UW uses artwork to help sharpen visual skills of future doctors

Medicine is often called a blend of art and science. But can studying Picasso and Gauguin turn budding doctors into better diagnosticians?

That's the premise behind an elective introduced this fall quarter to University of Washington medical students.

Called "Visual Thinking: How to Observe in Depth," the class uses art to sharpen the skills doctors need when examining patients.

The UW class — along with similar workshops for medical residents at Swedish Medical Center, which also began this fall — is centered on a trademarked concept called Visual Thinking Strategies (VTS). It trains students to observe objectively and critically, filtering out bias and assumptions that can cloud their perception.

The training can get doctors to "stop making diagnoses in 20 seconds and ask, 'What is the patient telling us?' " said Tamara Moats, a former education curator at Henry Art Gallery and one of two instructors of the UW class.

Equally important, the method trains students to consider what is unknown.

At a recent class at the Henry Art Gallery, Moats asked her group of first- and second-year medical students to examine a large-scale photograph of sunbathers in Hawaii, taken by American photographer Richard Misrach.

Moats said the students scrutinized the image in detail — from the way the footprints in the sand grow denser as they edge closer to the water to what the wide personal spaces between sunbathers say about American society.

It wasn't until 20 minutes into the discussion that a student finally brought up an unspoken mystery: "How did he do this?"

Misrach's 6- by 10-foot scene depicts a bird's-eye view of a large swath of beach. Turns out he shot his "On the Beach" series from the balcony of an adjacent high-rise hotel.

"That was a teachable moment," Moats said.

While VTS is used in hundreds of schools around the country to teach visual literacy, its use in medicine is relatively new. Only a handful of medical schools offer classes in it, including Harvard, Yale and Cornell.

The UW and Swedish are believed to be the first institutions in the Northwest to join them.

Moats starts with representational art, then moves on to more abstract, difficult pieces. Students have analyzed a range of works, from Winslow Homer's "The Life Line" to Roman portraits to aboriginal art.

In addition to the Henry, the class has visited the Frye Art Museum and the Seattle Art Museum.

Jay Gantz, a second-year student, said the training opened his eyes to the pitfalls of jumping to clinical conclusions.

Gantz recalled one VTS class that featured a photograph of a patient with unusual red markings near the shoulder. The connected lines branched outward and seemed to be beneath the skin.

The students quickly suspected a vascular condition. They were startled to learn the patient had been burned by a lightning strike.

Now Gantz thinks all med students should be highly encouraged — if not required — to take VTS instruction.

At Swedish, the training is required of family-medicine residents at the hospital's Central Area campus.

Mindy Stern, who helped launch the monthly workshops, said the residents were enthusiastic. Not the most likely habitués of museums, they challenged each others' interpretation of art. A figure who might appear sad to one viewer may seem merely pensive or even content to others, and the onus is on the students to back up their suppositions.

"This is a wonderful way of enhancing diagnostic skills," Stern said.

Oren Slozberg, executive director of a nonprofit research group that developed the VTS curriculum, said it helps hone the skills doctors need to carefully assess symptoms while considering different hypotheses.

"There is an assumption that everyone sees, so everyone makes the same meaning out of it," he said. But that's like expecting a 7-year-old to derive the same meaning from Shakespeare as a mature reader.

Evidence that the training improves clinical judgment is encouraging but limited.

In a study published earlier this year in the Journal of General Internal Medicine, researchers compared 24 Harvard medical and dental students who took a course offered with the Boston Museum of Fine Arts and 34 peers who did not.

During a visual-skills exam, the VTS students on average made 18.3 accurate observations compared with an average of 13.3 in the other group.

Researchers couldn't say, though, how long the students might retain their observational skills or whether those skills would translate into actual clinical benefits for patients.

Kyung Song: 206-464-2423 or ksong@seattletimes.com