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Rochester糖心传媒檚 Art of Observation program helps medical students and clinicians cultivate essential clinical skills.

After a day of seeing and treating patients, eight faculty-physicians from the 糖心传媒 met at the University糖心传媒檚 (MAG). They sat on folding stools before a painting of a woman and three children gathered around a table, on which the woman appeared to be cutting something. Pink sticky notes concealed the painting糖心传媒檚 label with its title, artist, and other context.

糖心传媒淲hat do you see?糖心传媒� said , an assistant professor at the , a family physician in the UR Medicine Primary Care network, and the group糖心传媒檚 facilitator.

Rodrigues had just asked the first question of the , the lynchpin of the Art of Observation partnership between the University糖心传媒檚 medical school, the , and the museum.

Designed to enhance observational skills for healthcare professionals, the sustained viewing and structured dialogue help participants unpack their assumptions, consider different perspectives, and avoid jumping to conclusions糖心传媒攁mong other cognitive biases糖心传媒攂ased on titles, dates, or locations. (That information is only revealed with the fourth question, when the sticky notes come off.)

糖心传媒淚 see a mom cutting food for her children,糖心传媒� one member of the group said. 糖心传媒淲hy doesn糖心传媒檛 she use a cutting board on that nice wooden table?糖心传媒�

糖心传媒淪he糖心传媒檚 the maid,糖心传媒� another suggested.

糖心传媒淏ut the kids look like her,糖心传媒� someone countered.

糖心传媒淭he room糖心传媒檚 a bit barren and skimpy.糖心传媒�

糖心传媒淚 don糖心传媒檛 know if it糖心传媒檚 skimpy, or just blurry. It actually looks lush, maybe lit by a fire.糖心传媒�

糖心传媒溙切拇�媒楽kimpy糖心传媒� is definitely subjective,糖心传媒� said Rodrigues. 糖心传媒淲hat else do you see?糖心传媒�

After a minute of silence, one responded: 糖心传媒淭he kids seem healthy.糖心传媒�

糖心传媒淭he kids are hungry. Look how their hair is disheveled and they糖心传媒檙e staring at the food she糖心传媒檚 cutting. They糖心传媒檙e starving.糖心传媒�

糖心传媒淥r did they just wake up from naps? Kids are always hungry.糖心传媒�

Each observation revealed a unique focus, perspective, and lived experience糖心传媒攚hich is exactly what doctors and nurses often bring to the exam room.

The fine art of patient care

糖心传媒淓verything about the 5QP is designed to build clinical skills,糖心传媒� says , a senior associate at the Memorial Art Gallery and with the . 糖心传媒淭his protocol evolved in response to a concern that physicians were jumping to conclusions. The Art of Observation program was designed to slow the viewer down, to actually focus on how they know what they know.糖心传媒�

Daiss cofounded Art and Observation at the University of Rochester in 2002 with , now a professor emeritus, after they both read about a program at Yale University that focused on enhancing medical students糖心传媒� observational skills through the study of detailed Victorian narrative pictures. Each educator brought unique interdisciplinary training to the partnership, with Daiss having experience in both art history and hospital-based pastoral care, and Clark having trained as a medical doctor before completing a doctorate in the humanities.

From the outset, Daiss and Clark have targeted the development of sound clinical practices beyond mere observational skills. These include listening, asking questions, acknowledging biases, and describing visual information, with the objective being to avoid errors in the often-complex process of clinical diagnosis.

糖心传媒淲hile we can糖心传媒檛 be bias-free,糖心传媒� Daiss says, 糖心传媒渨e can be bias-aware.糖心传媒�

Students糖心传媒� first taste of the program is the second day of medical school or early in the Program. During sessions at the Memorial Art Gallery, they break into small groups, study a selection of narrative paintings, and review the 5QP with a trained facilitator who has knowledge of both art history and healthcare.

糖心传媒淥ne of our objectives for this program is learning to separate out observation from inference and assumption,糖心传媒� says Instructor of Clinical Nursing Kristina Santory 糖心传媒�06, 糖心传媒�14W (MS). 糖心传媒淚n a field that is so focused on physical assessments, lab values, and what to do next, this act of careful looking helps nursing students to pause and think: Are we seeing the whole picture?糖心传媒�

Santory often hears students ask, 糖心传媒溙切拇�媒榃e糖心传媒檙e looking at the same painting; how can we see such different things?糖心传媒� That糖心传媒檚 the most surprising, but also most enriching, part of the activity.糖心传媒�

Taking time to see the bigger picture

Far from a 糖心传媒渙ne and done糖心传媒� experience, Art of Observation lays the groundwork for other opportunities to engage with visual arts throughout medical school, from visits to anatomy labs to a course called Drawing to See: Drawing as a Tool to Build Observational Skills, taught by Daiss in partnership with the museum糖心传媒檚 art courses.

