The Art of Observation-E-Veritas, 6/29/09

A group of Miller School physical therapy doctoral students spends a day at UM’s Lowe Art Museum, contemplating and interpreting artwork to sharpen their observational skills and become better diagnosticians
Patrick Manrique and 11 of his classmates stood in front of the sculpture of a squatting Miami Dolphins football player and stared at its lifelike features.

Art discussion: Department of Physical Therapy students, including Christen Tucker, right, listen to Lowe Art Museum docent Sara DeTchon during a recent workshop designed to sharpen their observation skills.
After looking straight into the figure’s eyes, Manrique formed an opinion and shared it with the group, explaining that the football player was an exhausted athlete “catching a quick break in the heat of battle.”
Some of his classmates, however, had a different opinion. To them, the player’s posture and appearance suggested a dejected athlete whose team had been defeated.
Manrique and his classmates aren’t art history majors but future healers—third-year doctoral students in the University of Miami Miller School of Medicine’s nationally ranked physical therapy program.
Their recent one-day field trip to UM’s Lowe Art Museum—where they pondered paintings, photographs, and sculptures and then described what they were seeing and how they arrived at their impressions—was intended to improve the observational skills they will need to make accurate diagnoses.
“They weren’t there to learn about art,” says Hope Torrents, school programs coordinator at the Lowe who helped arrange the visit. “The premise is that looking and talking about artwork makes them better diagnosticians, better listeners. They have to mine artwork for details. Art is open to multiple interpretations. It’s about listening to other people’s ideas.”
FLEXIBLE THINKING
Physical therapists, like physicians, have to open their minds to several possibilities just to arrive at the correct diagnosis. But sometimes they concentrate too heavily on finding the one right answer without being flexible and considering different options.
Observing and discussing art “gets them to realize there’s a lot of different things going on, and that’s the same thing with patients,” says Sherrill Hayes, professor and chair of the Department of Physical Therapy. “Are they limping? Is there a muscular or skeletal problem? We have to be very observant and have to pick up on nuances that the patient is showing us, either in their facial expressions or in something about their body. Then, it’s not only a matter of being more skilled at visual observation, but being able to state what they’re seeing.”
While the Miller School currently has no elective or required class in which students study art to improve their observational skills, Hayes has been using the technique as a module in some of her classes since 2003, showing her students PowerPoint images of paintings and sculptures and having them analyze and interpret them.
She got the idea after reading an article in her daughter’s Yale University alumni magazine about a faculty member, Irwin Braverman, who developed a class that uses art with the goal of making better physicians.
“I was intrigued,” Hayes says. “My daughter was an art history major at Yale, and she helped me identify some paintings that were very detailed as far as the story that was being told. So I started doing this with our first doctor of physical therapy class, and I’ve been doing it ever since.”
The recent field trip to the Lowe was the first time Hayes had ever brought a group of her students to a museum. But she hopes the field trips will occur more often.
THE VTS TECHNIQUE
During their visit, the students looked at such varied art as Italian artist Leonardo Coccorante’s Port of Ostia During a Tempest, an oil-on-canvas painting that shows architectural ruins with a seascape during a storm. They also looked at some of the Lowe’s Renaissance and Baroque works, contemporary photographs, and sculptures like Duane Hanson’s Football Player, 1981, forming impressions of the works by using a technique called Visual Thinking Strategies (VTS), a K-5 and middle school curriculum and teaching method that develops critical thinking, communication, and visual literacy skills.
Torrents has been teaching VTS to Miami-Dade School teachers for the past seven years as part of the Lowe’s magnet schools program, and she and the museum docents also use the technique with visitors.
“It’s not about people coming in and getting lectured to,” she explains. “It’s about them finding meaning for themselves through artwork.”
But research on whether observing and interpreting art can help improve the observational skills of physicians is limited. “There are a few small studies showing improvement in diagnostic inspection skills,” says Alex Mechaber, associate dean for undergraduate medical education at the Miller School, adding, “We are exploring the creation of a master clinician elective that might incorporate instruction in these observation skills.”
Physical therapy student Manrique, though, is a believer, and hopes his experience at the Lowe will make him a better clinician. “So much of communication is nonverbal,” says the former Army officer and paratrooper from the 82nd Airborne Division who spent a year in Iraq. “The art of observing patients can give clinicians clues where to steer the flow of a physical examination. I believe that my patients will be appreciative of my ability to pick up on subtle clues.”
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