A day at the Fleming Museum teaches Doctor of Physical Therapy students that the diagnosis starts with the eye of the beholder

It all started with a pair of children’s moccasins. Reuben Escorpizo, a clinical associate professor in the Department of Rehabilitation and Movement Science, first saw the pair of early 20th century shoes at a Fleming Museum workshop about incorporating art into classroom curricula.

He noticed how thin the soles were and considered how, where and when a child might have worn them. “I pictured a child who had a shoe that was comfortable, but less functional. I wondered how the child walked and moved around with less support, especially with uneven terrain at the time, and about the developmental effects on other joints of the body,” says Escorpizo, who is also a practicing physical therapist. 

Escorpizo realized he had inferred that information about the child just by observing the shoes and their shape, form and physical profile. That’s when he got the idea to challenge his Doctor of Physical Therapy students to do the same. With the support of fellow DPT faculty member Elizabeth Sargent, Escorpizo collaborated with the Fleming Museum to customize an exhibit comprising art and artifacts featuring the human body for his students to practice their clinical reasoning and observation skills, and test their knowledge of the movement system. A relatively new concept, the movement system encompasses multiple, interrelated systems of the body that interact to influence an individual’s movement.

Fleming Museum manager of collections and exhibitions Margaret Tamulonis pulled objects including a woman’s corset, shoes, and a sculpture of a leaning Buddha for the class to carefully examine and discuss. Students moved through the exhibit with a prompt to simply write their observations about the pieces and any discomfort or symptoms they thought the subjects displayed. Escorpizo’s goal for the experience was to have his class defend their observations through clinical reasoning, an essential skill required of physical therapists.

“Students have to be able to demonstrate clinical reasoning about what the best possible care for a patient might be, which ultimately results in sound clinical decision making. Once they go through and observe the body and consider movement systems—for example how muscle power inefficiency in the hip, reduced cardiovascular endurance and aging may affect a patient’s walking—then they’re not just assessing the patient using random examination techniques or grasping at every single thing without defensible reasoning,” explains Escorpizo. 

While at the museum, the class considered how the statue of Buddha leaning on its side could demonstrate a patient’s discomfort in the neck, the hands and wrists or even the feet. They observed a woman in a portrait with unique posture and discussed what physical trauma or injury, or habitual posture from childhood might have caused it.

“Is there a correct way of looking at it? Maybe not. The next step is talking to the patient or client. It’s all part of their clinical reasoning and how they would do that in real life as opposed to in a classroom with environmental constraints and standardized conditions of a client or patient,” says Escorpizo. As DPT students move through the curriculum, they build on the skills they practice in the museum when they begin to interact with patient simulations and real patients in clinics, rehabilitation centers and the community. 

For Tamulonis, who is no stranger to helping University of Vermont students enhance their studies through art, Escorpizo’s class wasn’t the average discipline she usually works with in the Fleming. She enjoyed listening to their discussions about the art from their discipline’s perspective and looks forward to working with Escorpizo and his students in the future.

“One of the joys of working with students from UVM is that they come in and they make observations about things that maybe I have not observed before. Having these fresh eyes and these bright minds working on objects is really exciting,” says Tamulonis.

“I certainly encourage anyone to come in and look at the artwork that we have here and really go with it in whatever direction they choose. We have over 25,000 objects, which I think of as 25,000 different research projects. There’s so much for students to work on.”

PUBLISHED

01-16-2019
Kaitlin Shea Catania
Pair of children’s moccasins
Part of the Fleming Museum collection, a pair of children’s moccasins from the early 20th century inspired Escorpizo to incorporate art into his movement systems and clinical reasoning curriculum. (Photo: Reuben Escorpizo)