A visual literacy course for dermatology trainees

A visual literacy course for dermatology trainees

A pilot course with the aim of improving the visual literacy of trainee dermatologists from a regional training programme in Manchester in North West England was developed following discussions between senior dermatologists, an arts educator (Helena Tomlin) and a regional art gallery (Salford Museum and Art Gallery). The course ran from September – November 2015 and was funded by the Dermatology Centre of The University of Manchester Academic Health Science Centre.

Description of the arts activity

Each workshop followed a similar pattern, with a focus on an individual artwork from the collections of Salford Museum and Art Gallery. These were selected in collaboration with curators from the gallery, and were chosen so that participants could be allowed close inspection of the work on an easel set at eye level. The artworks were all paintings and included abstract work, landscape, still life, portraiture and figurative artwork. A different artwork was used for each workshop to demonstrate a particular theme discussed beforehand with the dermatology team. These included the use of colour, texture, pattern and composition in artwork. Participants were encouraged to debate between themselves, present their ideas and consider the viewpoint of the artist. They were helped to develop their own descriptive style, as well using art materials in ‘experiments’ that encouraged an understanding of the artist’s individual methods. In each workshop participants discussed the similarities between observing and documenting skin diseases in the clinic and exploring (always with the opportunity of using magnifying glasses) the analysis of the individual artworks.

Details of the project participants

8 dermatology trainees, who were selected by the training programme co-ordinator (from The Dermatology Centre, Manchester Academic Health Science Centre), participated in 5 art gallery sessions of approximately 2 hours, after an introductory session at Salford Royal Hospital where the arts educator met the trainees and dermatology teaching staff informally.

Project management

Professor Christopher Griffiths led the project, in collaboration with the Dermatology Centre at Salford Royal.
Helena Tomlin, art historian and arts educator was employed on a freelance basis to develop, plan and run the course.
Curators at Salford Museum and Art Gallery were responsible for the care of the artwork and the venue in which the training was held.

Consent for photography and use of written material was gathered from all participants: trainees, course trainers and curators.
There was no cost to participants.

Evaluation methods and findings

Published and Unpublished Reports:

Letter to British Journal of Dermatology, submitted:
A visual literacy course for dermatology trainees
L.L. Griffin1, N.Y.Z. Chiang1, H. Tomlin2, H.S. Young1, C.E.M. Griffiths1
1. Dermatology Centre, Salford Royal, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
2. University of Manchester, Manchester, UK

A visual literacy course for dermatology trainees
Presentation at British Association of Dermatology, July 2016
Dr L.L. Griffin

Visual Observation for Trainee Dermatologists using original artworks at Salford Art Gallery
Presentation at ‘Objectively Speaking - the value and practice of object based teaching’
Conference at The British Museum, April 2016
Helena Tomlin

Evaluation Methods
In January a post-course Clinical and Observational Skills Assessment was undertaken using artwork and clinical images. Due to availability, four of the course participants and three controls completed the assessment. The course participants and control subjects were asked to identify key visual features from photographs of common dermatological conditions. They were also presented with two previously unseen paintings and asked to comment on texture, lines and contour, colour (or shading) and contrast for both the clinical and artwork images.
Scores were assigned for correct answers, which were pre-set by dermatologists (clinical images) and an arts educator (artwork). The assessors were blinded regarding course participation. Descriptive statistics were used to analyse the results. Due to availability, four of the course participants and three controls completed the assessment. The control group comprised one final year registrar, one penultimate year registrar and a senior international clinical fellow.

Results

Following post-course evaluation, all participants rated the course as either excellent (n=3, 37.5%) or very good (n=5, 62.5%). Participants also reported subjective improvement in observational skills applicable to dermatology practice (strongly agree n=2, 25%; agree n=6, 75%). The majority believed their written and verbal descriptive skills had improved (n=7, 87.5%). There was less certainty regarding the effect on relationships and interpreting patients’ emotional responses, which could be reflective of the timing of feedback collection, which was directly after the last session of the course.

Trainees gave positive feedback regarding improvement in their clinical skills. One participant commented in the post-course evaluation that “I felt I was able to appreciate colours in my surroundings better and I have also begun to notice the subtle difference in colours in patients’ rashes”. Another stated, “I was encouraged to describe and write down what I saw from the paintings with reference to the forms, colour, texture, meaning and emotions. This exercise has enabled me to describe things better”.

Consistently positive post-course feedback was received regarding improvement in observational and descriptive skills.

The post-course assessment compared available participants (n=4) with controls (n=3). There was no significant difference in mean +/- standard deviation observations for clinical images (Controls: 12.67 +/- 3.79; Participants:  13.25 +/- 2.50; p = 0.81) or artwork (Controls:  43.00 +/-10.54, Participants 60.75 +/-18.41; p = 0.2). However, this would be expected due to the small sample sizes and relative under powering of the study.

Supported using public funding by the Arts Council England