Medical school won't teach you to observe – but art class will, study finds

By John Murphy, MDLinx
Published September 8, 2017

Key Takeaways

Medical students who took an art training course scored significantly better in professional observation skills than their peers who didn’t take the course, according to a new study from researchers at the University of Pennsylvania’s Perelman School of Medicine and Children’s Hospital of Philadelphia (CHOP), in Philadelphia, PA.

The medical students who participated in the three-month art class were able to take the skills they had learned in the art museum and apply them in clinically meaningful ways in medical school, the researchers reported. Their results were published in the journal Ophthalmology.

Observation and description are critical skills for physicians (particularly ophthalmologists), yet courses in medical schools tend to emphasize identification of memorized clinical signs rather than formally teaching students how to observe and describe, noted the study’s lead author Jaclyn Gurwin, MD, an ophthalmology resident at the University of Pennsylvania’s Scheie Eye Institute in Philadelphia, PA. As a result, medical students and practicing physicians have been criticized for lacking these skills.

In contrast, education in visual arts is reputed to excel in teaching observation and descriptive abilities. “The skills I learned studying fine arts in college are invaluable to me now as a physician,” Dr. Gurwin said. “I saw the impact art education had on my approach to medicine, and I wanted to recreate that experience for others in the field.”

To prove this, Dr. Gurwin and colleagues tested whether visual arts training can help medical students with their clinical training. The researchers randomized 36 first-year medical students into two groups: one group took a three-month art training course, consisting of six 90-minute art observation sessions that were custom-designed and taught by professional art educators at the Philadelphia Museum of Art. The sessions used the “Artful Thinking” approach, which emphasizes introspection and observation before interpretation. The other (control) group received no formal training, but they were given free membership to the museum.

Before and after the training, both the art training group and the control group were given written tests to assess their ability to describe three types of images: works of art, retinal pathology images, and external photographs of eye diseases.

By the end of the study period, the art training group had significantly improved their scores in observational skills (an average increase of 19 points from baseline) compared with the control group (an average decrease of 13.5 points from baseline). Subgroup analyses further showed that art training improved clinical observational skills of retinal disease and external eye disease as assessed by photos.

In a post-study questionnaire, students reported they were already applying the skills they learned in art training to their medical training.

“After just the first session, I found myself listening to a radiologist discuss the same principles we used to look at art in analyzing a CT scan,” one student commented. “Later I found our practice creating narratives [in the art classes] helped guide me through standardized patients.”

Previous studies have found that art observation training, when combined with a medical clinical component, improved students’ descriptive abilities. But this study suggests that art training alone can help to teach medical students to become better clinical observers.

“The results of this study are incredibly encouraging, showing that art observation training can improve medical and ophthalmological observational skills,” Dr. Gurwin said. “We hope that the improved observational abilities from this training will translate to improved clinical effectiveness, empathy and, ultimately, will make better physicians.”

Given the success of this study, the Perelman School of Medicine is already offering the art training course to first-year medical students for the 2017 fall semester.

The researchers are also planning to further investigate the effectiveness of more focused training and testing of empathy, and how long the clinical impact of art training lasts during medical school.

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