p² = 0.10 in 2020, but not significant (H₄₅) in the other models. Additionally, the main effects of gender (H₁₂, H₂₂, H₄₁) and category of profession (H₁₃, H₃₂, H₄₂) were not significant in any model. Similarly, while the interaction between category of profession and working years (H₃₆) was significant in one model (the model including frequency, category of profession, and working years) F(9, 427) = 2.290, p =.016, η_p² = 0.046 in 2021, the interactions between frequency and gender (H₁₄, H₂₄), frequency and category of profession (H₁₅, H₃₄), frequency and working years (H₂₅, H₃₅), and category of profession and working years (H₃₆, H₄₆) were not significant in any model. Finally, none of the 3-way interactions were significant in any model (H₁₇, H₂₇, H₃₇, H₄₇). Post-hoc analyses indicated that physicians and nurses with 5 to 10 years of working years and a frequency greater than 1 demonstrated a significantly greater increase in life attitude scores compared to other groups, including both other and non-medical professionals. These findings suggest that profession and years of working experience play crucial roles in influencing life attitude.

Table 4 Summarized results of hypotheses testing set 1 ~ 4 (P values, Result)

Although the interaction effects between frequency and category of profession did not reach statistical significance, they still displayed trends of differences in hypotheses set 1 (frequency, gender, category of profession; F(6, 811) = 1.997, p =.064, η_p² = 0.15 in 2020 and F(6, 451) = 2.036, p =.060, η_p² = 0.26 in 2021, and set 3 (frequency, category of profession, working years; F(6, 427) = 2.086, p =.054, η_p² = 0.28) in 2021. The interaction plots are presented in Figs. 1 and 2. They show that the life attitude scores for a frequency ≥ 2 in the physician and nurse groups are higher than those in the frequency = 0 group. This effect is not observed in other medical and non-medical staff (Fig. 3c and d). And that the average life attitude scores significantly increased with frequency for physicians and nurses with 5 to 10 years of working experience, as well as for nurses with less than 5 years of experience (Fig. 4a and b), but also not for other medical and non-medical professionals.

Fig. 3

Interactional plots of frequency, gender and category of profession

Fig. 4

Interactional plots of frequency, category of profession and working years

Discussion

Mindfulness and self-awareness are crucial for healthcare professionals to apply and self-regulate their clinical practices [41]. Art can play a significant role in fostering self-awareness and empathy [42]. The use of art is becoming increasingly popular in medical education [43]. In undergraduate medical training, art courses aim to enhance empathy, self-awareness, and communication skills, which are essential for patient care [44,45,46,47,48,49,50,51,52,53]. In the postgraduate and hospital employee setting, art interventions offer a unique opportunity to address specific challenges such as hierarchical structures, emotional burnout, and detachment. Arts-based learning can foster a more democratic environment [24], making it particularly valuable for hospital staff education. While many medical schools have begun offering art courses over the past decade, there is limited understanding of their implementation in postgraduate medical environments and among non-medical hospital personnel. Our study is the first quantitative study to investigate the effects and influential factors of art-mediated educational strategies on life attitudes among all staff of teaching hospitals. While the primary focus of teaching hospitals has traditionally been on clinical training and patient care, there is an increasing recognition of the importance of fostering life attitudes among staff to promote staff well-being, empathy, and the quality of patient care. In this context, training hospital staff on life attitudes is an emerging focus aimed at improving both their personal well-being and their professional interactions with patients.

