Medical Schools have been using fine arts training to enhance their curriculum. The following are studies where visual thinking strategies have been studied and some data collected on the effectiveness.
Klugman, C, Peel, J, Beckmann-Mendez, D. Art Rounds: Teaching Interprofessional Students Visual Thinking Strategies at One School. Academic Medicine 2011; 86(10): 1266-1271
PURPOSE: The Art Rounds program uses visual thinking strategies (VTS) to teach visual observation skills to medical and nursing students at the University of Texas Health Science Center San Antonio. This study’s goal was to evaluate whether students’ exposure to VTS would improve their physical observation skills, increase tolerance for ambiguity, and increase interest in learning communication skills.
METHOD: In January 2010, 32 students attended three, 90-minute sessions at which they observed and commented on three pieces of art in small groups led by museum educators. Pre and posttest evaluations included Geller and colleagues’ version of Budner’s Tolerance of Ambiguity Scale, the Communication Skills Attitudes Scale, and free responses to art and patient images. Statistical analyses compared pre and post time looking at images, number of words used to describe images, and number of observations made according to gender and discipline.
RESULTS: Students significantly increased the amount of time they spent looking at art and patient images (P = .007), the number of words they used to describe art (P = .002) and patient images (P = .019), and the number of observations made of art (P = .000) and patient images (P = .001). Females increased the time spent observing significantly more than did males (P = .011). Students significantly increased their tolerance for ambiguity (P = .033) and positive views toward health care professional communication skills (P = .001).
CONCLUSIONS: The authors speculate that these improved skills may help in patient care and interprofessional team interactions.
Naghshineh S, Hafler JP, Miller AR, Blanco MA, Lipsitz SR, Dubroff RP, Khoshbin S, Katz JT. Formal art observation training improves medical students’ visual diagnostic skills. Journal of General Internal Medicine 2008; 23(7): 991-7.
BACKGROUND 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.
OBJECTIVE To improve students’ visual acumen through structured observation of artworks, understanding of fine arts concepts and applying these skills to patient care.
DESIGN Prospective, partially randomized pre- vs. post-course evaluation using mixed-methods data analysis.
PARTICIPANTS Twenty-four pre-clinical student participants were compared to 34 classmates at a similar stage of training.
INTERVENTION 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.
MEASUREMENTS 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.
RESULTS 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 alt=” ” title=”” v:shapes=”_x0000_i1035″>=0.03).
CONCLUSIONS This interdisciplinary course improved participants’ capacity to make accurate observations of art and physical findings.
Dolev JC, Friedlaender LK, Braverman IM. Use of fine art to enhance visual diagnostic skills. Journal of the American Medical Association 2001; 286(9): 1020-1.
Observational skills that define the astute clinician are usually only acquired after years of clinical experience. Recognizing both the subtle and obvious visual details is a critical aspect of visual diagnosis or “seeing.” Nonetheless, the formal teaching of observational skills is rarely included in the medical curriculum. We studied whether the experiential process of seeing such visual details can be enhanced in medical students through systematic visual training using representational paintings.
Bardes CL, Gillers D, Herman AE. Learning to look: developing clinical observational skills at an art museum. Medical Education 2001; 35(12):1157-61.
CONTEXT: Clinical diagnosis involves the observation, description, and interpretation of visual information. These skills are also the special province of the visual arts. We describe an educational collaboration between a medical school and an art museum, designed for the purpose of developing student skills in observation, description, and interpretation.
OBJECTIVES: In the programme, medical students first examine painted portraits, under the tutelage of art educators and medical school faculty. Then, the students examine photographs of patients’ faces and apply the same skills.
CONCLUSION: This programme, well-received by students and faculty, appeared to help the students not only in improving their empirical skills in observation, but also in developing increased awareness of emotional and character expression in the human face.
Shapiro J, Rucker L, Beck J. Training the clinical eye and mind: using the arts to develop medical students’ observational and pattern recognition skills. Medical Education 2006; 40(3):263-8.
INTRODUCTION: Observation, including identification of key pieces of data, pattern recognition, and interpretation of significance and meaning, is a key element in medical decision making. Clinical observation is taught primarily through preceptor modelling during the all-important clinical years. No single method exists for communicating these skills, and medical educators have periodically experimented with using arts-based training to hone observational acuity. The purpose of this qualitative study was to better understand the similarities and differences between arts-based and clinical teaching approaches to convey observation and pattern recognition skills.
METHOD: A total of 38 Year 3 students participated in either small group training with clinical photographs and paper cases (group 1), or small group training using art plus dance (group 2), both consisting of 3 2-hour sessions over a 6-month period.
FINDINGS: Students in both conditions found value in the training they received and, by both self- and instructor-report, appeared to hone observation skills and improve pattern recognition. The clinically based condition appeared to have been particularly successful in conveying pattern recognition concepts to students, probably because patterns presented in this condition had specific correspondence with actual clinical situations, whereas patterns in art could not be generalised so easily to patients. In the arts-based conditions, students also developed skills in emotional recognition, cultivation of empathy, identification of story and narrative, and awareness of multiple perspectives.
CONCLUSION: The interventions studied were naturally complementary and, taken together, can bring greater texture to the process of teaching clinical medicine by helping us see a more complete ‘picture’ of the patient.
