Pediatric Annals

Editorial Free

Orthopedic Pearls and Observation Through Fine Art

Joseph R. Hageman, MD

This issue of Pediatric Annals is the second part of a series of articles, guest edited by Dr. Robert J. Bielski, on common clinical pediatric orthopedic presentations. On many occasions, I have attended Dr. Bielski's clinical conferences in which he educates participants regarding the management of a disease or problem and emphasizes the role of the primary care physician. Therefore, I am confident that you will enjoy and learn from these articles as much as I did.

Observation Through Fine Art

In last month's issue, we discussed some new strategies for making clinical care more efficient and “seamless” with principles of the Lean Hospital approach and quality improvement process.1 Now, I would like to introduce an educational intervention that I have partnered on with medical students and instructors who teach strategies for refining observation skills in the context of fine art. This was first introduced in a novel course at the Harvard Medical School2 in which third-year medical students visited a museum of fine art and spent time refining their observation skills with the help of instructors.

A painting by illustrator Sir Luke Fildes entitled “The Doctor.” Reprinted with permission from the Tate Museum.3

A painting by illustrator Sir Luke Fildes entitled “The Doctor.” Reprinted with permission from the Tate Museum.3

This program was also recently introduced (with the assistance of Joel Schwab) at The University of Chicago at the Smart Museum in which John Harness (program coordinator) coordinated opportunities for third-year medical students who are rotating in general pediatrics to spend a couple of hours reviewing different forms of visual art. During these sessions, he has the students describe, sketch, and work with a colleague to convey their feelings about the art. My role, as a general pediatrician, was to assist in summarizing their viewing experiences after the exercises were completed. I had the students describe how their observations may have clinical relevance to what they witness with patients and their families on the floor, in the clinic, and in the emergency department.

Harness has continued to expand the program, leading a course for first-year medical students entitled “Visual Art and Medicine,” which explores the same topics with a more in-depth focus. I would encourage readers to discover more about similar programming for possible implementation at their institutions. I would be interested in hearing feedback.

An Illustrator's Painting

I am a collector of Charles Dickens' writings as well as the work of his illustrators, so I include for your viewing one of my favorite paintings by Sir Luke Fildes entitled “The Doctor.” Take a few minutes to study this painting and then consider your thoughts and feelings about how what you ascertain could be applied clinically.


  1. Parker B, Johnson A, Suett P, et al. Lean hospital: managing for daily improvement in the neonatal intensive care unit. Paper presented at: 3rd Annual Illinois Perinatal Quality Collaborative Conference. November 2015; Chicago, IL.
  2. Naghshineh S, Hafler JP, Miller AR, et al. Formal art observation training improves medical students' visual diagnostic skills. J Gen Intern Med. 2008;23(7):991–997. doi:10.1007/s11606-008-0667-0 [CrossRef]
  3. Sir Luke Fildes. The doctor. (exhibited 1891) Accessed May 11, 2016.

Pediatric Annals Interim Editor-in-Chief Joseph R. Hageman, MD, is an Emeritus Attending Pediatrician, NorthShore University HealthSystem; and a Senior Clinician Educator, The University of Chicago Pritzker School of Medicine.

Address correspondence to Joseph R. Hageman, MD, via email:


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