Quantitative metrics and psychometric scales in the visual art and medical education literature: a narrative review

Figures & data

Table 1. Observation Scales and Measurements used to Assess Visual Arts Programming

Quantitative Observation Metrics

Visual Arts-Based Studies

Number of observations(± prespecified grading rubric) Time spent observing an image Number of words used to describe an image

(1) Dolev et al. 2001 – Pre-/post-testanalysis of clinical images gradedon a 9 or 10-point rubric. (2) Naghshineh et al. 2008 – Pre-/post-test analysis of patient photographs and artistic images usinga prespecified rubric. A qualitativeanalysis of image descriptions wasalso undertaken. (3) Klugman et al. 2011 – Pre-/post-testanalysis of clinical and artisticimages by word count and numberof observations. (4) Jasani et al. 2013 – Pre-/post-testanalysis of patient photographs bynumber of observations.A qualitative analysis of imagedescriptions was also undertaken. (5) Klugman et al. 2014 – Pre-/post-testanalysis of clinical images by wordcount and number of observations. (6) Huang et al. 2016 – Pre-/post-testanalysis of artistic and dermatologicimages by number of observations. (7) Gurwin et al. 2017 – Pre-/post-testanalysis of clinical and visual artimages. Clinical images were gradedon a prespecified rubric. Visual artimages were subjectively awardedpoints for observations,associations,interpretations, flexibility, andempathizing (no prespecifiedrubric). (8) Goodman et al. 2017 – Pre-/post-test analysis of radiographic imagesgraded on prespecified rubrics. (9) Agarwal et al. 2020 – Pre-/post-testanalysis of clinical images by wordcount and time spent analyzing each image. A qualitativeanalysis of image descriptions was alsounderta ken.

Table 2. Psychometric Scales Utilized to Assess Visual Arts Programming (All domains were evaluated using Likert Scales)

Domain	Psychometric Scale	Means Assessed	Visual Arts-based Studies Utilizing Scale(s)
Ambiguity	Modified Tolerance for Ambiguity Scale (TFA)	A 7-item questionnaire that measures an individual’s comfort (or discomfort) with ambiguity.	Klugman et al. 2011 Klugman et al. 2014 Gowda et al. 2018 Strohbehn et al. 2020
Bias	Best Intentions Questionnaire (BIQ)	A 24-item questionnaire test that assesses how physician biases may affect patient care.	Gowda et al. 2018
Burnout	The Maslach Burnout Inventory (MBI)	A 22-item questionnaire that measures three components of burnout in health professional populations: emotional exhaustion, depersonalization, and low sense of personal accomplishment.	Orr et al. 2019
Communication	Communication Skills Attitudes Scale (CSAS)	A 26-item questionnaire that assesses student perceptions towards learning communication skills.	Klugman et al. 2011 Klugman et al. 2014
Empathy & Compassion	The Compassion Scale Inter-reactivity Index (IRI) Jefferson Scale of Empathy Reading the Mind in the Eyes	A 24-item questionnaire that measures compassionate responses through three conflicting domains: kindness-versus-indifferences, common humanity-versus-separation, and mindfulness-versus-disengagement. A 28-item questionnaire that measures affective empathy (empathic concern, personal distress) and cognitive empathy (perspective taking, fantasy). A 20-item questionnaire that measures cognitive and affective components of empathy in health professional populations. Theory of the Mind inspired scale designed to gauge an individual’s ability to intuit the emotional state of others through pairing an image of someone’s eyes with their internal emotional state.	Zazulak et al. 2015 – IRI scale Zazulak et al. 2017 – IRI scale, Compassion Scale Gurwin et al. 2017 – Reading the Mind in the Eyes Strohbehn et al. 2020 – JSPE
Grit	Short Grit Scale (GRIT-S)	An 8-item questionnaire that measures two components of grit: perseverance of effort and consistency of interest.	Strohbehn et al. 2020
Mindfulness & Reflection	The Five-Facet Mindfulness Scale The Groningen Reflection Ability Scale (GRAS) The Mindful Attention Awareness Scale (MAAS)	A 39-tem questionnaire that assesses five domains of mindfulness: description, self-expression, acts of self-awareness, non-judgment of inner experience, and non-reactivity to inner experience. A 23-item questionnaire that measures reflective ability along three domains: self-reflection, empathic reflection, and reflective communication. A 15-item questionnaire that assesses dispositional mindfulness, which is the ability to be aware of and pay attention to the present moment.	Zazulak et al. 2017 – Five Facet Mindfulness Scale Gowda et al. 2018 – GRAS Strohbehn et al 2020 – MAAS