Beyond the Image Frame: An Art-Based Pedagogical Framework for Teaching Diagnostic Reasoning in Breast Ultrasound to Medical Students

Breast ultrasound is a key diagnostic method for breast cancer and relies heavily on the interpretation of visual cues. At the same time, medical education is increasingly being driven by time constraints, which favors rapid pattern recognition, limiting the scope for reflective image analysis and the diagnostic process. Therefore, the aim of this study was to propose and evaluate an artistic and pedagogical teaching model, inspired by the interpretive practices of Italian High Renaissance painting, as a tool to support the development of diagnostic reasoning in breast ultrasound. This model focuses on careful observation, analysis of the relationship between detail and the overall image, and the conscious transformation of visual cues into clinical meaning. This study was conducted during the four-day ARSA Think Tank Meeting (ARSATTM). Medical students worked in four groups; two groups received methodological training based on visual cue analysis, and two did not. All groups performed identical tasks involving the interpretation of breast ultrasound images and ultrasound examinations on real patients. The results indicate that an artistic-pedagogical teaching model to promote more coherent and reflective diagnostic reasoning in breast ultrasound is feasible. Therefore, integrating this approach may be a valuable addition to medical students' ultrasound education in the realities of limited clinical time.