January 19, 2018

Malcolm Gladwell: How medical students can be better physicians

Daily Briefing

    A small study suggests that medical students can become "better physicians" simply by taking lessons in how to observe art at a nearby museum—a finding that speaks to the benefits of cross-training in an increasingly specialized industry, Malcolm Gladwell and David Epstein write in Ophthalmology.

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    According to Gladwell and Epstein, the study, which was also published in Ophthalmology, involved 36 first-year medical students from the University of Pennsylvania, some of whom attended six 90-minute sessions on art observation at the Philadelphia Museum of Art, while the others were used as a control group. During the art observation sessions, the students were taught how to look at, describe, and discuss works of art, to assess whether the strategies learned would improve their observational and diagnostic skills as care providers.

    The researchers found that students enrolled in the lessons "substantially" improved their observational and diagnostic skills—and also demonstrated a greater level of empathy for their patients. "Taking would-be physicians out of the hospital and into a museum—taking them out of their own world and into a different one—made them better physicians," Gladwell and Epstein write. Meanwhile, the researchers observed "a decline in the overall score of the control group," suggesting that "without a foundation in the basic skills of observation, further medical training may have the effect of eroding the skills of the would-be ophthalmologists."

    The importance of belonging to a 'wider world'

    According to Gladwell and Epstein, individuals who excel in highly specialized fields often "know a great many things beyond their field." For instance, while scientists in the United States have roughly the same number of hobbies as the general public, scientists who are inducted into national academies typically have more—and Nobel laureates are at least 22 times more likely to have serious hobbies that are not related to their field.

    By contrast, "the prevailing trend in medicine … has been toward greater and greater specialization in training," Gladwell and Epstein write. For example, classes on physical examination in medical schools typically only "focus on memorization of clinical signs" rather than focusing on the skill of observation, leading students to develop an algorithmic approach to diagnosis, according to the authors. "And algorithms, of course, are algorithmic," Gladwell and Epstein write, "wonderful so long as they are facing a problem they have seen exactly before, and terrible when confronted with a novel situation."

    Noting that the study—and related observations—are somewhat "whimsical," Gladwell and Epstein conclude that while "a medical expert is rightfully concerned with the particular and narrow aspects of their specialty," research reminds us that "the best expert is the one who also belongs to the wider world" (Epstein/Gladwell, Ophthalmology, January 2018; Rege, Becker's Hospital Review, 1/4).

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    Physician burnout links to a 16% decrease in patient satisfaction, an 11% increase in reported medical errors, increased turnover, and early retirement. Act now to prevent further damage to your business, physicians, and patients.

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