By M.A. MALONE
It’s not as though School of Medicine students traded stethoscopes for berets. But the Cantor Center for Visual Arts worked its magic in January as medical students darted through the galleries tracking down artworks with the enthusiasm of 10-year-olds at a scavenger hunt.
Despite the excitement, it was no party; this was the launch of a new course, "Looking with Care: A Medical Observational Skills and Visual Arts Curriculum."
Born through the efforts of Jacqueline Dolev, MD, second-year internal medicine resident at Stanford Hospital; Elliott Wolfe, MD, director of the Office of Medical Student Professional Development; Audrey Shafer, MD, associate professor of anesthesia at the VA-Palo Alto Health Care System; and Patience Young, curator for education at the Cantor Center for Visual Arts, the class is designed to help doctors-to-be hone their observational skills.
First-year medical students write their observations while studying photographs before fanning out through the Cantor Center for Visual Arts. It’s part of a new class to help doctors-to-be become better observers. PHOTO: M.A.MALONE
By gazing at an artwork for 10 minutes, students and doctors can become better diagnosticians, explained Dolev. "The works of art are unfamiliar to the students so they don’t have the same bias they would if they were looking at a person," she said. " They search for and collect all of the details in the paintings because they do not have a bias as to which visual attribute is more important over another. This lowered threshold of observation directly applies to examing a patient."
Dolev became interested in combining medical studies and fine art as a first-year medical student at Yale. That interest snowballed into a three-year randomized study she conducted which showed how students who participated in fine-art training significantly improved observational skills when compared to a control group. This concept was later incorporated into the curriculum at Yale and Dolev’s findings were published in the Journal of the American Medical Association medical education issue.
Coincidentally, Wolfe, Shafer and Young had been developing a similar project with a fourth-year medical student at Stanford around the same time. Enter Dolev as a Stanford resident. She was hard at work one day in one of the wards when Wolfe caught a glimpse of her nametag and recognized her as the author of the JAMA article. They then started collaborating.
On the first day of the course, 80 first-year medical students passed through Cantor’s deserted galleries (closed to the public that day), assembling in a lecture hall. In a pre-test, they were asked to study photos of people, or parts of people, who had various medical conditions. They then had three minutes to jot down their observations. Next, they were divided into groups of six, with each student assigned to a preselected work of art. The students then scattered to track down their assigned painting or sculpture. After spending 10 minutes to note as many visual details as possible, they returned to their groups.
The groups rotated through the galleries, stopping at each of the chosen works. The student assigned to it then presented it to the group, describing his or her observations. This sparked others to offer their own observations along with an avalanche of suppositions.
"The woman is elderly and her hanging head makes her look exhausted and dejected," said one. "The muscles in her back are straining and the way her hand reaches across her back makes me think she has back pain," offered another. "Her face is haggard and her cheeks are sunken." "She looks worn out, as if she’s ready to die." "I don’t understand the cloth on her thigh. Is it a washcloth or is it a drape that’s fallen off her?"
They were discussing Rodin’s sculpture, "She Who Was the Helmet-maker’s Wife," which shows an old woman with deflated breasts and sagging skin.
Docents, two stationed at each artwork, acted as facilitators, keeping the students focused on the visuals. They stoked discussions with open-ended questions such as, "What in this sculpture is anatomically correct or incorrect?" They also kept the 14 groups rotating from work to work.
Student Justin Odegaard said it was a positive experience. "I think the majority of us noticed an increase in our own retention of detail and impression," he said, adding that details previously marginalized, whether consciously or unconsciously, were now making an impression. "Many participants felt their focus had been broadened through the observations of their fellow participants."
The new class has been officially accepted into the curriculum and will be offered once a year during winter term.
Stanford Report, February 19, 2003