{"id":644542,"date":"2025-04-08T14:36:51","date_gmt":"2025-04-08T18:36:51","guid":{"rendered":"https:\/\/www.rochester.edu\/newscenter\/?p=644542"},"modified":"2025-11-19T07:58:25","modified_gmt":"2025-11-19T12:58:25","slug":"art-of-observation-medical-students-clinicians-biases-644542","status":"publish","type":"post","link":"https:\/\/www.rochester.edu\/newscenter\/art-of-observation-medical-students-clinicians-biases-644542\/","title":{"rendered":"Want to be a better doctor or nurse? Take a look at this painting."},"content":{"rendered":"<h2><strong>Rochester\u2019s Art of Observation program helps medical students and clinicians cultivate essential clinical skills.<\/strong><\/h2>\n<p>After a day of seeing and treating patients, eight faculty-physicians from the <a href=\"https:\/\/www.rochester.edu\/\">University of Rochester<\/a> <a href=\"https:\/\/www.urmc.rochester.edu\/\">Medical Center<\/a> met at the University\u2019s <a href=\"https:\/\/mag.rochester.edu\/\">Memorial Art Gallery<\/a> (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\u2019s label with its title, artist, and other context.<\/p>\n<p>\u201cWhat do you see?\u201d said <a href=\"https:\/\/www.urmc.rochester.edu\/people\/112360968-natercia-r-rodrigues\">Natercia Rodrigues \u201919M (MS)<\/a>, an assistant professor at the <a href=\"https:\/\/www.urmc.rochester.edu\/smd\">School of Medicine and Dentistry<\/a>, a family physician in the UR Medicine Primary Care network, and the group\u2019s facilitator.<\/p>\n<p>Rodrigues had just asked the first question of the <a href=\"https:\/\/medhum.digitalscholar.rochester.edu\/\">Five Question Protocol (5QP)<\/a>, the lynchpin of the Art of Observation partnership between the University\u2019s medical school, the <a href=\"https:\/\/son.rochester.edu\/\">School of Nursing<\/a>, and the museum.<\/p>\n<p>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\u2014among other cognitive biases\u2014based on titles, dates, or locations. (That information is only revealed with the fourth question, when the sticky notes come off.)<\/p>\n<div style=\"float: right; width: 50%; font-size: .9em; padding: 50px;\">\n<p><iframe loading=\"lazy\" title=\"YouTube video player\" src=\"https:\/\/www.youtube.com\/embed\/9iTu-IxUngc?si=aUQ1loiBfT-yFjIE\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p><strong>BLENDING ART AND MEDICINE<\/strong> By observing our Memorial Art Gallery masterpieces, students and clinicians discover new angles to understanding patients and providing better care.<\/p>\n<\/div>\n<p>\u201cI see a mom cutting food for her children,\u201d one member of the group said. \u201cWhy doesn\u2019t she use a cutting board on that nice wooden table?\u201d<\/p>\n<p>\u201cShe\u2019s the maid,\u201d another suggested.<\/p>\n<p>\u201cBut the kids look like her,\u201d someone countered.<\/p>\n<p>\u201cThe room\u2019s a bit barren and skimpy.\u201d<\/p>\n<p>\u201cI don\u2019t know if it\u2019s skimpy, or just blurry. It actually looks lush, maybe lit by a fire.\u201d<\/p>\n<p>\u201c\u2018Skimpy\u2019 is definitely subjective,\u201d said Rodrigues. \u201cWhat else do you see?\u201d<\/p>\n<p>After a minute of silence, one responded: \u201cThe kids seem healthy.\u201d<\/p>\n<p>\u201cThe kids are hungry. Look how their hair is disheveled and they\u2019re staring at the food she\u2019s cutting. They\u2019re starving.\u201d<\/p>\n<p>\u201cOr did they just wake up from naps? Kids are always hungry.\u201d<\/p>\n<p>Each observation revealed a unique focus, perspective, and lived experience\u2014which is exactly what doctors and nurses often bring to the exam room.<\/p>\n<h3><strong>The fine art of patient care<\/strong><\/h3>\n<div class=\"side-right\">\n<h3><strong>The Five Question Protocol of the Art of Observation<\/strong><\/h3>\n<p>What do you see?<\/p>\n<p>Does this remind you of anything?<\/p>\n<p>What\u2019s the story? What is your evidence?<\/p>\n<p>What information would confirm your hypotheses?<\/p>\n<p>What did you observe about yourself?<\/p>\n<\/div>\n<p>\u201cEverything about the 5QP is designed to build clinical skills,\u201d says <a href=\"https:\/\/www.urmc.rochester.edu\/people\/112363945-susan-daiss\">Susan Dodge-Peters Daiss<\/a>, a senior associate at the Memorial Art Gallery and with the <a href=\"https:\/\/www.urmc.rochester.edu\/medical-humanities\">Department of Health Humanities and Bioethics<\/a>. \u201cThis 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.\u201d<\/p>\n<p>Daiss cofounded Art and Observation at the University of Rochester in 2002 with <a href=\"https:\/\/www.urmc.rochester.edu\/people\/112358929-stephanie-clark\">Stephanie Brown Clark<\/a>, now a professor emeritus, after they both read about a program at Yale University that focused on enhancing medical students\u2019 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.