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There is art to observe, and then there is the art of observation. Recently, 51 Salus Physician Assistant Studies (PA) students stepped outside of their busy classroom and into the Philadelphia Museum of Art to participate in the first of a series of workshop known as the Art of Observation.
The workshops, designed by the Museum’s educators, Adam Rizzo and Suzannah Niepold, helps students improve upon their technical skills in observation, listening, interpretation, communication and empathy with the intent of applying the same skills to the clinical practice of medicine.
The sessions have been structured around the Artful Thinking approach, developed by Project Zero at Harvard University, and focuses on six thinking dispositions: Observing and Describing, Questioning and Investigating, Reasoning, Comparing and Connecting, Exploring Viewpoints and Finding Complexity. Perelman School of Medicine at the University of Pennsylvania approached the museum in 2014 to develop an optional course for their first-year medical students as a means of developing and refining their observation, communication, and evidential reasoning skills.
Margie Singer, administrative coordinator for the Salus PA Program, discovered the workshop from a newspaper article published last year describing the partnership between the Museum and the University of Pennsylvania. She brought it to the attention of Donna Agnew, MSPAS, PA-C, PA, Program director and interim dean for the University’s College of Health Sciences, who also thought it would be a great inclusion to the program’s curriculum. The PA faculty worked with museum educators to design a pilot series of workshops aligned with the program's three Physical Diagnosis courses.
The workshops are centered around three specific themes: Observing and Describing, Interpreting, and Empathy, Perspective and Recognizing Bias. “That’s not to say that these sessions are siloed to the point that we don’t touch on the other topics, however, we wanted to scaffold the curriculum so that we start with the basics and move up to more complex and creative thinking,” Rizzo said.
The first exercise engaged the students in an observation and visual breakdown of a specific painting – without knowing the title, artist, and general subject beforehand. Rizzo and Niepold guided the discussion as they divided the painting into quadrants. The students then tried to describe the painting using only visual descriptors without providing interpretation or subjective input.
For the second activity, students were partnered and seated back to back. As one faced a painting, the other faced away with a paper and pencil in hand ready to draw what their partner described. This exercise was a test of observation, detailed communication, and listening. The activity garnered a lot of laughs when it came time to reveal the final product of the exercise, and to see if it bared a resemblance to the artwork they were supposed to recreate based on their partner’s observations.
A debriefing followed the activity, which helped students place what they had just learned into theory within the context of a clinical setting.
Besides building upon essential observational skills, they also learned to observe with a more empathetic eye - a competency required of all healthcare providers. Marcus Newsom, ‘20PA used the knowledge he learned from the workshop right away. “It is also important to communicate every detail about a patient, whether minor or major, with other providers to ensure that each provider who comes in contact with the patient is able to provide their best care to help the patient,” he said.
Kimberley McCarty, ‘20PA said that part one of the workshop exceeded her expectations. “I was skeptical at first about how going to an art museum would relate to our studies as Physician Assistant students, but it was exciting to get out of the classroom and lab for half the day and experience a whole different atmosphere,” she said.
Overall, student feedback has been overwhelmingly positive as they recognize the value in the development of such skills foundational to providing quality patient care.
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By implementing this workshop into the PA curriculum, Salus has taken another important step to stay at the forefront of healthcare education. “I hope that more universities, like Salus, will rediscover the value of the humanities in all of its forms in medical education,” said Rizzo.
For student feedback about the workshop, please see below.
Did the first workshop meet or exceed your expectations?
The workshop exceeded my expectations. At first, I wasn’t too sure what to expect as it was a completely new experience for me overall. Also, I wasn’t sure as to how it would directly correlate with the healthcare field. After the workshop, I was able to see exactly how it will be applicable to my career as a provider.
What did you like best about it?
Besides the useful information I learned by participating in this workshop, the thing I liked best was the environment. I really liked that we were able to go to the Philadelphia Art Museum and gain knowledge that will help us become better providers. For the most part, it is assumed, to be a better provider, a student should be at a healthcare related clinic or reading textbooks, but I really enjoyed being able to go to an environment that is not healthcare related and still be able to learn and gain useful knowledge to help us be better providers.
