Preparing medical students to become skilled at clinical observation

Abstract

Background: Observation is a fundamental skill for physicians and it is has been the subject of a resurgent interest. Although strategies for teaching observation have been described previously, many of them linked conceptually to emerging insights in visual literacy and aesthetic development, principles of clinical observation have not been elucidated.

Aims: The purpose of this study was to develop a set of principles that would be useful in guiding educators teach medical students how to observe.

Methods: The authors conducted a comprehensive review of the literature on the history and theory of clinical observation. They then consulted a group of individuals from a highly diverse background who, based on the nature of their work, were considered to have expertise in observation.

Results: Informed by the literature and the group of experts, the authors developed a set of four guiding principles relating to pedagogy and eight core principles of clinical observation. In the context of curriculum renewal at the Faculty of Medicine, McGill University, these principles were then used to create specific teaching modules.

Conclusions: Principles that are pragmatic in nature, anchored in a theoretical framework of visual competence and applicable to medical education have been developed and successfully deployed.

Let someone say of a doctor that he really knows his physiology or anatomy, that he is dynamic–these are real compliments; but if you say he is an observer, a man who really knows how to see, this is perhaps the greatest compliment one can make. J.M. Charcot ()

Additional information

Notes on contributors

J. Donald Boudreau

Dr BOUDREAU is a core member of the McGill Center for Medical Education and is currently involved in undergraduate medical curriculum development; this represents his main research interest. His clinical work is in the field of respiratory medicine.

Eric J. Cassell

Dr CASSELL is Professor Emeritus at Cornell University and is an Adjunct Professor in the Department of Medicine, McGill University. The focus of his scholarly activity is on the topic of suffering and healing in medicine. He is retired from clinical practice.

Abraham Fuks

Dr FUKS, erstwhile Dean of the Faculty of Medicine, McGill University, has a research interest in the use of language in medicine and is currently involved in numerous projects that include the intersection of clinical hermeneutics and narratology.