<\/p>\n<p>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.<\/p>\n<p>\u201cWhile we can\u2019t be bias-free,\u201d Daiss says, \u201cwe can be bias-aware.\u201d<\/p>\n<figure id=\"attachment_645642\" aria-describedby=\"caption-attachment-645642\" style=\"width: 2000px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-645642\" src=\"https:\/\/www.rochester.edu\/newscenter\/wp-content\/uploads\/2025\/04\/inline-art-of-observation-MW031325UR_-832.jpg\" alt=\"Woman seen from the side gestures at &quot;Bread and Butter&quot; painting by Albert Neuhuys.\" width=\"2000\" height=\"1333\" srcset=\"https:\/\/www.rochester.edu\/newscenter\/wp-content\/uploads\/2025\/04\/inline-art-of-observation-MW031325UR_-832.jpg 2000w, https:\/\/www.rochester.edu\/newscenter\/wp-content\/uploads\/2025\/04\/inline-art-of-observation-MW031325UR_-832-630x420.jpg 630w, https:\/\/www.rochester.edu\/newscenter\/wp-content\/uploads\/2025\/04\/inline-art-of-observation-MW031325UR_-832-768x512.jpg 768w, https:\/\/www.rochester.edu\/newscenter\/wp-content\/uploads\/2025\/04\/inline-art-of-observation-MW031325UR_-832-1536x1024.jpg 1536w, https:\/\/www.rochester.edu\/newscenter\/wp-content\/uploads\/2025\/04\/inline-art-of-observation-MW031325UR_-832-1920x1280.jpg 1920w, https:\/\/www.rochester.edu\/newscenter\/wp-content\/uploads\/2025\/04\/inline-art-of-observation-MW031325UR_-832-1680x1120.jpg 1680w, https:\/\/www.rochester.edu\/newscenter\/wp-content\/uploads\/2025\/04\/inline-art-of-observation-MW031325UR_-832-1250x833.jpg 1250w, https:\/\/www.rochester.edu\/newscenter\/wp-content\/uploads\/2025\/04\/inline-art-of-observation-MW031325UR_-832-1024x683.jpg 1024w, https:\/\/www.rochester.edu\/newscenter\/wp-content\/uploads\/2025\/04\/inline-art-of-observation-MW031325UR_-832-660x440.jpg 660w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" \/><figcaption id=\"caption-attachment-645642\" class=\"wp-caption-text\"><strong>EYE TO EYE:<\/strong> Natercia Rodrigues, an assistant professor in the Department of Family Medicine and the Department of Health Humanities and Bioethics, leads an Art of Observation session in which faculty-physicians analyze <em>Bread and Butter<\/em> by Dutch artist Albert Neuhuys. (University of Rochester photo \/ Matt Wittmeyer)<\/figcaption><\/figure>\n<p>Students\u2019 first taste of the program is the second day of medical school or early in the <a href=\"https:\/\/son.rochester.edu\/explore-absn\/\">Accelerated Bachelor\u2019s in Nursing<\/a> 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.<\/p>\n<p>\u201cOne of our objectives for this program is learning to separate out observation from inference and assumption,\u201d says Instructor of Clinical Nursing Kristina Santory \u201906, \u201914W (MS). \u201cIn 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?\u201d<\/p>\n<p style=\"font-weight: 400;\">Santory often hears students ask, \u201c\u2018We\u2019re looking at the same painting; how can we see such different things?\u2019 That\u2019s the most surprising, but also most enriching, part of the activity.\u201d<\/p>\n<h3><strong>Taking time to see the bigger picture <\/strong><\/h3>\n<p>Far from a \u201cone and done\u201d 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<em>, <\/em>taught by Daiss in partnership with the museum\u2019s <a href=\"https:\/\/mag.rochester.edu\/creativeworkshop\/\">Creative Workshop<\/a> art courses.<\/p>\n<p>Piper Schneider \u201927M (MD) says her experience with Art of Observation primed her to invoke the 5QP as she studied the live model in Drawing to See<em>. <\/em>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. \u201cThe 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?\u201d she says.<\/p>\n<p>As Schneider prepares for clinical rotations as a medical student, she plans to \u201ccheck in\u201d with herself using queries that arose during Art of Observation. \u201cAm 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.\u201d<\/p>\n<figure id=\"attachment_645652\" aria-describedby=\"caption-attachment-645652\" style=\"width: 2000px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-645652\" src=\"https:\/\/www.rochester.edu\/newscenter\/wp-content\/uploads\/2025\/04\/inline-art-of-observation-MW031325UR_-681.jpg\" alt=\"Two women seen from a low angle looking at art in the Memorial Art Gallery.