Evaluation of the ABCD-method in art-based observational training of medical students and surgical residents in the museum

Aug 28, 2026

Uploaded by Finn

Evaluation of the ABCD-method assessed structured art-based observational training for medical students and surgical residents in a museum setting. In collaboration with the Rijksmuseum, participants engaged in workshops using a layered observation approach (attention, beholding, communication) with a diagnostic medical feature to contextualize findings. A post-workshop survey measured course length and structure, usefulness, and contribution to professional development across groups with and without the medical feature.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Background

Methods

Program Design

The ABCD-method

Results

Conclusion

Original Research Evaluation of the ABCD-method in art-based observational training of medical students and surgical residents in the museum. Thomas van Gulik, M. D., PhD1a, Stella Bult, M. D., BA1b, Pien de Ruiter, BSc1 1 Surgery, Amsterdam University Medical Center, The Netherlands Keywords: Surgical education, Medical Humanities, Art-based training, Observational skills, Art museum [https://doi.org/10.5281/zenodo.14838239](https://doi.org/10.5281/zenodo.14838239) | International Journal of Surgical Education | | | --- | --- | | Background
Art-based learning in an art museum potentially adds to programs in medical education. In collaboration with the Rijksmuseum in Amsterdam, we set up an art-based educational course for medical students and surgical residents in the museum. We devised the ABCD-method to structure observational training entailing close observation in layers and a group discussion. A medical feature was included to provide medical context to the image and discussion. We aimed to evaluate the ABCD-method in a series of art-based workshops in the museum.
Methods
A series of paintings and sculptures were selected in which a possible physical abnormality or detail was detected. Participants observed the artworks in workshops containing exercises and group discussions. The ABCD-method includes A for attention, B for beholding what you see, C for communication and D for diagnosis. The program was evaluated in a post-workshop survey using a questionnaire rating ‘length and structure’of the course, ‘usefulness’ and ‘contribution to professional development’. Two groups were defined, one in which the workshops did not include the medical feature (group I), and the other in which the complete ABCD-method was followed (group II) .
Results
In total, 128 participants joined the workshops, of which 63 in group I and 65 in group II. All except one in group I, returned the questionnaires (response rate 99%) . Possible diagnostic interpretations and associated medical conditions ranged from neonatal macrosomia, to goitre and Cushing’s syndrome. We describe three art objects and associated conditions in more detail: Erb’s palsy, congenital clubfoot and accessory nerve lesion. In group I, scores for ‘length and structure’, ‘usefulness’ and ‘contribution to professional development’ of the workshops, were 74.2%, 95.2% and 88.7%, respectively. These items scored higher in group II, ie 92.3%, 93.8% and 92.3%, respectively.
Conclusion
Structured observation in the museum using the ABCD-method including a medical, diagnostic feature, proved a valued approach in art-based observational training for medical students and surgical residents. | | | BACKGROUND
Art-based learning has been recognized as an important element in the educational program of medical students and residents in training.1‑3 Several studies have shown en- | hancement of observational skills and social competencies through examining visual arts.4,5 A museum provides an excellent setting for observational training as it combines a fine collection of art works with an inspiring environment.6 Surgery largely depends on visual assessment of physical findings and diagnostic imaging necessary to consider a | a Shared first authorship Correspondence: [t. m.vangulik@amsterdamumc.nl](t. m.vangulik@amsterdamumc.nl)b Shared first authorship surgical intervention, in conjunction with patients’ conditions and preferences.7 In particular in the OR, visual recognition of an anatomical situation and visual guidance of manual movements are paramount in performing an operation, whether in open surgery or in endoscopic procedures undertaken laparoscopically or robot-assisted. Eyehand coordination is key in operative surgery and starts with critical observation. Training the eye therefore, is as important in surgical education as training of manual skills. In collaboration with the Rijksmuseum in Amsterdam, we have set up an art-based course

FAQs

What is the ABCD-method used in the training?

The ABCD-method structures observation into attention (A), beholding what you see (B), communication (C), and diagnosis (D) by adding a diagnostic medical context to the artwork discussion.

How were participants and workshops organized in the study?

A series of paintings and sculptures with detectable possible abnormalities or details was selected. Participants joined workshops with exercises and group discussions; one group did not include the medical feature while the other followed the complete ABCD-method.

What improvements were observed when the medical diagnostic feature was included?

Scores for length and structure, usefulness, and contribution to professional development were higher in the group that followed the complete ABCD-method, indicating greater perceived value of the structured approach with medical context.

Aug 28, 2026

Uploaded by Finn