October 19, 2019

Art, Medicine, and a Real Education

More and more doctors today are using methods taught in art class to help diagnose their patients. Yes, art class.

At a time when budget cuts are marching in lockstep to slash, or eliminate, art lessons at the elementary and high school level, universities are embracing the study of art as never before. It is a backlash that's been long overdue.

Scientific studies conducted by major universities throughout the country are proving that training the eye to fully observe, and respond to, a work of art can effectively enhance the observational and diagnostic skills of medical students. I'm hoping these studies (and they are many, as you'll soon see) will have a trickle down influence on the development of art programs for the lower grades as well.

Just as advances in neuroscience have recently shown (what many educators have long known) that simply learning to play an instrument and studying music creates new brain patterns that enhance both math skills and overall academic achievement, proper education in the visual arts achieves an equally positive (if different) effect. For the greater good of humanity, it's time we reintroduced both music and art as essential components of every child's education, from grade school on up.

Acing AP classes and the ACT and SATs does not an educated member of society make. It takes a critical mind — one aware of, and able to contemplate, shades-of-gray nuances and contradictory information — to become a sustainable adult in our increasingly complex world. If our children are to survive the 21st century, we need original thinkers as never before.

How does the study of art enter this picture? Let's go back to 1999, when Yale University School of Medicine faculty member Dr. Irwin Braverman and Linda Friedlaender, curator of education at the Yale Center for British Art (home to the largest collection of British artwork outside the U.K.), jointly developed a course called “The Art of Medicine.” (It went on to become a required visual tutorial for all first-year School of Medicine students.)

By encouraging doctors-in-training to “diagnose” portraits in the collection, the tutorial reinforces essential, and often neglected, patient observation skills. This works in direct contrast to our age's tendency to rely solely on high-tech imaging and tests.

Fully observing a person with one's own eyes and not missing a single detail (as students were quick to discover while contemplating centuries'-old portraits) can't happen while staring fixedly at rows of data on a computer screen. But it can make all the difference between a correct and inaccurate diagnosis … and life and death.

Due to the program's success, over 50 universities around the country now implement similar arts instruction for their physician trainees. Nevertheless, many individual schools of medicine still feel the need to prove the efficacy of their particular version of the program for themselves.

In 2008, Sheila Naghshineh, MD, and her team published a study based on Harvard University's intensive, 10-week elective arts/clinical course for medical students called “Training the Eye.” The course teaches basic art observation and drawing skills (in order to enhance physical exams and diagnoses) at their local art museum, Boston's prestigious Museum of Fine Arts. Museum arts advisor Alexa Miller feels the study of artworks provides a safe way for students to train their eyes and minds to notice and accept ambiguity, and more nuanced interpretations.

As Miller explains: “The arts present a space where we can be in ambiguity in a safe and positive way where nobody is dying and nobody is suffering. Uncertainty is a very authentic part of life and problem solving. Uncertainty is welcome, helpful, and interesting in arts situations.”

Students who participated in seven or more Training the Eye course sessions were found to make 38% more observations than their peers — both in art and clinical settings. Course participants also provided more evidence for these observations. Anyone who's ever watched an episode of House can easily understand how important both careful observation and knowledgeable, reflective deduction can be for proper patient care.

I only became aware of this vital art-and-medicine coupling a few days ago — when my local, public-radio station ran a segment on how the University of Miami (UM) is supplementing the clinical training of all its medical, nursing and physical therapy students with visits to the school's on-campus Lowe Art Museum. At first, my newly “cynical” persona thought: Great! At least now this wonderful art museum — South Florida's first and most comprehensive — has a hard-science, practical reason to continue to exist (the only type that seems to count these days).

And I wasn't all that far off. Despite the results of both the Yale and Harvard studies, as well as arts programs implemented by some of our nation's most prestigious medical training facilities — including Rutgers, Brown and Johns Hopkins — and despite the success and popularity of museum-based workshops run by its own medical school since 2008, UM decided to test its “The Fine Art of Health Care” version of an arts program only this past June.

Not surprisingly, UM's tests are yielding yet more spectacular results. (Also, not surprisingly, Linda Friedlaender, the original Yale-based arts program co-developer, has recently decided to compile a comprehensive study of all arts program research conducted by the growing numbers of university medical/art teams.)

UM's art program is somewhat different in that it tends not to engage with “obvious” human figures (as in classic, representational British portraiture) for student observations. Instead, art gallery visits focus on more contemporary and non-representational large glass sculptures, as well as Baroque and Greek vases, for its diagnostic curriculum.

Hope Torrents, Lowe Art Museum's school programs coordinator, claims that a work of art's ambiguity, in and of itself, makes it “a perfect tool to get people to look harder and think longer.” To help train medical students to look longer and more thoughtfully, she employs Visual Thinking Strategies (VTS) — a series of open-ended questions designed to help museum visitors engage with art, first introduced in the late '70s. A 2011 UT San Antonio VTS study confirmed that students who spent time looking at art also spent more time looking at patient images.

For the University of Miami's study, 80 third-year medical students from UM Miller School of Medicine were divided into groups of 10 or 12. Half of these groups attended five Fine Art workshops; the other half (the control group) spent time visiting Vizcaya Museum & Gardens — a magnificent historical estate brimming with American and European art — but were given no specific art-appreciation training. Both groups of students were then timed on how long they spent collecting medical histories with a standardized set of patients.

Early results show that the VTS-trained students spent more time looking at, and engaging with, their patients, as well as considering a greater number of alternate diagnoses that did not merely conform to what appeared on the charts. In contrast, those who simply “had a nice time at Vizcaya” did not appear to change their more tunnel-vision, computer stats-oriented behavior.

Interviews with med students who'd been through the arts program were overwhelmingly positive. Many pointed to specific instances where their arts training “brought their eyes back to the patient.” It helped them to notice, for instance, a stressed sadness in the eyes, or an unusual growth, which they say they would never have picked up on from studying patient charts alone.

This change in focus is especially vital given a 2013 study by Johns Hopkins that found first-year medical residents spend 12% of their time interacting with patients … and more than 40% of their day glued to a computer screen. With group practices and insurance companies constantly pushing for greater productivity (i.e., seeing more patients in less time) alongside today's medical personnel's need to document and code everything for prior authorization and payment, these lopsided statistics should come as no surprise.

Based on my own recent experiences as a patient (or when accompanying one), I'm surprised if a doctor even looks up at all — other than to say hello upon first entering the room, for all of two minutes. So anything that forces medical practitioners to really see, and listen to, their patients is worthy of serious consideration.

Still, I can't help feeling that, in many ways, the idealism and time-honored goals of the practice of medicine imparted by our great teaching universities lie at cross purposes with the crass factory system even well- and sympathetically trained diagnosticians encounter — once they leave academia for the real world.

As patients, perhaps it's time we step up to our doctors, stare them in the face, and demand they look at us like the “unique works of art” we truly are.

And it certainly wouldn't hurt our society, and the world-at-large, to embrace arts training as a way to facilitate thoughtful, independent observation in everyone. Especially when it comes to the next generation. Let's use what we now know about an arts education to help teach our children well.

© 2015 Mindy Leaf

Follow Mindy's essays of biting social commentary at: “>https://askmamaglass.wordpress.com