Available online 5 November 2022
ObjectiveNumerous programs integrate arts and humanities methods to advance medical education competencies. Despite the highly visual and technical nature of the field of surgery, the current state of art utilization in surgical training is unclear. The purpose of this review is to gain a comprehensive understanding of how art has been utilized in surgical training, to investigate the purpose of such interventions, and to assess how art interventions may benefit surgeons.
DesignA systematic literature review using PRISMA methodology was conducted to identify articles published prior to February 2022 that investigated or described using art in surgical resident training. Qualitative themes were developed upon full review of the literature and categorized based on fundamental aspects of surgical education. The data was summarized by a narrative approach.
ResultsSix hundred seventy-four unique articles were initially identified, thirteen of which met inclusion criteria. Twelve studies employed drawing or sculpture in surgical residency training; one discussed art observation to foster mindfulness, teambuilding, and empathy. Eight articles utilized art as an evaluation tool, 2 for didactic and archival purposes, one employed exercises in art analysis to improve empathy and physician wellbeing, and 2 described courses in which art making was treated as a foundational skill. No articles discussed use of art for honing diagnostic skills, observation, or patient communication – competencies that have been addressed in other fields.
ConclusionsThis review highlights the small number of examples in the medical literature about visual arts in surgical training. The existing art-based surgical humanities studies identify opportunities for curricular innovation within surgical training.
Section snippetsINTRODUCTIONOver the past several decades, there has been widespread incorporation of arts and humanities in medical student education.1, 2, 3 Arts-based pedagogies such as Visual Thinking Strategies (VTS)4,5 have been demonstrated to improve critical thinking skills, visual literacy, and communication in the medical school context,6, 7, 8, 9 and courses and workshops that employ such art-based curricula are now offered at many medical schools.10, 11, 12, 13, 14 The American Association of Medical Colleges
MATERIALS AND METHODSA systematic literature review was conducted utilizing PubMed and Scopus by 2 independent investigators [SC and AD] to identify English language articles published prior to February 2022 that investigated or commented on the practice of art making or art observation in surgical residency education, in order to determine how art is currently used to train surgeons and the intent of incorporating art in surgical training. A time period limitation was not placed on older publications in order to
RESULTSEight hundred and nine articles were initially identified; 674 of which were unique articles after removal of duplicates. 504 articles were immediately excluded as they were unrelated to the topic of interest based on title alone (Fig. 1). Of the remaining publications, an additional 157 were excluded as they did not relate to a residency learner group or to art as the specific medical humanities intervention. One review article was identified that summarized the use of drawing and sculpture
DISCUSSIONIn this review, we identified examples of the use of visual art in surgical resident education for the purposes of preoperative planning, post-operative documentation, communication skills, fostering empathy and interprofessional collaboration, and for resident evaluation. The literature suggests that a resident's markings reflect knowledge of surface anatomy and decisiveness, the ability to draw a procedure—independent of artistic talent—can be utilized to assess knowledge about a procedure,
CONCLUSIONIncorporation of visual arts training into surgical residency is rare. Drawing on our experience in art-based education for medical students and other health professionals3,9,37, 38, 39,46, surgical education may benefit from broader application of this well-established pedagogical method, to improve critical thinking, observation, communication, perspective taking, cultural awareness, and empathy, which are all directly related to core competencies of surgery.
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