Your Questions about the Harvard Medical School Training the Eye Course, Finally Answered

Taken during a VTS session at the Museum of Fine Arts Boston, led by educator Dabney Hailey. Photo by Ruby Guo.

While we were students in the class “Training the Eye,” we had friends ask us what the course was about. By the time we were Teaching Assistants (TAs), they knew that we were doing that “class where you talk about art,” but still had no idea what we were up to on our Friday afternoons.

We loved being a part of this class and telling our friends all about it, so we compiled a list of questions from our peers that you might have, too.

Could you briefly introduce yourself?

Helen: Hi, my name is Helen and I’m entering my first-year as an MD/PhD student at Stanford University. I took Training the Eye during my junior year of college at Harvard, and then returned to TA during my senior year. I came into the class with several years of training in painting and drawing and a little bit of experience in 3D and digital media. As a premedical student and STEM major with a visual arts background, I was really interested in exploring the intersection between art, medicine, and science.

Ruby: I'm currently a fourth-year medical student at Harvard. I took the course during my first year of medical school and came back to TA this past year. I have been making and appreciating art from the moment I could hold a crayon and it has served as a constant source of inspiration throughout my life.

What’s the Training the Eye (TTE) course about?

Ruby: Hah, where do I begin? It’s a three-month-long course at Harvard Medical School that meets Friday afternoons. It’s led by physicians, dentists, and visual arts educators. The majority of the class is usually HMS students, although we often have students from other programs joining us as well. The class is all about developing visual analysis skills, first with art, and then learning to apply these skills to our own clinical encounters. A typical class starts with a medical lecture by one of the course directors or a guest speaker, and then we walk over to one of the amazing art museums (like the Museum of Fine Arts, Boston, Isabella Stewart Gardner Museum, and MassArt Art Museum, just to name a few) to discuss a work of art or try some drawing exercises. It’s crazy how lucky we are to be within walking distance to these museums. And how passionate the course leadership is - I think they've been running the class since 2004!

Helen: Absolutely, I think the longevity of this course and its course leadership as well as the active involvement of former students (as TAs, guest speakers, or even course faculty) really demonstrate how passionate the people in TTE are about the class and how impactful it is. I would say three major goals of the class are: 1) developing the habit of looking closely, 2) learning to discuss observations with a group, and 3) becoming familiar with and excited about local art museums! If you’re looking for an interesting and encouraging way to achieve any of these goals, this class is for you!

How do you analyze art? Is there an art historian who guides you through the museum?

Helen: One of our course instructors, Dabney Hailey, is a former museum curator who has really dedicated herself to teaching others a discussion method called Visual Thinking Strategies (VTS). VTS is a unique way to approach art because it requires no prior knowledge or context, uses evidence-based reasoning, and embraces ambiguity in a group conversation. From the beginning of the class, Dabney helps frame how you look at and talk about art using VTS, and then you have the chance to put this into practice in the museum and in patient encounters. All of the teaching staff are trained VTS coaches, so when we do small group discussions in the museum, you’ll get to analyze some incredible artwork and get feedback on how you’re facilitating that conversation.

Ruby: Yep, VTS is really the bedrock of the class. It’s cool because there are peer-reviewed studies showing that it helps healthcare providers improve their observation, critical thinking, and communication skills. I know it sounds sort of hand-wavey, so I encourage you to read this post by our colleague, Truelian, that goes into details about her experience facilitating a session!  

You mentioned that there’s some drawing involved. Can I still take the course if I can’t draw? Do I need to prepare for the course in any way?

Ruby: No, there are no requirements for the class! Many students do have some sort of interest in the medical humanities, as you would expect for an elective, but you don’t need anything except an open mind and an appetite to engage with your peers about art and medicine. I have a personal suspicion that people with less experience in the visual arts might even take away more from the course.

Helen: I completely agree, no background is necessary! While the class does prioritize medical and dental students, we also frequently have cross-registered undergraduates and graduate students without any formal training in medicine or visual arts in the class, who are able to bring unique perspectives to our conversations.

Besides the lectures by physicians, how is this connected to medicine?

Helen: The class is structured to be about half didactic and half practical, and while the didactic parts might seem more obviously related to medicine because of the lecture content, the practical parts in various art museums are just as relevant and important. Not only is there a ton to learn about people and the history of medicine through the art that we look at, but also practicing observation and discussion using VTS prepares you for effectively diagnosing and communicating with patients and being an effective team member in a professional setting.

Ruby: Yeah, there’s a reason it’s called the “art” of medicine. It’s about much more than making the right diagnosis or memorizing the classes of antibiotics. How can we use our best tool - our senses - to care for patients?

What did you hope to get out of the class when you enrolled? Did it live up to your expectations?

Ruby: To be honest, I wasn’t sure what to expect when I decided to enroll! I was a first-year medical student at the time, and we were trapped in Zoom school for most of the semester. I was so excited to find a class that combined my interests in art and medicine - two things that I had always separated in my mind. Even though it was virtual, it ended up being a great experience, and it stands out to me as one of the highlights of my first year.

Helen: For a long time, I had struggled to picture how I might incorporate my visual art background into a career in medicine. The faculty of this class were the first people I had met who had accomplished this and put it into practice, so I was eager to learn about how art and medicine came together in each of their career journeys and different ways that I might be able to do the same in the future. Not only did I get inspiring stories and useful skills out of the class, but I also found a community of mentors and peers who want to help me navigate this intersection.

Now that you’re a few years out, what do you feel like has stuck with you?

