×

We would all be better off if medical students spent more time in art galleries and studios.

Evidence and anecdotes make clear an urgent need for better patient care. According to this study of 118 doctors across the U.S., only 31% of surveyed physicians correctly diagnosed four case studies—while rating their confidence of accuracy at an average of 6.8 out of 10. Within the process of diagnosis, physical examinations play a fundamental role. However, physical exams are often rife with errors and misperceptions, leading to a slew of potentially disastrous consequences for the patient: inaccurate or delayed diagnosis, improper or no treatment, unnecessary testing (and expenses), and complications.

While an effective physical exam involves touching, listening, and measuring vitals, looking is irrefutably an essential component of the practice. This study from the University of Washington School of Medicine finds that only about a quarter of selected doctors could locate and identify physical symptoms related to HIV; in the three cases, the percentages of physicians who correctly diagnosed the abnormalities were 25.8%, 22.7%, and 17%. As these results suggest, visual observation is a crucial but underdeveloped skill in medicine.

This lack of competency in visual observation seems to stem from gaps in the medical school curriculum. Medical school foregrounds scientific knowledge but neglects to teach the foundational skill of close observation. As the introduction of this paper, which reports the results of a partnership between Weill Cornell Medical College and the Frick Collection, explains, “Courses in physical diagnosis teach the students to recognize normal and abnormal findings, especially the cardinal signs and symptoms of disease, but do not emphasize the actual skill of careful looking in itself. Looking is often assumed.” For the sake of patient care, it’s time to stop assuming.

Enter the visual arts. Looking at art is a slow, deliberate process of observation and reflection to form a well-founded conclusion or interpretation. Creating art requires meticulous attention to and consideration of your subject (whether tangible or conceptual) before ever making the first mark. In my years studying art before and during college, I learned how to see more thoroughly than before, and to perceive details others do not. Deliberate looking is the crux of the visual arts—and it is precisely the skill that many of our doctors are lacking.

Although science and the arts are frequently portrayed as mortal enemies, I am far from the first to believe they can be successfully married. The idea that engaging with various subject areas can foster empathy, critical thinking, and the ability to make sense of complex, nuanced topics is fundamental to any defense of the liberal arts. I attended a liberal arts college that emphasized the value of interdisciplinarity; while I studied color theory in painting class, I was writing lab reports about the visible light spectrum for physics class. Although my 9:30 AM physics lectures hardly inspired me to leap out of bed, they did provide me with an alternate, methodical perspective on a topic I thought I knew. Understanding the scientific bases of color and light allowed me to manipulate them in my work, and ultimately made me a more adept artist. In the same way, artistic practices help sharpen and develop medical skills.

But don’t just take my word for it. The Association of American Medical Colleges (AAMC), which administers the MCAT and of which every accredited American and Canadian medical school must be a member, has increasingly supported the integration of the arts and humanities into medical education. In their 2020 report, “The Fundamental Role of the Arts and Humanities in Medical Education,” the AAMC articulates the value of such curricular additions:

These [skills and competencies] include communication, teaming, adaptability, creativity, critical thinking, empathy, social advocacy, and resiliency. Human suffering and illness arise within complex contexts, and a physician’s ability to practice may be well served by exploration, construction of new ways of thinking, or even discovery of new questions or problems…Learner participation in integrative arts and humanities curricula may allow for deconstruction of silos of specialization…Being a doctor requires continuous learning, unlearning, and relearning and being able to formulate good questions, put disparate concepts together, and innovate.

It’s not just artists that want medical students to be exposed to the arts—it’s doctors too.

Over the past several decades, arts-based courses have been implemented into more and more medical school programs. Among the visual arts integration efforts that have been studied, the results are promising, especially in terms of improving visual analysis skills. A common way medical schools add art to the curriculum is through partnerships with nearby art museums or galleries. In one example, Harvard Dental and Medical School students were guided through careful observations of various artworks at the Boston Museum of Fine Art. A museum professional selected art that reflected medical themes and led the sessions. By the conclusion of the eight-week class, the students exhibited more sophisticated visual analysis skills between the pre- and post-course tests, while the control group’s abilities remained the same.

In a similar study, students at Weill Cornell Medical College analyzed pictures of patients, then turned to portraits displayed within the Frick Collection. Over the course of three sessions, students practiced their skills of “careful looking” and, by the end, demonstrated an increased observational maturity. The authors suggest students even gained insight into the individual humanity of the people whose faces they were examining.

A review of the literature surrounding the incorporation of visual arts courses into medical curricula affirms there is significant evidence such classes improve students’ observational capabilities—a potentially vital step towards increasing the efficacy of physical examinations. However, the doctors and museum professionals who authored this review are wary of whether other alleged benefits, such as increased empathy and a greater appreciation for diverse perspectives, can be substantiated. There is a lack of rigorous studies testing the validity of these claims, and these “soft” and interpersonal skills can be difficult to quantify. That being said, the development of important humanistic skills in visual arts-integrated medical courses has not been disproved. Instead, the lack of evidence indicates a need to devote more attention to implementing and evaluating such programs. In this article, professors from the University of Michigan Medical School delineate some standardized metrics that could be useful to measure the effectiveness of arts-focused medical coursework. Until more concrete assessments are conducted, we will have to rely on anecdotal evidence to explore more expansive advantages of the visual arts in medical education.

