Artwork is useful in teaching visual diagnostic skills

Samantha Chan Edinburgh

Researchers at Yale have shown that with the help of detailed artwork, first year medical students can be trained to become better observers. The two year study was a joint project between Irwin Braverman, professor of dermatology at Yale School of Medicine; Jacqueline Dolev, dermatologist and Yale graduate; and Linda Friedlaender, curator of education at the Yale Center for British Art. The three developed a tutorial called the Yale Center for British Art Project (YCBA), in which students were assigned a painting, given time to study it, and then asked to describe the painting to their peers based solely on what they had seen.

Eighty one students received the YBCA tutorial, while 65 students in a control group received a tutorial in clinical history taking and examination. All the students first took a pretest, which required them to describe photographs depicting people with various medical conditions. After the prescribed tutorial, both groups then sat a post-test consisting of a new set of photographs. The students who had received the YCBA tutorial improved their detection of details by 10%, while the control group showed no significant improvement (JAMA 2001;286:1020).

"The 10% improvement is statistically significant," said Professor Braverman. "It makes the point that you can visually train someone to be a better observer, and it has added a dimension to the way medical students are taught at Yale." Braverman said that the tutorial, which has been emulated by other medical schools, has become an official part of the curriculum and could also be applicable to continuing medical education for qualified doctors.

"The use of representational paintings capitalises on the students' lack of familiarity with the artworks," said Braverman. "The viewers 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 than another. This direct threshold of observation has direct application to the examination of the patient."

The findings of the study and examples of the paintings used can be viewed on the website: http://info.med.yale.edu/dermatology/html/faculty/indexpage.html



studentBMJ 2001;09:399-442 November ISSN 0966-6494