COLUMBIA — At the Yale School of Medicine in 1998, dermatology professor Irwin Braverman was becoming frustrated with his students.
He would point out subtleties in skin rash images they would memorize, but the doctors-in-training had difficulty analyzing patients with visual features they hadn't seen before.
"Art and the Art of Medicine"
WHO: Irvin Braverman, dermatology professor at Yale School of Medicine and founder of the observational skills workshop
WHAT: Interpretation of Victorian paintings to improve skills of medical diagnosis
WHEN: April 10 at 7 p.m.
WHERE: Stotler Lounge in the MU Memorial Union
COST: The event is free and open to the public.
Visual analysis has historically been understood as inherent and therefore not included in medical school curriculum, Braverman said. He attributes the students' difficulties to the rise of imaging technologies such as MRI and CT scans in the 1970s, which took the pressure off doctors to diagnose through observation alone.
Braverman found the solution to his problem not in a classroom or a laboratory, but rather, a museum: the Yale Center for British Art.
He decided to introduce his students to the museum's 18th- and 19th-century paintings and have them interpret the narrative artwork. Like patients whose symptoms point to multiple diseases, Victorian paintings tell stories full of ambiguity and contradictions that students must deal with.
"What do you do with noncoherent information? Do you take the information you like and discard the info that doesn't make sense? And the answer is, 'Of course not,'" Braverman said.
Braverman will share his insights at this year's Carlos Pérez-Mesa, MD, Lectureship in Medical Humanities at 7 p.m. April 10 in Stotler Lounge at MU's Memorial Union. At the event, sponsored by MU's Center for Health Ethics, Braverman will challenge audience members with the same exercises in careful detection and visual analysis that he uses in the one-day workshop required for all first-year students at the Yale School of Medicine.
Bill Bondeson, chairman of the lectureship committee, was close friends with Carlos Perez-Mesa, a long-time Columbia doctor and art patron who died in 2000. The lectureship was established in Perez-Mesa's honor and explores the intersection of medicine and fine arts. Previous speakers have included physicians, authors and an ophthalmologist who also conducts a symphony, but never someone in the visual arts.
"That just adds to it, as far as I'm concerned," Bondeson said. "We want to have all the arts represented."
Getting out of the laboratory is at the heart of Braverman's course.
"It isn't something you can lecture," Braverman said. "You can't get up in front of the class and show a painting and show how you analyze it. The students have to do it themselves."
In the "observational skills" workshop, each student is assigned a painting and spends 12 to 13 minutes noting objective details before giving an interpretation of the scene's meaning to three peers and an instructor. This leads to a second benefit.
"When the student comes up with a bunch of interpretations, and the other three students have some other ideas, they'll chime in, so what you have is students learning how to speak with one another, converse with one another, share ideas with one another in a teamwork-like fashion," Braverman said.
More than 25 schools have imitated the program since Braverman published a study on its effectiveness in 2001. Medical schools in Taiwan are currently considering it, and the activity has also been used in workshops by the New York Police Department and Scotland Yard.
"This is applicable to many different professions in making people more observant of what's going on around them and not just looking at those things that are grossly obvious, but looking at the subtle things," Braverman said.