\" width=\"2000\" height=\"1333\" srcset=\"https:\/\/www.rochester.edu\/newscenter\/wp-content\/uploads\/2025\/04\/inline-art-of-observation-MW031325UR_-681.jpg 2000w, https:\/\/www.rochester.edu\/newscenter\/wp-content\/uploads\/2025\/04\/inline-art-of-observation-MW031325UR_-681-630x420.jpg 630w, https:\/\/www.rochester.edu\/newscenter\/wp-content\/uploads\/2025\/04\/inline-art-of-observation-MW031325UR_-681-768x512.jpg 768w, https:\/\/www.rochester.edu\/newscenter\/wp-content\/uploads\/2025\/04\/inline-art-of-observation-MW031325UR_-681-1536x1024.jpg 1536w, https:\/\/www.rochester.edu\/newscenter\/wp-content\/uploads\/2025\/04\/inline-art-of-observation-MW031325UR_-681-1920x1280.jpg 1920w, https:\/\/www.rochester.edu\/newscenter\/wp-content\/uploads\/2025\/04\/inline-art-of-observation-MW031325UR_-681-1680x1120.jpg 1680w, https:\/\/www.rochester.edu\/newscenter\/wp-content\/uploads\/2025\/04\/inline-art-of-observation-MW031325UR_-681-1250x833.jpg 1250w, https:\/\/www.rochester.edu\/newscenter\/wp-content\/uploads\/2025\/04\/inline-art-of-observation-MW031325UR_-681-1024x683.jpg 1024w, https:\/\/www.rochester.edu\/newscenter\/wp-content\/uploads\/2025\/04\/inline-art-of-observation-MW031325UR_-681-660x440.jpg 660w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" \/><figcaption id=\"caption-attachment-645652\" class=\"wp-caption-text\"><strong>PAUSE, REFLECT, PROCESS:<\/strong> Rochester faculty-physicians can take part in the Art of Observation program for Continuing Medical Education credit. (University of Rochester photo \/ Matt Wittmeyer)<\/figcaption><\/figure>\n<p>Rodrigues, Daiss\u2019 former student and colleague, was likewise inspired by Art of Observation to develop the <a href=\"https:\/\/www.urmc.rochester.edu\/institute-innovative-education\/center-experiential-learning\/continuing-education\">Continuing Medical Education<\/a> session for Rochester faculty-physicians, called <em>Cura te ipsum <\/em>(Latin for \u201cheal thyself,\u201d and a play on the word <em>curate<\/em>).<\/p>\n<p>\u201cI think the 5QP perfectly parallels my experience within the doctor-patient relationship,\u201d she says. \u201cHaving the time to appreciate details and draw parallels to what we\u2019ve 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.\u201d<\/p>\n<p>For the fourth question of the 5QP\u2014\u201cWhat information would confirm your hypotheses?\u201d\u2014Rodrigues peeled off the sticky note to reveal the title, artist, and year: <em>Bread and Butter<\/em>, painted by Dutch artist Albert Neuhuys at the turn of the twentieth century. She added that George Eastman, one of Rochester\u2019s most notable philanthropists, kept this painting on prominent display in his East Avenue mansion.<\/p>\n<p>\u201cHe and his mother were very close,\u201d said Rodrigues, referring to Eastman. \u201cThat might help us think about why he chose this for his home.\u201d This prompted a flurry of comments.<\/p>\n<div class=\"pullquote\"><span style=\"font-size: 400%;\">\u201c<\/span>This 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.\u201d<\/div>\n<p>\u201cSo it <em>is<\/em> a mother and children!\u201d<\/p>\n<p>\u201cThey look just like her.\u201d<\/p>\n<p>\u201cHow else,\u201d Rodrigues asked the group, \u201cdoes this context support or resolve uncertainties in your conjectures?\u201d<\/p>\n<p>\u201cI feel better for this little family that they have access to butter!\u201d<\/p>\n<p>\u201cAnd I feel better that she isn\u2019t cutting into that table.\u201d<\/p>\n<p>\u201cUnless it\u2019s from IKEA,\u201d someone added, eliciting laughter from the others.<\/p>\n<p>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.<\/p>\n<p>The final question (\u201cWhat did you observe about yourself?\u201d) encourages participants to reflect on their experience with the 5QP and what they learned about themselves individually as well as members of a group.<\/p>\n<p>For William DiPasquale \u201924M (MD), a resident in anesthesiology at the Medical Center, this has become an ongoing\u2014and extremely valuable\u2014process in learning how to take care of patients, especially those nearing the end of life.<\/p>\n<p>\u201cMy 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\u2019t sure how to process those emotions,\u201d he explains. \u201cI reached out to Susie [Daiss], and she invited me to re-engage in the Art of Observation process.\u201d<\/p>\n<p>Dipasquale adds, \u201cThe 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\u2019m much more comfortable engaging with patients who are actively dying, largely thanks to this long-term reflective process. It\u2019s already shaping my career.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Rochester\u2019s Art of Observation program helps medical students and clinicians cultivate essential clinical skills.<\/p>\n","protected":false},"author":1402,"featured_media":645632,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[42472,13092],"tags":[42,936,18432,10026,41012],"class_list":["post-644542","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-medicine","category-the-arts","tag-alumni","tag-memorial-art-gallery","tag-school-of-medicine-and-dentistry","tag-school-of-nursing","tag-videos"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Want to be a better doctor or nurse? 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