In our study, attending (appreciating) workshops—defined as viewing the exhibited artworks and engaging with their underlying messages and meanings—had a consistent and positive effect on life attitudes, whereas participating (creating) workshops—referring to the active production of art, such as drawing or writing in response to guided prompts—did not. However, artistic creation involves active learning, which has been shown to enhance self-reflection, emotional engagement, and transformative learning, all of which are key components in fostering positive life attitudes [11, 41, 54]. Based on this, we anticipated that artistic creation would have a profound impact on life attitude scores; however, this was not reflected in our findings. Before analyzing the data, it’s important to note that participation is mandatory only for PGY physicians, while other staff are invited but not required to participate. It’s reasonable to assume that the lower life attitude scores in the participating group stemmed from those reluctant to join. We acknowledge this reality but recognize that making the course mandatory encourages students who might not otherwise engage to explore creativity. The aim of mandatory creativity was to provide structured opportunities for participants to reflect on their own experiences while engaging with the stories and perspectives of others. Previous research has demonstrated that artistic creation can foster empathy and promote perspective-taking, facilitating deeper connections with others’ life experiences [55]. The primary objective of the program was to cultivate self-awareness, empathy, and reflective practice among hospital staff through an arts-mediated educational strategy grounded in transformative learning. Participants, including physicians, nurses, administrative, and allied health staff, were invited to create free-form artworks based on personal or clinical experiences that had shaped their understanding of life and care. Over the course of a year, these artworks were developed individually or collaboratively. A week-long exhibition was held in a high-traffic area of the hospital, allowing staff and visitors to engage with the artworks. Finally, creators were invited to share the stories behind their work in oral presentations, fostering peer dialogue and deeper reflection. This engagement provides trainee physicians an opportunity to enhance their sensory and metaphorical perception and enjoy the intrinsic satisfaction that comes from creativity [56]. It has been reported that a small percentage of medical students—whether artistically inclined or not—may feel discomfort or annoyance when required to participate in mandatory creative assignments [56]. While the referenced study focused on undergraduates, similar dynamics may also apply to postgraduate healthcare trainees, who can experience unease when engaging in compulsory artistic expression. Nonetheless, such encounters may offer valuable opportunities for autonomous expression—‘giving voice to that which is typically unvoiced’—and fostering reflective growth [56]. In societies influenced by Confucian values—such as Taiwan— where emotional restraint and the notion that ‘silence is golden’ are often upheld, making a creative arts course mandatory may serve an important function in encouraging emotional expression and self-awareness [57, 58]. To respect individual preferences, the course allows flexibility in the mode of participation, including the option of collaborating in small groups of 2–3 people. This provides a degree of psychological safety for those who may initially feel uncomfortable with personal disclosure. Interestingly, previous research suggests that even individuals who initially resist such activities may come to appreciate the value of creative engagement over time [56]. While the notion of ‘compulsory creativity’ may appear paradoxical, in this context it functions less as a constraint and more as a catalyst—encouraging learners to step outside their comfort zones and potentially discover new forms of self-expression.

Our findings showed that attending the workshop two or more times was associated with significantly higher life attitude scores. Attendance at a single session also showed some benefit, particularly in 2021. This pattern may reflect a cumulative or reinforcing effect, where repeated engagement with the reflective and creative components of the intervention provides participants with more opportunities for internalization and transformation. Although the data suggest a trend favoring sustained participation, we do not interpret this as a linear or dose-dependent relationship. Rather, we view it as indicative of the potential benefits of ongoing engagement with emotionally expressive educational formats that allow for progressive personal meaning-making. Because our study was conducted anonymously, we were unable to compare pre- and post-scores. We cannot rule out the possibility of self-selection bias—namely, that individuals who already held more positive life attitudes were more motivated or open to participating in the workshop. Such individuals may be more receptive to activities involving reflection and creative expression, which could contribute to the observed associations. Therefore, while our results suggest a potential benefit of repeated participation, they should be interpreted with caution, and future research with randomized or controlled designs is needed to better establish causality. However, upon further analysis, we found that not all groups of gender, professions and working years with ≥ 2 attendances showed higher life attitude scores. This indicates that factors beyond inherent personality traits may also contribute to shaping participants’ life attitudes through the workshop experience. Specifically, variables such as the participants’ clinical roles, years of service, and the nature of their day-to-day involvement in patient care may influence the way they engage with the reflective process. These professional experiences shape not only their emotional responses but also the depth and content of their reflections. The workshop further offered an opportunity for participants to make sense of emotionally charged clinical encounters, explore the meaning of life through creative expression, and find resonance in the shared experiences of their peers.

Our results showed that physicians and nurses with fewer years of clinical experience exhibited the greatest improvements in life attitude scores when they attended the workshops more frequently. It was not observed in other medical professionals and non-medical staff. This is understandable, as physicians and nurses—particularly those early in their careers—often face intense pressure stemming from the demands of clinical work. In addition to acquiring technical competencies, they must also navigate complex interpersonal dynamics involving patients, families, peers, and supervisors. Previous studies have shown that young healthcare professionals are especially susceptible to occupational stress and burnout due to emotional demands, heavy workloads, and limited coping resources during this formative stage of their professional development [59, 60]. Artistic activities help explore emotions, fostering personal growth and well-being [53, 61,62,63,64,65,66].