Do you look forward to the additional workshops?
I do look forward to the additional workshops. I look forward to them because after the first workshop, I am eager to learn and see what other activities we will do that will help us become a better provider.
What did you learn?
From the workshop, I learned the importance to be observational when you encounter a patient coming in for care. I think most healthcare providers, or society as a whole, unconsciously make reflexive assumptions about a situation or individual. As we learned at the workshop, it is important to first observe what you see, and not to interpret or make assumptions until you are able to get more information from the patient or the situation. Also, I learned the importance of communicating effectively with members of the healthcare team. It is also important to communicate every detail (minor or major) to ensure that each provider who comes in contact with the patient is able to provide quality care.
Have you been able to put into action what you learned during the first workshop?
I was able to use the knowledge learned for the Philadelphia Art Museum right away. The information I learned from the workshop was put into action at my first hospital experience. I was able to take the information learned from the museum and directly apply it to my patient encounters at the hospital, which made my overall experience that much better. I felt the workshop gave me a different perspective that most PA students do not have because they did not have the same opportunity as we did at Salus.
Would you recommend it to other students?
Yes, I would recommend it to other students in the medical field. I do not think it should be limited to just PA or medical students though. I think any student that interacts with a patient in their field would benefit from this workshop at the Philadelphia Art Museum.
I just wanted to say I loved this experience. It was a like a vacation from the classroom. I truly didn’t know what to expect so I didn’t have any underlying expectations. My favorite part was when we partnered up and had to draw and convey the image we were seeing. I definitely look forward to the next experience!
This was the first time I did something like this; as students, you are usually always doing classwork and reading locked away in a library somewhere. The fact that we were able to strengthen our observational skills and interpret an image was mind-blowing. I learned so much from just this exposure. I learned that communication is crucial and there are some things that aren’t obvious to the naked eye. I would highly recommend this to other PAs and people in general. I truly feel this is something that the average person should be exposed to and learn to appreciate art from a different perspective. In addition, these skills will definitely help in everyday life experiences. After this workshop, I have tried to implement more observational and interpretation skills whenever possible. Lastly, I wanted to say that I have a newfound appreciation for modern art. We ended with a room full of images that initially I was judgmental on the quality of the art. It was after dissection and discussion that I understood the underlying message the artist was trying to express. Although I prefer traditional art, I was still able to put aside my biases and look deeper into the meaning behind this artwork. If I had to be specific as to what part of the art museum was the most influential, it would have been the ending. This portion of the workshop is what will make me a better clinician. To me, it represented a future patient that may be completely different from me and I have to put aside any assumptions and see this patient for who they are and look at the bigger picture to understand how I can provide the best care. Thank you again for this wonderful experience!
Did the first workshop meet or exceed your expectations?
The workshop really exceeded my expectations; it was really interesting to learn to strip away that natural inclination to automatically make an interpretation about what we are looking at, sort of bypassing the actual looking itself, and it’s much more difficult to do that than I thought.
What did you like best about it?
The descriptive and communicative activities we did with classmates at the museum, like describing the works of art to them as they tried to replicate them from our descriptions, really brought into focus a lot of the intricacies as well as the problematic parts of communication that felt really clinically relevant and immediate. I noticed that feeling pressured for time was really detrimental to my ability to communicate effectively and that my own assumptions – that someone would sort of innately understand what I meant when I spoke without really following up with them – was a valuable lesson. Also, when I looked at something without having any context to view it with versus when I was given some background on what I was looking at made a dramatic difference in how I perceived something.
Do you look forward to the additional workshops?
Definitely.
Have you been able to put into action what you learned during the first workshop?
