Linked article: F. Amatore et al. J Eur Acad Dermatol Venereol 2019; 33: 464–483. https://doi.org/10.1111/jdv.15340

Journal of the European Academy of Dermatology and VenereologyVolume 33, Issue 9 p. e310-e312 Letter to the Editor An art-based visual literacy training course to enhance clinical skills in dermatology trainees C.P.S.P. Ho Tiu, C.P.S.P. Ho Tiu Centre for Dermatology Research, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester, UKSearch for more papers by this authorL. Asfour, L. Asfour Centre for Dermatology Research, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester, UKSearch for more papers by this authorM. Jakab, M. Jakab Centre for Dermatology Research, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester, UKSearch for more papers by this authorH. Tomlin, H. Tomlin Centre for Dermatology Research, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester, UKSearch for more papers by this authorC.E.M. Griffiths, C.E.M. Griffiths Centre for Dermatology Research, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester, UKSearch for more papers by this authorH.S. Young, Corresponding Author H.S. Young Helen.s.young@manchester.ac.uk orcid.org/0000-0003-1538-445X Centre for Dermatology Research, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester, UKCorrespondence: H.S. Young. E-mail: Helen.s.young@manchester.ac.ukSearch for more papers by this author C.P.S.P. Ho Tiu, C.P.S.P. Ho Tiu Centre for Dermatology Research, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester, UKSearch for more papers by this authorL. Asfour, L. Asfour Centre for Dermatology Research, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester, UKSearch for more papers by this authorM. Jakab, M. Jakab Centre for Dermatology Research, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester, UKSearch for more papers by this authorH. Tomlin, H. Tomlin Centre for Dermatology Research, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester, UKSearch for more papers by this authorC.E.M. Griffiths, C.E.M. Griffiths Centre for Dermatology Research, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester, UKSearch for more papers by this authorH.S. Young, Corresponding Author H.S. Young Helen.s.young@manchester.ac.uk orcid.org/0000-0003-1538-445X Centre for Dermatology Research, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester, UKCorrespondence: H.S. Young. E-mail: Helen.s.young@manchester.ac.ukSearch for more papers by this author First published: 21 March 2019 https://doi.org/10.1111/jdv.15588Citations: 5Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume33, Issue9September 2019Pages e310-e312 RelatedInformation

DEAR EDITOR, First described by John Debes in 1968, visual literacy (VL) refers to the ability of an observer to derive meaning from images. In addition to understanding the image itself, the wider meaning is considered and deeper critical thinking encouraged. In contrast with other medical specialties, the interpretation of visual signs and gross pathology remains key to dermatological practice. Diagnostic accuracy may be increased by careful observation without preconceptions. Thus, description of lesions in dermatological practice may be considered as ‘the expression of pathological art’. On this basis we believe dermatologists should have fluent VL skills, which could be developed throughout their training. Randomized studies in medical schools in the U.S.A. have shown significantly improved visual diagnostic skills among course participants through the use of artwork in VL teaching. To our knowledge, no such training has previously been reported in U.K. dermatology. We developed a pilot course to investigate the benefit of VL training for trainee dermatologists. The course, led by an experienced art historian and educator (H.T.), was conducted for the first time in autumn 2015. Course participants were eight higher specialty trainees (specialist registrars) in dermatology: four in their final year (ST6), one penultimate year (ST5), two second year (ST4) and one first year (ST3). Participants attended five art-gallerybased sessions of approximately 2 h in duration, with additional self and group reflection following the course. All attendees maintained an art journal to record their experiences. Learning techniques included analysis of selected artwork, group discussion, short lectures and follow-up resources. Participants were exposed to diverse ranges of artwork in small workshops and gallery spaces. These included abstract, landscape, still life, portraiture and figurative artwork. A different piece of artwork was used to demonstrate the focus of each session, including the use of colour, texture, pattern and contrast. Participants were encouraged to challenge their own perceptions and consider the viewpoint of the artist, and to develop their own descriptive style (Fig. 1). Following anonymized postcourse evaluation, all participants rated the course as either excellent (n = 3, 38%) or very good (n = 5, 63%). Participants also reported subjective improvement in observational skills applicable to dermatology practice (strongly agree n = 2, 25%; agree n = 6, 75%). The majority believed their written and verbal descriptive skills had improved (n = 7, 88%). There was less certainty regarding the effect on relationships and interpreting patients’ emotional responses, which could be reflective of the timing of feedback collection directly after the last session of the course. Overall, trainees gave positive feedback regarding improvement in their clinical observational and descriptive skills. A postcourse clinical and observational skills assessment was performed using artwork and clinical images. Due to availability, four course participants and three controls completed the assessment. The control group comprised one final-year specialist registrar, one penultimate-year registrar and a senior international clinical fellow. Participants and controls were shown photographs of common dermatological conditions (a)