Journal of General Internal Medicine

, Volume 23, Issue 7, pp 991–997

Formal Art Observation Training Improves Medical Students’ Visual Diagnostic Skills

  • Sheila Naghshineh
  • Janet P. Hafler
  • Alexa R. Miller
  • Maria A. Blanco
  • Stuart R. Lipsitz
  • Rachel P. Dubroff
  • Shahram Khoshbin
  • Joel T. Katz
Original Article

DOI: 10.1007/s11606-008-0667-0

Cite this article as:
Naghshineh, S., Hafler, J.P., Miller, A.R. et al. J GEN INTERN MED (2008) 23: 991. doi:10.1007/s11606-008-0667-0

Abstract

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 = 0.03).

Conclusions

This interdisciplinary course improved participants’ capacity to make accurate observations of art and physical findings.

KEY WORDS

medical educationcurriculumphysical diagnosisphysical examinationfine art

Supplementary material

Copyright information

© Society of General Internal Medicine 2008

Authors and Affiliations

  • Sheila Naghshineh
    • 1
    • 2
  • Janet P. Hafler
    • 3
  • Alexa R. Miller
    • 4
  • Maria A. Blanco
    • 5
  • Stuart R. Lipsitz
    • 1
    • 8
  • Rachel P. Dubroff
    • 6
  • Shahram Khoshbin
    • 1
    • 7
  • Joel T. Katz
    • 1
    • 8
  1. 1.Harvard Medical School, Medicine Education OfficeBrigham and Women’s HospitalBostonUSA
  2. 2.University of CaliforniaLos AngelesUSA
  3. 3.Tufts University School of MedicineBostonUSA
  4. 4.Davis Museum and Cultural CenterWellesley CollegeWellesleyUSA
  5. 5.Harvard Graduate School of EducationCambridgeUSA
  6. 6.Department of MedicineColumbia University Medical Center, New York-Presbyterian, HospitalNew YorkUSA
  7. 7.Department of NeurologyBrigham and Women’s HospitalBostonUSA
  8. 8.Department of MedicineBrigham and Women’s HospitalBostonUSA