One such purported benefit is the ability to navigate situations that lack one clear explanation or solution. In a post from the AAMC’s blog, Adam Rizzo, a museum educator who works with medical students, expresses the value of encouraging medical students to engage with art: “By taking medical students out of their comfort zone and bringing them into the new context of the museum, students are faced with the challenge of interpreting artworks and artifacts that aren’t easily understood…Part of our job is to remind them that there isn’t always a right answer or even one answer. Art is a great way to explore that concept.” In other words, art can help students who are used to objectivity contend with subjectivity. Given that physicians are prone to extreme overconfidence, sitting with uncertainty could be a fruitful exercise in humility and adaptability.

Students who participated in Rizzo’s course reported they were able to better listen to and understand multiple viewpoints after guided group discussions in the museum. In another program, medical students at the University of Southern California’s Keck School of Medicine contemplated abstract contemporary art in Los Angeles’ Museum of Contemporary Art. In doing so, they learned to wrestle with complexities and nuance: “Students were able not only to apply their observational and interpretive skills in a safe, nonclinical setting but also to accept the facts that ambiguity is inherent to art, life, and clinical experience and that there can be more than one answer to many questions.” In our often discordant culture, physicians need to be able to sit with views that do not line up with their own.

The visual arts can not only help doctors take better care of their patients, but also of themselves. Alongside the COVID-19 pandemic, rates of physician fatigue and mental health issues surged; in 2021, 62.8% of doctors reported experiencing burnout. But this stress and exhaustion begins long before reaching M.D. status. This 2013 review, which looked at over three decades of relevant literature across PubMed/Medline and PsychInfo, estimates that half of U.S. medical students experience burnout at some point during their medical education. If medical students’ mental health has followed the trends of physicians and high school students, these statistics have likely only worsened in recent years. Amidst the rigor and expectations of medical school, it is essential to remember students are people, not just doctors-in-training.

Liselotte Dyrbye, a doctor whose work concerns physician well-being, says, “[Medical schools] play an enormous role in addressing [student burnout] … but teaching students self-care strategies can’t be the entire message…The institution also has to do the right thing and step up to create an environment where students can thrive and be challenged and learn.” Supporting medical students can take myriad forms, from taking a serious look at competitive school cultures to offering increased mental health services—and, of course, implementing arts-based courses into the curriculum.

The visual arts create space for personal enjoyment and relaxation within a demanding and draining environment, while still imparting crucial clinical skills. In one study conducted in the UK, a group of medical students at Norwich Medical School at the University of East Anglia elected to take a ten-week life drawing course with an anatomical emphasis. At the end of the class, the students gave overwhelmingly positive feedback and felt they had improved both their drawing skills and understanding of anatomy. In the post-course survey, the participants repeatedly mentioned their enjoyment of the course. Additionally, drawing helped them decompress from their other medical coursework. The authors of this paper assert the potential of visual arts-based courses like this to combat student burnout. By offering arts-integrated classes in their curriculum, medical schools can take a concrete step towards shifting the status quo into one that prioritizes the humanity and well-being of their students.

It may seem strange and unexpected to look to the arts to bolster medicine. But that is precisely why we must—if the entrenched systems are not functioning as they should, should we not utilize new and unfamiliar strategies? Visual art allows medical students to keep building the skills necessary for their career, while taking a break from intense scientific lectures. Observing and creating art teaches students to look more deeply, to recognize the simultaneous validity of multiple perspectives, and to relax. Patients, physicians, and medical students are needlessly suffering—and the beginning of a solution may be as simple as walking into an art gallery or flipping open a sketchbook.

Author

lkd44@georgetown.edu

Related Posts

Who Are We Protecting? Conflicts of the Choice Debate

Before I explore the cultural differences and similarities that define the abortion choice debate, have you read this short story, “The Ones...

Read out all

So You Tried a New Hobby in Lockdown—Now What?

I was lucky enough not to get COVID until April 2022. When it finally caught up with me, I spent my quarantine...

Read out all

Bulges

I frantically sketched the tilt of her shoulders and the contrary angle of her hips, charcoal dust settling on the toes of...

Read out all

To the Collector Go the Spoils: We Need to Change the Way We Credit Museum Donors and Donorship

Mary Lee Bendolph, Blocks and Strips, 2002, wool, cotton, corduroy, National Gallery of Art, Washington, Patrons’ Permanent Fund and Gift of the...

Read out all

Clearing the Dungeon: Telling New Stories with Old Tools in Dungeons and Dragons

Years of playing Dungeons and Dragons has taught me a very simple lesson about creativity: good work is original, great work is...

Read out all
css.php