A Randomized Controlled Trial of Art Observation Training to Improve Medical Student Ophthalmology Skills
Jaclyn Gurwin; Karen E. Revere; Stephanie M. Davidson; Suzannah Niepold; Rebecca Mitchell; Barbara Bassett;
Horace DeLisser; Gil Binenbaum
Perelman School of Medicine at the University of Pennsylvania
Introduction: We sought to evaluate the effects of formal observation training in the visual arts on the general and ophthalmological observational skills of medical students.
Methods: We collaborated with The Philadelphia Museum of Art (PMA) to conduct a randomized, controlled, single-masked trial of 36 first-year medical students, randomized 1:1 into art-training and control groups. The art-training group received six custom-designed 1.5-hour art observation sessions at PMA. All subjects completed pre and post testing, in which they described works of art, retinal pathology images, and external photos of eye diseases. Written descriptions were graded for observational and descriptive abilities by reviewers masked to group assignment and pre/post-status, using an a priori rubric.
Results: Observational skills, as measured by description testing, improved significantly in the training group (mean change +19.1 points) compared to the control group (-13.5)(p=0.001), and there were significant improvements for each art and clinical sub-score. In a post-study questionnaire, students reported applying the skills they learned in the museum in clinically meaningful ways at school.
Discussion: Observation is a key component of ophthalmological examination and diagnosis. It is a difficult but pivotal skill to teach especially for beginner students and residents who must rely on their descriptive abilities to convey exam findings. It is encouraging to learn that principles from the field of visual arts, which is reputed to excel in teaching observation and descriptive abilities, can be successfully applied to medical training.
Conclusion: Art observation training for medical students can improve clinical ophthalmology observational skills. Further studies can examine the impact on clinical care.
References: Shapiro J, Rucker L, Beck J. Training the clinical eye and mind: Using the arts to develop medical students’ observational and pattern recognition skills. Med Educ. 2006;40:263-8.