Original Article

Journal of General Internal Medicine

, Volume 23, Issue 7, pp 991-997

First online:

Formal Art Observation Training Improves Medical Students’ Visual Diagnostic Skills

  • Sheila NaghshinehAffiliated withHarvard Medical School, Medicine Education Office, Brigham and Women’s HospitalUniversity of California
  • , Janet P. HaflerAffiliated withTufts University School of Medicine
  • , Alexa R. MillerAffiliated withDavis Museum and Cultural Center, Wellesley College
  • , Maria A. BlancoAffiliated withHarvard Graduate School of Education
  • , Stuart R. LipsitzAffiliated withHarvard Medical School, Medicine Education Office, Brigham and Women’s HospitalDepartment of Medicine, Brigham and Women’s Hospital
  • , Rachel P. DubroffAffiliated withDepartment of Medicine, Columbia University Medical Center, New York-Presbyterian, Hospital
  • , Shahram KhoshbinAffiliated withHarvard Medical School, Medicine Education Office, Brigham and Women’s HospitalDepartment of Neurology, Brigham and Women’s Hospital
  • , Joel T. KatzAffiliated withHarvard Medical School, Medicine Education Office, Brigham and Women’s HospitalDepartment of Medicine, Brigham and Women’s Hospital Email author 

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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 education curriculum physical diagnosis physical examination fine art