Anatomy, Biochemistry, Cell Biology, Genetics, Immunology, and … Art??
Incorporating art classes in the first- and second-year curriculum of medical students has been a growing practice in schools across the country, aimed at correcting a perceived weakening of doctors’ physical exam skills in an era of advanced technology and rushed patient encounters. These classes are primarily utilized to build medical students’ observation and communication skills, increasing empathy, reflective thinking, patient focus, and interpretation of non-verbal cues. The ambiguity in art is correlated to the ambiguity in medicine, teaching students the necessity of considering a number of different possibilities before settling on a diagnosis, and of recognizing that straightforward conditions can present in unusual ways that can lead to misdiagnosis.
One of the first such classes was developed at Yale by Dr. Irwin Braverman, a dermatologist, in 1999. He found that medical students were often too hasty in their assessments or relied too heavily on hi-tech imaging and tests, rather than making detailed and careful observations and descriptions of what they saw in their patients. With the belief that developing skill in describing art would translate to skill in picking up on and describing information in medicine, he collaborated with the curator of education at the Yale Center for British Art to create the class, required of all first-year medical students. To sharpen their observational skills, students are asked, for instance, to carefully examine paintings whose titles and descriptions are hidden, replicating the experience of seeing a patient for the first time with no background knowledge. When they apply themselves to this task, they often find that their first impression of the scenario is not quite correct upon identifying additional clues in the smaller details. Dr. Braverman published a study in JAMA that reported a 10% improvement in the first groups of students’ ability to identify important details in patient encounters, and this type of observational learning program has subsequently been implemented in more than 20 other medical schools.
At Harvard, Dr. Joel Katz, who was a graphic designer before becoming an internist, designed a course for first- and second-year medical students called “Training the Eye: Improving the Art of Physical Diagnosis” in 2003. His students visit a variety of Boston-area museums, where they study artistic concepts such as symmetry, texture, form, and motion, which are then applied to the examination of patients in areas such as gait, breathing patterns, and patterns of rashes, as well as reading x-rays. The goal of Dr. Katz’s program, too, is to bolster students’ ability to look and listen carefully when they are performing hands-on exams and taking medical histories. He encourages students to avoid narrow thinking and hasty assumptions; rather, to note the context of the patient’s illness – the “scene” in addition to the “main character.” After taking the course, students were found to make 38% more observations on visual skills examinations of patients, as reported in the Journal of General Internal Medicine.
Penn State offers the course “Impressionism and the Art of Communication,” a collaboration between the College of Medicine and the McCann School of Art that teaches medical students to ask more open-ended questions of their patients. Students attempt to replicate a painting through descriptions elicited from a partner, based on the questions they ask of that partner. They also study “challenging” artists such as van Gogh, Gaugin, and Cezanne, representing communicating with challenging patients that may have underlying mental health issues.
More medical schools pick up on the concept of “visual literacy” each year, including Rutgers, Brown, Columbia, Washington University, Dartmouth, and USC. Leonardo daVinci is quoted as saying, “To develop a complete mind: Study the science of art; study the art of science. Learn how to see. Realize that everything connects to everything else.” More than 600 years later, this appears to still be apt advice.
Contributed by Holly Valovick -QLK