Museum Intervention

Wednesday, June 13th, 2012

A museum intervention is now mandatory for all first-year med students at Yale:

Called Enhancing Observational Skills, the program asks students to look at and then describe paintings — not Pollocks and Picassos but Victorian pieces, with whole people in them. The aim? To improve diagnostic knack.

Linda Friedlaender, the curator of education at the Yale Center for British Art, and Irwin Braverman, at Yale’s medical school, created the program a decade ago and guide groups through the New Haven museum. Each student is assigned a painting — “Mrs. James Guthrie,” say, by Lord Frederic Leighton — which they examine for 15 minutes, recording all they see. Then the group discusses its observations.

There is no redness, no apparent pressure, in Mrs. Guthrie’s fingers as she holds a flower. Does that mean she’s putting it into the vase — or taking it out? The conclusion matters less than the collection of detail. “We are trying to slow down the students,” Ms. Friedlaender told me. “They have an urge to come up with a diagnosis immediately and get the right answer.”

Many have been taught that schooling is a race to the finish. Others learned early that equations beat etchings (picture book writers, once considered the “academicians of the nursery,” have been trampled on the fast track to pre-K). Ms. Friedlander is realistic: “This is not an aesthetic experience we’re providing. The artwork is a means to an end.”

Surgeon Richard Selzer, in “Letters to a Young Doctor,” wrote: “I have seen sorrow more fully expressed in a buttocks eaten away by bedsores; fear, in the arching of a neck; supplication, in a wrist. Only last week I was informed by a man’s kneecaps that he was going to die. Flashing blue lights, they teletyped that he was running out of oxygen and blood.” The Yale intervention may not endow students with Dr. Selzer’s acute empathy. But a three-year study published in the Journal of the American Medical Association showed that, afterward, they are 10% more effective at diagnosis.

The program has expanded to more than 20 medical schools, including Harvard, Columbia and Cornell. It has also become part of Wharton’s executive education.

If your goal is to teach diagnosis, perhaps you should show students photos or videos of actual patients — but that’s so practical.

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