Formal Art Observation Training Improves Medical Students’ Visual Diagnostic Skills

Harvard Medical School, Medicine Education Office, Brigham and Women's Hospital, Boston, MA, USA.
Journal of General Internal Medicine (Impact Factor: 3.42). 07/2008; 23(7):991-7. DOI: 10.1007/s11606-008-0667-0
Source: PubMed


Despite evidence of inadequate physical examination skills among medical students, teaching these skills has declined. One method of enhancing inspection skills is teaching "visual literacy," the ability to reason physiology and pathophysiology from careful and unbiased observation.
To improve students' visual acumen through structured observation of artworks, understanding of fine arts concepts and applying these skills to patient care.
Prospective, partially randomized pre- vs. post-course evaluation using mixed-methods data analysis.
Twenty-four pre-clinical student participants were compared to 34 classmates at a similar stage of training.
Training the Eye: Improving the Art of Physical Diagnosis consists of eight paired sessions of art observation exercises with didactics that integrate fine arts concepts with physical diagnosis topics and an elective life drawing session.
The frequency of accurate observations on a 1-h visual skills examination was used to evaluate pre- vs. post-course descriptions of patient photographs and art imagery. Content analysis was used to identify thematic categories. All assessments were blinded to study group and pre- vs. post-course evaluation.
Following the course, class participants increased their total mean number of observations compared to controls (5.41 +/- 0.63 vs. 0.36 +/- 0.53, p < 0.0001) and had increased sophistication in their descriptions of artistic and clinical imagery. A 'dose-response' was found for those who attended eight or more sessions, compared to participants who attended seven or fewer sessions (6.31 + 0.81 and 2.76 + 1.2, respectively, p = 0.03).
This interdisciplinary course improved participants' capacity to make accurate observations of art and physical findings.

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Available from: Maria A Blanco, Dec 08, 2014
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    • "Indeed a subset of these students reported that the sessions increased their empathy by creating an opportunity to consider others' points of view, and reconsider their own preconceived notions; a useful skill that supports patient-centred care, and particularly so when dealing with patients whose clinical problems do not fit easily into a diagnosis. Naghshineh et al. (2008) provided medical students with 8 weeks of didactic sessions held in an art gallery that integrated physical diagnosis with art topics and life drawing. Students exhibited enhanced " visual literacy, " a term from a text edited by Flood and Lapp (1997), as illustrated in their sophisticated description of artistic and clinical imagery. "
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    • "This course enhances pre-service teachers' professional vision, such that they can better predict whether students can study by themselves or whether they need more focused instruction, by observing the students in a classroom environment (Stürmer et al., 2013). Furthermore, supervisors' comments and declarative knowledge also enhance the visual diagnostic skills of medical students (Naghshineh et al., 2008). These findings imply positive links between combined declarative knowledge/exemplar-based training and professional vision. "

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    • "The researchers found that students who were exposed to the training had significant improvement in identifying heart, lung and bowel sounds. Many researchers have demonstrated the use of visual art, such as paintings and photographs, as a way to improve physical diagnostic skills in the form of observing, identifying, discriminating and clustering data (Dolev, Friedlaender, & Braverman, 2001; Kirklin, Duncan, McBride, Hunt, & Griffin, 2007; Naghshineh et al., 2008; Pellico et al., 2012; Pellico, Friedlaender, & Fennie, 2009). This research has primarily been conducted using visual arts education techniques used originally to critique paintings and sculpture , often in collaboration with an art museum or gallery, to improve objective observational skills through visual stimuli (Braverman, 2001; Frei, Alvarez, & Alexander, 2010). "
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