Medical training has taken an artistic turn for some students at the School of Medicine. Dr. Irwin M. Braverman, professor in the department of dermatology and in the Yale Cancer Center, has introduced students to a method of learning that takes them out of the traditional classroom and into the museum.
In a tutorial called the "British Museum Project," Braverman instructs students to observe selected paintings at the Yale Center for British Art, and make judgments about how thoughts and feelings are communicated visually. His goal is to train students to become more careful observers by learning to decode an object's meaning and extract information through observation.
According to Braverman, with heightened observation skills, physicians can ask the questions necessary to make correct diagnoses without relying too much on costly blood tests and x-rays.
"Doctors have to be taught to pick up on details that are often overlooked," says Braverman. "It is through these details that they can come up with better diagnosis of patients. This makes them better doctors and benefits the patient."
Braverman came up with the new teaching method last November while thinking of ways to get his dermatology residents to sharpen their observational skills. He teamed up with Linda Friedlaender, curator of education at the Yale Center for British Art, to develop a tutorial that used highly detailed original works of art.
Students are assigned a painting and given time to observe and study it "like a rash that has been framed," quips Braverman. In turn, students describe the work based solely on what they see. They learn from group discussions, reactions and observations.
According to Braverman, before he came up with his concept, Friedlaender had already been thinking about developing the same kind of observational exercise for residents in the orthopaedics and rehabilitation department, which is chaired by her husband, Dr. Gary E. Friedlaender, professor in the department of orthopaedics and rehabilitation, who is also affiliated with the Cancer Center.
"There is a natural parallel between medicine and art," says Linda Friedlaender. "This tutorial hones some of the same observational skills involved in making a diagnosis."
The medical students who participated in the tutorial say they found it to be a significant step in their medical training.
"This exercise helped me to really think about and analyze patients," says Leo Kim, a first-year medical student. "Like very detailed paintings, the human body is very complex, and learning to look and really see all the details of a painting helps in diagnosing patients."
The tutorial also was an eye-opening experience for Dr. Susan Crowley, assistant professor of medicine (nephrology) and a group mentor for the tutorials. "I was surprised at how many details you can miss when looking at paintings or a patient," she says. "It was a learning experience for me as well as for the students I mentor."
Braverman and Friedlaender chose narrative oil paintings such as "The Gore Family" by Johann Zoffany, "The Deluge" by John Martin and "The Life of Buckingham" by Augustus Egg. The paintings were all literal representations, and they all told a story. Students looked for the relationship between the figures in the paintings, the significance of any landscape, and the location and date of the paintings.
Although Braverman has not studied the effects the tutorial has had on the nearly 30 students who have participated, he saw a marked improvement in the observational skills of his dermatology residents.
"They are taking the time to think more before they make a diagnosis," says Braverman, who plans to expand the program to include x-rays and photos of skin cells. "In the old days, before the advent of modern medical technology, doctors had to rely on the connection between the eyes and the brain. I hope this tutorial can restore some of those methods."
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