http://www.boston.com/ae/theater_arts/articles/2008/07/20/monet_gauguin_using_art_to_make_better_doctors/?page=full
Monet? Gauguin? Using art to make better doctors
New courses improve powers of observation
By Liz Kowalczyk Boston Globe Staff / July 20, 2008
Dr. Joel Katz's class of Harvard Medical School students meets on Friday afternoons at the Museum of Fine Arts, where they discuss the Seated Bodhisattva, a towering figure carved in ancient China, Joseph Mallord William Turner's Slave Ship, and other artworks Katz believes will make them better doctors.
On one Friday this spring, 24 of the country's most promising future physicians circled the limestone Bodhisattva as art instructor Alexa Miller posed a question: "What's happening here?" The students initially observed that the figure was made of stone and appeared peaceful. But she pushed them further. "What do you see that makes you say that?" she asked.
After an hour at the museum, the class walked back to Harvard Medical School to apply what they had learned about examining art to diagnosing breathing problems, skin rashes, and neurological disorders, and to reading lung X-rays.
Katz's class is one of a growing number of art courses offered to medical students nationwide and aimed at improving their observation and diagnostic skills at a time when doctors are increasingly relying on CT scans, Maris, biopsies, and other technology to do their work, even though it is far more expensive - and sometimes unnecessary to pinpoint illnesses.
Nana Aqua Judah, who graduated from Harvard in June and is now an obstetrics and gynecology resident in Toronto, said the art class taught her to look more carefully at patients for clues. For example, if a young mother looks run down, it might indicate she's too stressed to take a medication that requires five doses a day, leading Judah to prescribe a once- or twice-a-day drug. Besides, said Judah, who was taking six or seven classes at the time, "to me it seemed like a relief. We were going to an art gallery for a class."
At tradition-minded Harvard, many faculty were skeptical about the idea of using art to make better doctors when Katz proposed the class five years ago, especially since the first- and second-year students who enroll are already overwhelmed with work. But Katz's belief that physicians can improve their diagnostic skills by observing art was bolstered this month when he and his colleagues published a study in the Journal of General Internal Medicine showing that after completing the class, students' ability to make accurate observations increased 38 percent. When shown artwork and photos of patients, students were more likely to notice features such as a patient's eyes being asymmetrical or a tiny, healed sore on an index finger. Observations by a control group of students who did not take the class did not change.
"We're trying to train students to not make assumptions about what they're going to see, but to do deep looking. Our hope is that they will be able to do this when they look at patients," said Katz, an internist at Brigham and Women's Hospital and a former graphic designer. He said several studies show that doctors' physical exam skills, which include observation and taking a medical history, as well as the hands-on examination, are declining.
The most difficult part of the class for the high-achieving Harvard students, Miller said, seems to be letting go of their urge to find the one right answer. The Bodhisattva, for example, can spark a wide range of emotions, as the statue is towering and imposing when seen from the front but then "almost disappears into space" when looked at from the side, Miller said. As she pushes students to look harder at the sculpture, using a technique called visual thinking strategies, students' observations become more complex, and they notice that the Bodhisattva is powerful, but also small and poignant.
While diagnosing a medical condition involves reaching the right answer, often, to get there, doctors have to open their minds to myriad possibilities.
"When we get fixated on getting the right answer, we miss the diagnosis because it blocks the ability to think flexibly," Miller said. "We want them to puzzle through things."
Educators at other medical schools that offer art classes have similar goals. Weill Medical College of Cornell University has offered a noncredit art course in collaboration with the Frick Collection in New York City for eight years, while Yale Medical School runs an art observation course for medical students that is now a required class.
Students in the Harvard class study a wide range of original art, including oil paintings by Paul Gauguin, Claude Monet, and John Singer Sargent, and sculptures from Iran and India. Students have the option of drawing a nude model as well. Instructors draw exact parallels between some artworks and diagnosing illness; students, for example, study texture and pattern in Jackson Pollack's abstract Number 10, and then return to the medical school to study how patterns in patients' rashes can indicate specific conditions. But the course primarily trains students to look at what they're seeing more carefully.