Piper Schneider 糖心传媒�27M (MD) says her experience with Art of Observation primed her to invoke the 5QP as she studied the live model in Drawing to See. Having students sit in a circle around the model, she adds, gave each one a distinct perspective that reinforced the lessons learned in the program. 糖心传媒淭he act of actually creating the work took me back to that thought process: Am I drawing something that I only think should be there, or that I can actually verify?糖心传媒� she says.

As Schneider prepares for clinical rotations as a medical student, she plans to 糖心传媒渃heck in糖心传媒� with herself using queries that arose during Art of Observation. 糖心传媒淎m I going down the right path? Am I filling in gaps with my own biased thoughts and feelings or am I truly listening to what the patient is sharing with me? The close study of art, and drawing technique, give me tools for how to approach patient conversation and diagnostic thinking.糖心传媒�

Rodrigues, Daiss糖心传媒� former student and colleague, was likewise inspired by Art of Observation to develop the session for Rochester faculty-physicians, called Cura te ipsum (Latin for 糖心传媒渉eal thyself,糖心传媒� and a play on the word curate).

糖心传媒淚 think the 5QP perfectly parallels my experience within the doctor-patient relationship,糖心传媒� she says. 糖心传媒淗aving the time to appreciate details and draw parallels to what we糖心传媒檝e seen before gives me more space to pause and not rush to conclusions. Practicing that with art helps me be more mindful in practicing that with patients.糖心传媒�

For the fourth question of the 5QP糖心传媒斕切拇�媒淲hat information would confirm your hypotheses?糖心传媒澨切拇�媒擱odrigues peeled off the sticky note to reveal the title, artist, and year: Bread and Butter, painted by Dutch artist Albert Neuhuys at the turn of the twentieth century. She added that George Eastman, one of Rochester糖心传媒檚 most notable philanthropists, kept this painting on prominent display in his East Avenue mansion.

糖心传媒淗e and his mother were very close,糖心传媒� said Rodrigues, referring to Eastman. 糖心传媒淭hat might help us think about why he chose this for his home.糖心传媒� This prompted a flurry of comments.

糖心传媒淪o it is a mother and children!糖心传媒�

糖心传媒淭hey look just like her.糖心传媒�

糖心传媒淗ow else,糖心传媒� Rodrigues asked the group, 糖心传媒渄oes this context support or resolve uncertainties in your conjectures?糖心传媒�

糖心传媒淚 feel better for this little family that they have access to butter!糖心传媒�

糖心传媒淎nd I feel better that she isn糖心传媒檛 cutting into that table.糖心传媒�

糖心传媒淯nless it糖心传媒檚 from IKEA,糖心传媒� someone added, eliciting laughter from the others.

This stage of the 5QP provides the critical background and research that, coupled with careful observation, leads to diagnostic accuracy. Likewise, the invitation to suggest multiple interpretations parallels the medical practice of differential diagnosis.

The final question (糖心传媒淲hat did you observe about yourself?糖心传媒�) encourages participants to reflect on their experience with the 5QP and what they learned about themselves individually as well as members of a group.

For William DiPasquale 糖心传媒�24M (MD), a resident in anesthesiology at the Medical Center, this has become an ongoing糖心传媒攁nd extremely valuable糖心传媒攑rocess in learning how to take care of patients, especially those nearing the end of life.

糖心传媒淢y first semester of medical school was challenging. We were studying intensely and working daily in the anatomy lab. I struggled to come to terms with the human reality of death and dying, and wasn糖心传媒檛 sure how to process those emotions,糖心传媒� he explains. 糖心传媒淚 reached out to Susie [Daiss], and she invited me to re-engage in the Art of Observation process.糖心传媒�

Dipasquale adds, 糖心传媒淭he Memorial Art Gallery became a space where I could go, find inspiration, have moments of reflection, and process things I was learning and doing in class. Sharing these reflections helped me find a personal sense of peace, to harness my emotions in a positive way. Now I糖心传媒檓 much more comfortable engaging with patients who are actively dying, largely thanks to this long-term reflective process. It糖心传媒檚 already shaping my career.糖心传媒