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Formal Art Observation Training Improves Medical Students’ Visual Diagnostic Skills

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Journal of General Internal Medicine Aims and scope Submit manuscript

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.

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Acknowledgment

Grant support was provided by The Creative Center, New York, NY. We appreciate the administrative assistance provided by Linda Grover and Robert E. Heroux. We are grateful to Judith Hill for her contribution to the assessment process. Judy Pembroke, Wai-Kit Lo, M.D., course faculty members, MFA collaborators, including Barbara Martin, and participants in the 2003–2004 TE pilot, provided important creative contributions to the course design. Assessment tools were developed with the input of Philip Yenawine, Abigail Housen, and Patricia Foley of Visual Understanding in Education. The funding organization had no role in the (1) design or conduct of the study, (2) collection, analysis, or interpretation of the data, or (3) preparation, review, or approval of the manuscript.

Name and date of any conferences

Some of this material was presented at the October 2006 Medical Education Day poster session, Harvard Medical School, Boston, MA.

Conflict of interest

None disclosed.

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Corresponding author

Correspondence to Joel T. Katz M.D..

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11606_2008_667_MOESM1_ESM.doc

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Naghshineh, S., Hafler, J.P., Miller, A.R. et al. Formal Art Observation Training Improves Medical Students’ Visual Diagnostic Skills. J GEN INTERN MED 23, 991–997 (2008). https://doi.org/10.1007/s11606-008-0667-0

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