I had my first clinical experience after attending the workshop and though I’m still very new to this I think I took with me from the workshop the idea that my words have more weight than I’m always aware of and just because someone may have nodded their head or verbalized understanding doesn’t mean that I was necessarily effective in communicating. What I hope to get out of future workshops at the museum in correlation with my clinical experiences is continuing to be aware of the fact that there is a lot of depth and nuance to communicating with others – both patients and with other students or faculty - and that I need to be cognizant of my own biases and aware of ones that others may have, and remember that others may perceive things differently than I do or communicate differently than I do. I hope as I develop my descriptive vocabulary as it pertains to medicine during my didactic education I can, with these workshops, learn to be creative and flexible with how I employ it.
Would you recommend it to other students?
Definitely.
Did the first workshop meet or exceed your expectations?
The first workshop at the Philadelphia Art Museum definitely exceeded my expectations. I was skeptical at first about how going to an art museum would relate to our studies as Physician Assistant students, but it was exciting to get out of the classroom and lab for half the day and experience a whole different atmosphere. I enjoyed seeing the creative, imaginative artworks and learning how to interpret and understand what the artists have created and are trying to express to the observer.
What did you like best about it?
I liked the activity where we paired up and one partner was looking at a painting and the other partner was looking away and could not see the painting. The partner facing the painting had to describe the painting to the partner that could not see it and then he/she had to draw the painting based on only the partner’s description. Then the two partners switched positions, so we could experience both sides of the exercise. Both sides did have their own difficulties. As the person describing, it was difficult to have to describe the painting with the most specific, yet relatable details to the other partner so he/she could understand what to draw. At the same time, the person drawing felt helpless because he/she were fully reliant on the person describing the painting. At the end of the exercise, it was interesting to see the disconnect that occurred between the real painting and our drawings.
This exercise can be connected to a healthcare provider having to explain the details of a patient’s disease or having to relay instructions to the patient. The healthcare provider might think they are explaining the medical information and instructions clearly, but in reality, the patient does not understand the terminology or details of the instructions. Healthcare providers need to learn how to explain the instructions in a clear way that the patient understands. She/he needs to look at the visit from the patient’s perspective, not their own, which as the drawing exercise we did shows, can be difficult to accomplish.
Do you look forward to the additional workshops?
Yes, I am excited to see more artwork and exhibits at the art museum and learn more about connecting the thought process behind creating art and analyzing art to my future as a health professional. I believe that there are strong connections between learning the best way to analyze the purposeful, specific details that an artist wants you to observe and implying those skills to analyzing patient’s behavioral cues, working through a patient’s medical issues, and providing the best, quality care for a patient.
What did you learn?
As Physician Assistant students most of us are predominantly left-sided thinkers as opposed to right-sided, so it was beneficial to learn the best way to observe a painting and analyze what the artist is trying to convey with their art. We learned that artists have a specific goal or purpose to putting small details in their paintings. We went through an exercise where we separated a big painting into four quadrants and described the details of the painting one quadrant at a time. I picked up on multiple details I would have missed if I only glanced at the painting as a whole. Those little, purposeful details helped me to put together the story behind the painting I would have missed if I did not carefully go through and analyze each part of the painting. By the end of this exercise, I learned how the process of observing and interpreting the details of artwork can be connected to examining and caring for my future patients.
Have you been able to put into action what you learned during the first workshop?
The art museum workshop helped me to learn better clinical skills to help improve my patient’s visit. I learned that it is important to observe and interpret all aspects and characteristics of a patient when you are visiting and speaking with them. You need to observe, but also interpret their facial expressions, behavioral cues, tone of their voice, any visible symptoms, any signs of distress, anxiety, frustration, etc. This process is important because patients can tell the healthcare provider one thing, but their behaviors can suggest another. Many patients can be too anxious to express their real concerns or not know the best way to do so during a visit. If the medical provider can pick up on these small details, then he/she can know what questions to ask and can better help the patient. It is important to observe those small details, but then also learn how to connect them back to the patient and accomplish the main goal which is helping the patient with their medical issues in the best way possible.
Would you recommend it to other students?
I would recommend this to other students because no matter what field of study you are in it is important to learn how to observe and interpret the behaviors of other people in any situation. Observation and interpretation can be especially helpful if you are put into a new situation. It is also very interesting to get to see the broad range of artwork at the museum.
