A fledgling partnership followed these initial conversations. In 2002, the year that the medical educator was granted a teaching fellowship to develop a visual arts-based “intervention,” the museum educator took a part-time leave from the museum to pursue intensive training as a hospital-based chaplain.

During the 2002-2003 academic year, we teamed to design a pilot program in the museum that taught observational skills, using a small-group model common to both museum and bedside teaching.

The pilot project borrowed elements from the innovative approach described in the 2001 JAMA article¹, with significant differences. From its inception, the learning objectives and design of the University of Rochester project targeted the development of observational skills as well as other communication aptitudes, particularly listening, and describing visual information. The pilot also focused on clinical reasoning and “humanistic skills” related to the physician-patient relationship, which are typically designated as skills of professionalism, cultural sensitivity, and self-awareness.

Dolev et al. demonstrated a change in visual diagnostic skills as a result of their art museum intervention and inferred that these skills could be applied to patients in clinical settings. They did not, however, provide a framework that connected the process of looking at a work of art with the clinical diagnostic practice to do so. Our team designed the five questions to connect explicitly the diagnostic process of working up a patient with a healthcare team and the teaching approaches of museum educators with its diversity of visitors. In addition, we purposely added questions to encourage self-observation and reflection on each student’s personal assumptions and affective responses to both team dynamics and the artwork.

Informing our expanded focus beyond the development of basic observational skills, we concentrated on learning objectives derived from specific non-science knowledge, skills and attitudes from the Association of American Medical Colleges (AAMC)directives for undergrad education—the Medical School Objectives Project (MSOP)²—and from several Core Competencies³ identified by Accreditation Council for Graduate Medical Education (ACGME).

^1. Dolev, J., Friedlaender, L., & Braverman, I. (2001). Use of fine art to enhance visual diagnostic skills. JAMA, 286(9), 1020–1021.
^2. Anderson, M.B. et al (1998). Report I: Learning objectives for medical student education-guidelines for medical schools, American Association of Medical Colleges.https://members.aamc.org/eweb/upload/Learning%20Objectives%20for%20Medical%20Student%20Educ%20Report%20I.pdf
^3. The Core Competencies were: Patient Care, Medical Knowledge, Practice-Based Learning and Improvement, Interpersonal and Communication Skills, Professionalism, and Systems-Based Practice. Currently, ACGME has developed specialty-based milestones “to help all residencies and fellowships produce highly competent physicians to meet the health and health care needs of the public.” See http://www.acgme.org/What-We-Do/Accreditation/Milestones/Overview for more information.