Helen: I’ve found that VTS is applicable far beyond the museum. In essence, practicing VTS really drove home the importance of looking and thinking. I’ll start medical school soon, and I’m excited to be able to apply VTS in clinical settings to better understand and help people, but for now I’ve really enjoyed just being able to take in and reflect on the world around me. I think my interpersonal relationships and enjoyment of my daily life have benefited from the observation, critical thinking, and communication skills that VTS helped me develop.

Ruby: The VTS sessions stand out to me the most, too. As a participant, you make observations about the piece in front of you, and the facilitator asks for evidence: For example, what do you see that makes you say that this person is angry? To provide evidence, I might point out the slight downturn at the corners of the mouth, the furrow between the eyebrows. Then the facilitator asks, what else can we find? Someone else might make a conflicting observation, noting the subject’s sadness, and the facilitator would build a space with multiple views.

So… what stays with me now? I learned to slow down. To avoid jumping to conclusions. To see and hear the patient in front of me. To be comfortable with ambiguity - which there is a lot of in medicine.

Any examples?

Ruby: Once, when I was admitting an otherwise healthy, elderly patient with pneumonia, the family members shared their concern that he was actively dying. Rather than simply addressing this statement, I probed further, asking what they saw that led them to that conclusion. In doing so, I was able to focus on their observations and educate them - in this case, framing delirium as “brain confusion” that would likely resolve with the infection.

I have learned that huge disconnects can exist between the medical team and patients. Basically - people standing in the same room, looking at the same patient, can come to wildly different conclusions. As trainees and physicians, it’s our job to parse out what the basis of those disconnects are and help correct them. By focusing on the “what” rather than the “why,” we can shift the conversation away from bias and assumption.

Helen: For the past two years, I’ve been a Public Service Representative for undergraduates at Harvard, and each year I organize one service or community-building event. This year, I organized a trip to the MFA and used VTS to lead discussions about social justice issues portrayed in art, and more informally talked to my peers about how they might incorporate service in their future careers. It was challenging to teach people VTS in such a short amount of time, but I think it produced some thoughtful conversations and helped people look and think in new ways. For me, my experience as a facilitator helped me be more confident in guiding people through confusion, discomfort, and ambiguity, especially since many of the subjects that we touched on during the session aren’t always easy to talk about.

Why did you want to become a TA?

Helen: Honestly, I didn’t get enough of the class the first time around! I really liked the teaching team, I missed being in the museums, and I wanted to get other people excited about the class and generally about how art and medicine fit together, too. From my past teaching experiences, I also knew that teaching a class is just as much of a learning experience as being a student, so I was curious about what more I could learn from having a different perspective in the class.

Ruby: Hmm, two reasons. One, I enjoyed the class a lot when I took it as a first year, and I wanted to give back. Two, I had experienced VTS from two perspectives - as a facilitator and as a participant - but, like Helen, I was curious how it would be from the standpoint of someone coaching the facilitator. In addition, I was coming back with two clinical years of medical school under my belt, and wondered how different it would be now that I was more “seasoned."

Was it a different experience the second time around?

Ruby: Definitely. As a TA, you see what goes on behind-the-scenes, including the huge coordination effort leading up to and throughout the course. In terms of the other things I mentioned, it was so fun to work with first years and watch them grow and become VTS rockstars by the end. I also brought my clinical experience into our debriefings and had really specific encounters that I could talk about to say, hey, this will actually be useful for your career.

Helen: Yep, we started our own training on how to be a great VTS coach months before the class began! I learned a lot as a TA, and to echo Ruby, it’s so rewarding to see students in the class get excited about art and become confident in VTS. A major highlight for me was the long-range project presentations in the MFA, where each student got to demonstrate how far they had come in looking closely and making a diagnosis based on their observations.

Alright, you’ve got me hooked, how can I join the class?

Helen: TTE is typically held in the spring, from March to May. For those interested in cross-registering, make sure to petition to join the class early since there are a limited number of seats available each year for cross-registration, and enroll in the class prior to the enrollment deadline for your school, which could be as early as January. The course number is PB 707.

Ruby: For HMS students, during the course registration period, they'll send out an email with instructions. You usually have to email the course coordinator, but it varies from year to year.

What’s next for you in the world of visual arts in healthcare?

Helen: Stanford has a great arts and humanities in medicine program called Medicine & the Muse, with lots of course and extracurricular offerings in visual arts that I’m excited to explore. A former instructor of TTE, Dr. Sam Rodriguez, now teaches a similar course at Stanford, and I’m looking forward to meeting him and learning about his journey in art and medicine. Further in the future, I hope I’ll be able to apply the skills I developed in TTE in my clinical practice – I’m so grateful to our course faculty for demonstrating all the ways this is possible and impactful.

Ruby: Wow, I didn't know that Stanford had a similar course! It's great that you'll be able to stay involved. For myself, I'm working with some of the course leadership on a project aiming to understand the long-term impact of the Training the Eye course on its alumni, and I'm very excited to see what we learn. In addition, this year I had the opportunity to serve as Editor-in-Chief of HMS In Vivo, which is our annual medical humanities magazine. We're having our launch event for this year's publication this week. So many wonderful things to look forward to!

Ruby Guo, MD student at Harvard Medical School
Helen Wang, MD/PhD student at Stanford University

If you’d like to learn more about Visual Thinking Strategies and you are not an HMS student, check out this new CME course at Harvard Medical School for healthcare providers: Training our Eyes, Minds, and Hearts: Visual Thinking Strategies for Health Care Professionals