Art Observation Training Improves Medical Students' Visual Literacy
Basic physical examination skills among medical students, residents and practicing physicians have been on the decline. Simple procedures that were routinely done by health care providers, such as careful inspection, are now often replaced by expensive laboratory tests and radiological exams. In an effort to change this trend, researchers from Brigham and Women’s Hospital (BWH) designed a pre-clinical course for Harvard Medical School students to enhance their diagnostic abilities and improve their visual acumen through close observation and guided discussion of fine art and artistic concepts and application of these new skills to clinical patient assessments. The researchers found that the students who took the course had a 38 percent increase in overall accurate visual observations of patients and art work compared to otherwise similarly-trained control students in the study. The findings appear in the July, 2008 issue of the Journal of General Internal Medicine.
The course, Training the Eye: Improving the Art of Physical Diagnosis is a nine week pre-clinical course that meets weekly for two-and-a-half-hour sessions, and features observation exercises at Boston’s Museum of Fine Art (MFA) and lectures linking visual arts concepts with physical diagnosis. An optional ninth class is offered where students have the opportunity to draw the human body from a live model with professional art instruction available. Both the students in the class and the control group took pre-course and post-course visual skill examinations.
As an example, in one session the students practiced inspecting, verbally describing, interpreting and building on the analyses of how form was used in works by ancient Chinese and aboriginal artists exhibited at the MFA, and then explored how careful examination of form in patients can reveal the causes of various breathing disorders. Other artistic topics studied by the students in the matched museum and didactic sessions included luminance (patient color), texture and pattern (dermatology), symmetry (neurology), and line contour (radiology). The works of art included paintings by Pablo Picasso, Claude Monet, John Singer Sargent, Jackson Pollack, Jan Steen and others.
The researchers, led by Joel Katz and Shahram Khoshbin, from the Departments of Medicine and Neurology at BWH, found that students completing the course made more accurate observations on the visual skills exam compared to the control group. There was an average increase of 5.41 observations per image, after the taking the course. The control group showed no improvement in the average number of observations. Overall, students in the class showed a 38 percent improvement in accurate observations compared to the control students. In addition, class participants described images with a higher level of sophistication and complexity.
"Our findings suggest that through the structured study of works of art and medical imagery, visual inspection skills, including those directly relevant to clinical medicine, can be improved," said Katz. He added, "At a time when physical examination skills are waning, I am encouraged that an interdisciplinary course designed to help develop better visual literacy can expand medical students’ diagnostic capabilities. An unintended benefit of the course was to inspire busy medical students with the wonders of the extraordinary MFA collection just down the street."