Visual Thinking Strategies: A New Role for Art in Medical Education
By Jo Marie Reilly, MD, Jeffrey Ring, PhD, and Linda Duke
April, 2005
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Summary: The use of humanities in medical education has become increasingly popular. Art, dramatic plays, poetry, narrative essays, and music all strive to facilitate awareness of the art of medicine, increasing compassion and empathy. Medical schools and residency programs increasingly incorporate various works from the humanities as tools to stimulate dialogue, discussion, and awareness among their medical learners, particularly in areas of doctoring, the experience of illness, and end-of-life issues. One humanities teaching strategy that has been less often incorporated in medical education, however, is the communal viewing of artistic paintings as a modality to increase sensitivity, team building, and collaboration amongst medical trainees.
Introduction
The use of humanities in medical education has become increasingly popular. Art, dramatic plays, poetry, narrative essays, and music all strive to facilitate awareness of the art of medicine, increasing compassion and empathy.1 Medical schools and residency programs increasingly incorporate various works from the humanities as tools to stimulate dialogue, discussion, and awareness among their medical learners, particularly in areas of doctoring, the experience of illness, and end-of-life issues.2,3 One humanities teaching strategy that has been less often incorporated in medical education, however, is the communal viewing of artistic paintings as a modality to increase sensitivity, team building, and collaboration amongst medical trainees.
There are no documented programs of art observation training in medical residencies and few such programs for medical students. Dolev and colleagues4 demonstrated improved visual diagnostic skills in medical students who participated in art observation workshops. Similarly, Bardes and colleagues5 found that medical students enthusiastically participated in art observation workshops, with resulting improvement in observation of painting and photographic details and of facial human emotions. Most exposures to art in the medical curriculum, when they do
occur, tend to be limited to depictions of surgeries and rounds from classic paintings that are included in lectures on the history of medicine.
While the use of artistic paintings as tools to increase awareness among medical students and residents has rarely been investigated, it has become increasingly common to use art images to teach younger audiences. One specific approach to teaching, known as Visual Thinking
Strategies (VTS), was codeveloped by Abigail Housen, a cognitive psychologist, and Philip Yenawine, an art educator. 6,7 Housen’s original research focused on aesthetic meaning making—the thinking strategies people use to find meaning in a work of art. In correlating sample thoughts from an open-ended interview (where people “think out loud” about an art image) with the amount of art experience subjects reported on a questionnaire, Housen discovered that thinking strategies cluster into five stages. She and Yenawine used the thinking characteristics of people in the beginning stages, stage one and stage two, to design teaching protocols that would offer appropriate challenge and support growth. Those protocols, collectively called VTS, use facilitated group discussion of an art image to help people look carefully, put their observations and ideas into words, and actively “scaffold” on the thoughts of others.
VTS has been used with younger students in classroom settings and art museums to teach critical thinking, visual literacy, and communication skills.8,9 As students look at increasingly complex art forms, facilitated by a VTS instructor, their aesthetic observations and reasoning skills grow. These skills have been documented as transferring from art viewing to reading and writing. While VTS has not been studied in medical education, the authors have implemented VTS strategies with carefully selected “medical art pieces” to stimulate cognitive thinking, teamwork, and critical learning in medical residents and faculty. More specifically, we noted some key parallels between the group process of reviewing
radiographic studies on rounds and the VTS experience.
1. Grant VJ. Making room for medical humanities. J Med Ethics 2002;28:45-8.
2. Reilly J, Ring J. Innovations in teaching: turning point. Fam Med 2003;35(7):474-5.
3. Ring J, Reilly J. Tuesdays with Morrie: a humanities teaching exercise in palliative and end-of-life care. Fam Med 2003;35(8): 552-3.
4. Dolev JC, Friedlaender LK, Braverman I. Use of fine art to enhance visual diagnostic skills. JAMA 2001;286:1020.
5. Bardes C, Gillers D, Herman A. Learning to look: developing clinical observational skills at an art museum. Med Educ 2001;35:1157-61.
6. Housen A. Aesthetic thought, critical thinking and transfer. Arts Learning Journal 2002;18(May):1.
7. Housen A. Validating a measure of aesthetic development for museums and schools. ILVS Review: A Journal of Visitor Behavior 1992;Nov 2:2.
8. Yenawine P. Thoughts on visual literacy. Handbook of research on teaching literacy through the communicative visual arts. MacMillan Library Reference, 1997.
9. Visual understanding in education. www.vue.org.
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