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Accurate, objective observation is a critical component of clinical diagnosis and patient management, which in turn is essential for successful diagnostic reasoning by advanced practice nurses. The purpose of this quasi-experimental study was to enhance nurse practitioner students' observation and reflective thinking skills using Looking Is Not Seeing, a reflective practice/experiential learning technique that uses art objects to teach observation (Pellico, Friedlaender, & Fennie, 2009). Students' posttest observation and interpretation scores showed statistically significant improvement over pretest scores. Students' mindfulness scores and their own perceived observational and interpretive ability were statistically significantly higher after participating in the study. Building on the established record of successful visual literacy programs for nursing and medical students at other institutions, this research can help educators implement the Looking Is Not Seeing pedagogy.
Keywords: observational skills; mindfulness
It seems that individuals look carefully at people and things but frequently do not remember much of what they see (Elkins, 1996). We may ask ourselves, "What did I see?" "How did I miss that?" It is often difficult to remember details of an event and to describe and interpret it objectively. It is easy to get lost in the forest and not see the trees (Johnson, 2008). In fact, evidence suggests that most medical students do not learn how to look at patients but rather how to identify findings (Bardes, Gillers, & Herman, 2001). Techniques to help people see more of the trees and not just the forest, while at the same time learning how to link the trees with the forest, can help health care professionals improve their diagnostic abilities.
As part of Fairfield University's initiative to increase interprofessional collaboration, the director of the university's art museum proposed using the museum in a teaching strategy linked to the School of Nursing's objective of expanding students' reflective thinking ability. The Looking Is Not Seeing pedagogy uses art objects to practice articulating what an individual sees, to hone skills in identifying and interpreting what is seen (Pellico et al., 2009). Nursing faculty and art history faculty planned two sessions in which graduate nursing students viewed paintings and communicated their observations clearly and objectively, avoiding stereotyping, as a reflective practice/experiential learning technique to enhance their skills in performing physical examinations of their patients.