Dr. Robert Brown, a pulmonologist at Massachusetts General Hospital and a course instructor, gets undressed above the waist to give his lecture on breathing muscles. Three patients enter the classroom, including a quadriplegic man who also is shirtless, a woman with muscular dystrophy, and a woman with a deformed spine. Afterward, students list what they saw. Brown wants them to notice that his upper rib cage moves outward while the paralyzed patient's upper rib cage moves inward. Paralysis of the diaphragm is a diagnosis doctors often miss, he said, but inward movement of the belly while breathing is one sign.
If they look carefully "during the physical exam they can begin to put the pieces together," he said.
While research into doctors' physical exam skills is sparse, there is a consensus in medicine that those skills are waning. Some doctors believe medical schools are giving short shrift to the physical exam, but others believe these skills atrophy once doctors graduate and start practicing their specialty.
"When I've been to Africa and the Amazon and there are no CT scans and X-rays and it's just you and a flashlight and a stethoscope and something to look into the patients' ears, you have nothing to fall back on other than your clinical skills," said Dr. Ronald Silvestri, a pulmonologist at Beth Israel Deaconess Medical Center who runs Harvard's doctor-patient course, which teaches the physical exam.
In the United States, he said, doctors turn more quickly to these widely available tests and tend to be very rushed when seeing patients. "If you have a 10-minute visit, how good an observer can you be?" While Silvestri believes the quality of care doesn't suffer from the widespread use of diagnostic tests, he thinks the overall healthcare system does.
"It's one reason that American medical care is so expensive," he said.
But whether art classes will have a lasting impact remains an open question.
Students in the course run by Katz and Brigham neurologist Dr. Shahram Khoshbin were evaluated immediately after they took the course, not as practicing doctors, when they will face the threat of malpractice lawsuits for wrong diagnosis.
http://www.usatoday.com/news/education/2002-05-20-arts.htm
Study: Arts education has academic effect
By Tamara Henry, USA TODAY
WASHINGTON — Schoolchildren exposed to drama, music and dance may do a better job at mastering reading, writing and math than those who focus solely on academics, says a report by the Arts Education Partnership.
"Notions that the arts are frivolous add-ons to a serious curriculum couldn't be further from the truth," says James Catterall, education professor at the University of California-Los Angeles, who coordinated the research.
The report is based on an analysis of 62 studies of various categories of art — ranging from dance, drama, music and visual arts — by nearly 100 researchers. It's the first one to combine all the arts and make comparisons with academic achievement, performance on standardized tests, improvements in social skills and student motivation.
Catterall says the studies suggest that arts education may be especially helpful to poor students and those in need of remedial instruction.
"While education in the arts is no magic bullet for what ails many schools, the arts warrant a place in the curriculum because of their intimate ties to most everything we want for our children and schools," Catterall says.
The report took two years to produce, with funding from the National Endowment for the Arts and the U.S. Department of Education.
Gerald Sroufe of the American Educational Research Association describes the report as "a benchmark" and "a starting place for future research in the arts because it represents a fairly comprehensive picture of what research-based knowledge exists." However, he says, the report is "necessarily a thin volume, including some rather thin studies."
Eileen Mason of the National Endowment for the Arts says that President Bush has requested $11 million to support arts education projects.
"We are eager for more research," Mason says. "We want to learn more about how we can best convey to our children the knowledge and skills required to create, perform and respond to the arts. At the same time, we need to know more about how the arts help to develop other capacities of our children, such as language, reading and spatial reasoning."
School officials often complain that arts programs tend to be the first cut in schools facing budget deficits.
G. Thomas Houlihan, executive director of the Council of Chief State School Officers, acknowledges that many school superintendents, principals and teachers are unaware of the value of arts education.
He says copies of the report will be distributed to school leaders throughout the nation.
Houlihan says he was impressed by the one study finding that "arts motivate and reach certain students."