Schaff, Pamela B, Suzanne Isken, and Robert M Tager. 2011. “From Contemporary Art to Core Clinical Skills: Observation, Interpretation, and Meaning-Making in a Complex Environment.” Academic Medicine 86 (10) (October): 1272–1276. doi:10.1097/ACM.0b013e31822c161d.
Many medical schools have incorporated experiences with representational or figurative art into the curriculum in an effort to improve learners’ powers of observation, visual diagnostic skills, and pattern recognition skills or to enhance communication skills, foster teamwork, and/or improve empathy. The Keck School of Medicine of the University of Southern California has partnered with Los Angeles’ Museum of Contemporary Art to design an educational experience with the goal of honing students’ abilities to observe, describe, and interpret complex information. The authors discovered that through a constructivist approach to viewing and discussing nonrepresentational, contemporary art, students were able not only to apply their observational and interpretive skills in a safe, nonclinical setting but also to accept the facts that ambiguity is inherent to art, life, and clinical experience and that there can be more than one answer to many questions. This intervention, entailing extensive guided inquiry, collaborative thinking, and process work, has allowed students and faculty to reflect on the parallel processes at work in clinical practice and art interpretation. In patient encounters, physicians (and physicians-in-training) begin with attention and observation, continue with multiple interpretations of that which they observe, move to sorting through often ambiguous evidence, proceed to collaboration within a community of observers, and finally move to consensus and direction for action. In the worlds of both art and medicine, individuals imagine experiences beyond their own and test hypotheses by integrating their own prior knowledge and intuition and by comparing their evidence with that of others.
Gaufberg, EG and Williams, MR. Reflection in a Museum Setting: The Personal Responses Tour. Journal of Graduate Medical Education: Dec 2011; 3(4): 546-549
INTRODUCTION: We describe an educational innovation piloted by the director of education at a university art museum and a physician-educator using the museum holdings as reflective triggers for medical learners. This innovation is distinct from the emerging trend of using art to build observation skills, enhance pattern recognition, and improve diagnostic acumen. Our intervention is specifically designed to promote individual reflection, foster empathy, increase appreciation for the psychosocial context of patient experience, and create a safe haven for learners to deepen their relationships with one another.
METHODS: Individuals randomly selected a question from a set prepared by the authors to guide a reflective exploration of the galleries. Each question was different, but all invited an emotional response-a connection between a work of art and some aspect of life or medical practice, for example, “Focus on a memorable patient, and find a work of art that person would find meaningful or powerful” or “Find an image of a person with whom you have difficulty empathizing.” The exploration ended with a shared tour of evocative objects selected by the participants. The duration of the exercise was approximately 1.5 hours and required minimal faculty preparation.
RESULTS: Most of the participants rated the exercise as 5 (excellent) on a 5-point Likert scale and particularly cited the effectiveness at stimulating reflection on meaningful issues and community building.
DISCUSSION: The exercise is easily reproducible in any art gallery space. The same basic format and facilitation technique opens new and different conversations depending on the composition of the group and the choice of artwork. Museum-based reflection warrants further experimentation, analysis, and dissemination.
In many ways, the practice of medicine has been a visual science from the time of the early Renaissance anatomists to the high-speed scanners of today. But images of patients and their anatomical parts do not necessarily lead to an understanding of their problems. Meaning must follow the sensory experience and be coupled with reflection. The visual arts, therefore, can be used to help physicians in training increase their observational and interpretive skills. Works by classic and contemporary artists can be used to increase awareness of the complex nature of human beings and their conditions, which lie beneath the appearances. In addition to painting, television, motion pictures, and printed media may also be used in classroom settings to educate. Medical schools that do not have accessible fine arts or humanities programs may form allegiances with local artists to increase communication and understanding between these disciplines.
Perry, M, N Maffulli, and S Willson. 2011. “The Effectiveness of Arts‐Based Interventions in Medical Education: a Literature Review.” Medical Education.
CONTEXT: Arts-based interventions, which aim to foster understanding of the patient’s perspective and to enhance communication skills, have been part of the medical curriculum for several years. This review aims to evaluate the available evidence base for their effectiveness and to suggest the nature of future work.
METHODS: The MEDLINE, Google Scholar and ISI Web of Knowledge databases were searched for published articles on studies that have attempted to evaluate the efficacy of an arts-based approach in undergraduate medical education. Further articles were identified through cross-referencing, discussion with colleagues and hand-searching key journals. One mixed, 10 qualitative and four quantitative studies were reviewed.
RESULTS: Some studies claim that arts-based interventions are effective in altering attitudes, but poor descriptions of methodology and results make it difficult to judge these claims. No studies consider the effects on behaviour. The evidence base for using arts-based interventions to foster diagnostic observation skills is stronger. However, their effect on other clinical skills has not been studied.
CONCLUSIONS: There is a need for further studies to produce a rigorous evaluation of arts-based interventions in terms of their effects on attitudes, behaviour and technical skills other than those involved in observation.
OTHER LINKS OF INTEREST:
ART AT THE UCLAMEDICALSCHOOL
Art can capture a multitude of meanings and help us see the world in different ways, including a way to understand those with illness. The Center for Educational Development and Research at
the David Geffen School of Medicine at UCLA will be sponsoring a rotating series of shows in our new medical education building, the LearningResourceCenter, curated by guest artist, Ted Meyer. While illness is considered unpleasant – something to be observed from a distance, avoiding close inspection – we hope these images succeed in compelling viewers to do the opposite: to be drawn in closer and discover how it relates to the whole person.