The Synergy Between Art and Improved Health Outcomes
“Dim the lights,” called Hope Torrents, school programs coordinator for the Lowe Art Museum at the University of Miami. As the room went dark, a screen revealed a painting of a woman with a breast exposed, sword in hand, and two obscure faces to her right. Torrents asked audience members to look closely at the image and share what they saw.
“She’s getting ready for a mammogram,” exclaimed one woman. “She’s asking who’s next,” said another audience member, referencing the sword. Others picked up on the artist’s contrast of color and light to convey life and death, and one person commented on how the painting portrayed the woman’s confidence and power.
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Panelists (L-R) Sherrill H. Hays, Professor and Chair,
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The exercise was a practice in Visual Thinking Strategies (VTS), which aims to change how medical students train for the profession, during the panel session “Harnessing the Power of Art to Improve Health Outcomes,” part of the University of Miami Global Business Forum, Jan. 12–14, 2011.
VTS can help providers become more acute observers, and it enhances their cognitive, logical, visual, social and linguistic skills, according to Abigail Housen, who co-founded VTS. Students, she explained, need to listen with their eyes. “Our eyes are often the first to perceive, and our eyes remind us to test our thinking, our assumptions, to look more carefully, to review what we presume to know,” she said. “It’s often our eyes that open our minds.”
VTS involves asking three questions: What’s going on here? What do you see that makes you say that? And what more can you find? The questions can be applied to a clinical setting, where photos are shown and the same questions are asked. The goal is to try to improve visual observation, listening skills and communication — particularly interdisciplinary communication.
As multidisciplinary approaches become commonplace, professionals will need to collaborate to come up with a working diagnosis when a patient presents with seemingly disconnected signs and symptoms, said Sherrill H. Hayes, professor and chair of UM’s department of physical therapy. “It’s not innate to all of us in medicine,” she said. “Diagnosis is often about pattern recognition, and the more people see and observe and develop their clinical expertise, the better they get at this.” Here’s where art and medicine collide: “Art enhances this visual observation, and therefore clinical skills,” she said.
But VTS extends beyond visual observation. The practice of listening to others describe what they see, and repeating it back, or paraphrasing, is the counterpart to taking a good medical history, something everyone in the health profession does, or should do. “We have to listen to our patients. We have to observe our patients. We have to make sure we’re hearing correctly and interpreting correctly,” explained Hayes.
With the advancement of technology and social media such as Facebook, texting, Twitter and other forms of virtual communication, many people find themselves out of practice with these skills. Current students, in particular, need to practice, Hayes said, noting that many times these students miss the nuances gleaned by looking at someone’s face. These nuances provide incredible information about health and disease through the observation of emotion and expressions of pain.
Studies have shown that art can help: Exposure to art leads to increased frequency and accuracy of visual observation, and improves accuracy of communication relating to patient history.
“Evidence drives us in the medical setting and research,” said Hayes, who surveyed her own students as well. She saw a 38 percent improvement in the accuracy of clinical descriptions after her 2009 class saw artworks in the classroom. Her 2011 class, which viewed artworks in the Lowe museum, showed a 70 percent improvement.
Nonetheless, additional studies are needed, said physician Alex J. Mechaber, senior associate dean for undergraduate medical education and associate professor at the UM Miller School of Medicine. He believes that the humanities and the arts add value to medical training, providing insight into the human condition while nurturing skills such as observation, analysis, empathy and self-reflection. Those skills, he said, are critical for creating compassionate medical professionals.
Mechaber also believes incorporating art into the curriculum allows students to get in touch with their feelings and thoughts, and to talk about issues that aren’t discussed regularly in medical education, such as the emotional and spiritual patient experiences. “This can be vitally important to help decrease the erosion of empathy that we see in our trainees over time,” he said. “Patients are frequently unhappy with medical care because physicians often fail to demonstrate humanistic qualities that are so essential to providing good, quality care.”