Our data were collected from 2020 to 2021. Although COVID-19 emerged globally in 2020, Taiwan remained relatively unaffected for much of that year due to swift containment strategies and border control measures. It was not until May 2021 that Taiwan experienced a significant community outbreak, which led to the implementation of strict isolation measures and movement restrictions [67, 68] Thus, our data span two distinct phases in Taiwan: the early pandemic period in 2020, when the local impact of COVID-19 was limited, and the mid-2021 outbreak period, when significant public health restrictions were implemented. During 2021, entrance restrictions and the shift to online presentations due to COVID-19 significantly reduced attendance rates. Although this change might have limited the opportunity for some attendees or participants to fully engage with the exhibition and activities, the individuals who did attend may have experienced heightened personal reflection due to the unique challenges posed by the pandemic. Despite these challenges, our findings show that even with reduced face-to-face interactions, the attendees or participants who engaged with the workshops reported improved life attitude scores, which may suggest that the emotional and reflective aspects of the experience still had a meaningful impact.

Our findings have implications for arts-based medical education programs aimed at a broad range of hospital staff, including physicians, nurses, allied health professionals, and administrative personnel. These programs, while not specifically focused on traditional faculty development, seek to foster self-awareness, emotional resilience, and meaning-making among staff. The objective is to promote personal reflection and empathy, which are key components of Whole Person Care. By engaging staff in creative exercises, the program helps them develop a deeper understanding of their roles in patient care and strengthens their capacity to contribute to compassionate, patient-centered healthcare. Three key principles of the learning environment were integral to the design of the intervention: openness, compulsory but increased autonomy, and room for emotion. Openness was fostered by creating a non-judgmental, safe space for participants to engage in artistic expression. Compulsory but increased autonomy was achieved by requiring participation while allowing individuals to choose their preferred mode of engagement, whether individually or in small groups, and to engage at their own pace. Finally, room for emotion was a central component, with the creative process providing participants with opportunities to express and reflect on their emotions, which is essential for building emotional resilience and empathy in a healthcare setting. We highlight an unexplored area concerning which hospital staff populations benefit most from the learning experiences of creating and appreciating artworks. Our findings suggest that repeated participation in arts-based workshops improves life attitudes and emotional well-being, with potential benefits differing by staff role and experience level. Further research is needed to explore which specific factors influence the effectiveness of these interventions. In addition, our study underscores the need for innovative curricula that support new physicians and nurses through the emotional challenges they face in the early years of their careers. Such programs could help cultivate emotional resilience, enhance self-awareness, and foster empathy, ultimately improving both personal well-being and patient care.

This study has several limitations. First, to encourage participants to express their attitudes towards life, the study was anonymous, which prevented a pre-post analysis of life attitude scores and hindered the ability to establish causal links between art workshops and life attitudes. However, based on the correlation between workshop participation frequency and life attitude scores, we infer a positive influence of the workshops. Second, COVID-19 restrictions altered workshop processes and reduced participation, though the results remained consistent with pre-restriction findings, supporting the credibility of our conclusions.

Third, the response rate was below 30% in 2020 and even lower in 2021. We could not assess the life attitudes of non-responders. However, non-response itself may reflect a specific life attitude, as survey respondents are often more socially engaged [69]. Our study found lower response rates among male participants, physicians, and new employees. While factors like indifference or negative life attitudes could explain this, our findings did not show significantly lower life attitude scores among these groups. Further efforts to increase response rates are needed.

Conclusion

Our study demonstrates that art-mediated educational interventions positively influence life attitudes among hospital staff. Participants who both attended and actively participated in art workshops had higher life attitude scores than those who only attended or participated, with both groups outperforming non-engaged staff. Notably, the frequency of engagement was positively correlated with life attitude scores among physicians and nurses, especially those with fewer years of work experience. This pattern was not observed among other healthcare professionals or non-medical staff. These findings suggest that art-mediated educational interventions can enhance life attitudes among hospital staff, with engagement frequency, professional category, and work experience serving as key moderating factors. Early-career physicians and nurses appear to derive the greatest benefit, highlighting the potential of transformative learning through art to cultivate resilience. Integrating art-based strategies into healthcare education may therefore promote holistic growth and well-being among healthcare professionals.