Duke medical school students trade in stethoscopes for stencils with an interdisciplinary program aimed to improve communication with patients.
First-year Duke medical school students attend a 90-minute program at the Nasher Museum of Art, led by Juline Chevalier, curator of education at the Nasher. The program, which began in 2006, kickstarts their week of learning about physical examination practices, and students complete several observation and description exercises to develop skills for interacting with patients.
“Our primary goal is to increase careful looking and increase communication skills between medical students and each other, and helping them put that in perspective in being better communicators in their future professional lives,” Chevalier said.
The Nasher’s program begins with slides of images in the lecture hall. Chevalier shows students an image of artwork, people, or patients, for 20 seconds and then asks them to write a description of that image. The students compare their descriptions with those of their peers, recognizing what they noticed and how they were looking at the image versus how other students interpreted the image.
“We try to touch on the fact that we all have lenses, and everything about who we are influences how we see things in the world, how we see patients and how we see artwork,” Chevalier said.
For the second activity, students venture into the galleries for “back-to-back” drawing, when one student describes an artwork to another student facing away from the painting, and the second student draws the image based on the peer’s description. This exercise in the museum highlights issues with patient communication that occur in hospitals and creates an awareness about potential strengths and weaknesses for students.
“[This exercise] really points out the importance of observation and the fact that people will pick up on things differently and observe differently, and their communication can be easily misunderstood,” said Dr. Barbara Sheline, assistant dean for primary care at Duke University Health System.
Because first-year students do not take care of actual patients, the immediate impact of the program cannot be measured directly, but Chevalier said she believes the program has been a success thus far.
“Students experience communication outside their comfort zones and observe images besides X-rays and cell cultures which can improve their visual acuity,” she said. “Even if we don’t have measureable results, just the fact that we’ve gotten all the medical students to the museum at once is a success.”
Marianne Wardle, Andrew W. Mellon coordinator of academic programs at the Nasher, is beginning to develop an elective course as an extension of the existing Nasher program. The class will meet for eight two-hour sessions, elaborating on observation and communication as well as beginning drawing practices and other exercises.
“Trying to draw something creates another pathway in your brain for you to understand [the image],” Wardle said. “We would also possibly explore issues of the assumptions we make when we first see something, breaking those bounds, whether its bias, racial or gender-based—instead we would focus on what we actually see instead of what we think we see.”
The course will be modeled after similar programs offered at the University of Chicago, Harvard University and New York University and will be offered to nursing and physical therapy students as well as medical students.
“It is important for students to practice communicating together with people who are going to be their future coworkers,” she said.
Wardle noted that the Nasher’s personal collections and the professors teaching the class will shape the course, constructing an elective that is unique to Duke.
“We are not interested in whether medical students can use the proper art history terms,” she added. “Instead, we are interested in whether they can use vivid language to describe what they see, so others, especially their patients, can understand.”