really good stuff travel through the attached device, the clinician’s eye is removed from the ophthalmoscope’s viewing hole. This reduces the field of view of the patient’s fundus. In order to eliminate this problem, the design has since been incorporated within the existing housing of a conventional direct ophthalmoscope. In due course, a randomised trial will evaluate the impact of this new teaching ophthalmoscope on the teaching and assessment of medical students in fundoscopy. REFERENCE 1 Gupta RR, Lam W-C. Medical students’ self-confidence in performing direct ophthalmoscopy in clinical training. Can J Ophthalmol 2006;41 (2):169–74. Correspondence: Christopher Schulz, Department of Anatomy, Brighton and Sussex Medical School, University of Sussex, Brighton BN1 9PX, UK. Tel: 00 44 1273 877810; E-mail: [email protected] doi: 10.1111/medu.12434

Clinical sketches: teaching medical illustration to medical students Kevin T Liou, Paul George, Jay M Baruch & Francßois I Luks What problem was addressed? Many physicians draw. We are not all artists, but we often use pictures instead of thousands of words, whether to explain medical concepts to students or procedures to patients. Cultural, language and educational barriers may hinder verbal communication, and the use of simplified diagrams can enhance patients’ understanding of their medical condition.1 Of course, not all sketches are created equal. But just as medical students can be taught how to communicate better with patients and colleagues, so too can they develop the rudiments of sketching as an acquired rather than an innate talent. What was tried? Rather than teaching detailed artistic illustration to a few ‘talented’ individuals, we sought to inculcate basic graphic rules to a large group of medical students. Twenty-three first-year medical students with different artistic backgrounds participated in our medical illustration workshop as part of an arts and humanities-based curriculum. We emphasised three aspects of illustration as a tool: (i) organising one’s thoughts and clarifying anatomic relationships; (ii) using the optimal complexity level

of a sketch to illustrate a problem most clearly, and (iii) choosing the most representative aspects or steps of a procedure. The workshop combined a presentation on the historical role of medical illustration, discussions on why it remains relevant today, and hands-on exercises on the principles of basic drawing, perspective, lighting, shadows, shading and texture. In one exercise, we asked students to simplify head and neck plates from an anatomy atlas in order to make them easily understandable by a patient. In another, students worked in pairs: one student illustrated adult and foetal blood circulation with the aid of diagrams and the other provided feedback. Finally, we showed a video of a laparoscopic adrenalectomy and asked students to illustrate the operation, limiting themselves to only three figures. With this added constraint, students had to decide whether to include or leave out certain steps. The ability to select which details are relevant to the larger picture – to offer an accurate synthesis – is also essential in non-visual aspects of clinical practice, such as in formulating diagnoses and delivering oral presentations. What lessons were learned? A total of 85% of students rated the workshop ‘valuable’ or ‘very valuable’. Although the intent was not to complement anatomy classes, it may have been more useful, in retrospect, to match the technical aspects with the students’ anatomic knowledge. In future workshops, we plan to coordinate the drawing exercises with anatomy instructors and to select topics that have already been covered. Interestingly, some students commented that our illustration exercises highlighted gaps in their anatomy knowledge base, revealing connections between anatomical structures they had not noticed before. Many questions remain. Is basic illustration a skill for all, or a tool for the artistic few? When – and for how long – should it be taught? How can it be useful to all, regardless of specialty interests? Does it really make us better communicators? And how do we measure this? REFERENCE 1 Stone CA. Can a picture really paint a thousand words? Aesth Plast Surg 2000;24:185–91. Correspondence: Francßois I Luks, Department of Paediatric Surgery, Alpert Medical School, Brown University, 2 Dudley Street, Suite 190, Providence, Rhode Island 02905, NJ, USA. Tel: 00 1 401 228 0556; E-mail: [email protected] doi: 10.1111/medu.12450

ª 2014 John Wiley & Sons Ltd. MEDICAL EDUCATION 2014; 48: 522–548


Clinical sketches: teaching medical illustration to medical students.

Clinical sketches: teaching medical illustration to medical students. - PDF Download Free
42KB Sizes 0 Downloads 4 Views