The Arts Education Partnership is a coalition of more than 100 national education, arts, philanthropic and government organizations. CCSSO and the National Assembly of State Arts Agencies administer the partnership under a cooperative agreement with the Education Department and the National Endowment for the Arts.
The Arts Education Partnership, arguing for the importance of arts in schools, says various art forms benefit students in different ways:
· Drama. Helps with understanding social relationships, complex issues and emotions; improves concentrated thought and story comprehension.
· Music. Improves math achievement and proficiency, reading and cognitive development; boosts SAT verbal scores and skills for second-language learners.
· Dance. Helps with creative thinking, originality, elaboration and flexibility; improves expressive skills, social tolerance, self-confidence and persistence.
· Visual arts. Improve content and organization of writing; promote sophisticated reading skills and interpretation of text, reasoning about scientific images and reading readiness.
· Multi-arts (combination of art forms). Helps with reading, verbal and math skills; improves the ability to collaborate and higher-order thinking skills.
“STEM education,” as used in this report, includes the subjects of mathematics, biology, chemistry, and physics, which have traditionally formed the core requirements of many state curricula at the K-12 level. In addition, the report includes other critical subjects, such as computer science, engineering, environmental science and geology, with whose fundamental concepts K-12 students should be familiar. The report does not include the social and behavioral sciences, such as economics, anthropology, and sociology; while appropriately considered STEM fields at the undergraduate and graduate levels, they involve very different issues at the K-12 level.
Understanding Science, Technology, Engineering, and Math (STEM) Skills http://www.iseek.org/careers/stemcareersandskills.html
Think about key skills needed in today's workplace: problem solving, analytical thinking, and the ability to work independently. What do they all have in common? They're all related to STEM (science, technology, engineering, and math).
STEM on the Job
Most employers want workers who are able to reason and solve problems using some math, science, or technology knowledge. Key STEM skills include:
· Analytical skills to research a topic, develop a project plan and timeline, and draw conclusions from research results.
· Science skills to break down a complex scientific system into smaller parts, recognize cause and effect relationships, and defend opinions using facts.
· Mathematic skills for calculations and measurements.
· Attention to detail to follow a standard blueprint, record data accurately, or write instructions.
· Technical skills to troubleshoot the source of a problem, repair a machine or debug an operating system, and computer capabilities to stay current on appropriate software and equipment.
Think STEM is just for geeks? Not true! Many workers in STEM fields use "soft" skills at work as much as they use math and science. These soft skills include:
· Communication and cooperation skills to listen to customer needs or interact with project partners.
· Creative abilities to solve problems and develop new ideas.
· Leadership skills to lead projects or help customers.
· Organization skills to keep track of lots of different information.
Is a STEM career a good fit for you? Match your skills with STEM occupations using the Skills Assessment.
What Do Employers Really Want? Top Skills and Values Employers Seek from Job-Seekers
http://www.quintcareers.com/job_skills_values.html
by Randall S. Hansen, Ph.D., and Katharine Hansen, Ph.D.
Most job-seekers wish they could unlock the secret formula to winning the hearts and minds of employers. What, they wonder, is that unique combination of skills and values that make employers salivate with excitement?
Every employer is looking for a specific set of skills from job-seekers that match the skills necessary to perform a particular job. But beyond these job-specific technical skills, certain skills are nearly universally sought by employers. The good news is that most job-seekers possess these skills to some extent. The better news is that job-seekers with weaknesses in these areas can improve their skills through training, professional development, or obtaining coaching/mentoring from someone who understands these skills.
Numerous studies have identified these critical employability skills, sometimes referred to as "soft skills." We've distilled the skills from these many studies into this list of skills most frequently mentioned.
Skills Most Sought After by Employers
So, what are these critical employability skills that employers demand of job-seekers?
Communications Skills (listening, verbal, written). By far, the one skill mentioned most often by employers is the ability to listen, write, and speak effectively. Successful communication is critical in business.