Medical dramas on television: a brief guide for educators

Beyond lectures and practical courses: Teaching pharmacology using imaginative pedagogical tools

Pharmacology has broadened its scope considerably in recent decades. Initially, it was of interest to chemists, doctors and pharmacists. In recent years, however, it has been incorporated into the teaching of biologists, molecular biologists, biotechnologists, chemical engineers and many health professionals, among others. Traditional teaching methods, such as lectures or laboratory work, have been superseded by the use of new pedagogical approaches to enable a better conceptualization and understanding of the discipline. In this article, we present several new methods that have been used in Spanish universities. Firstly, we describe a teaching network that has allowed the sharing of pedagogical innovations in Spanish universities. A European experience to improve prescribing safety is described in detail. The use of popular films and medical TV series in biomedical students shows how these audiovisual resources can be helpful in teaching pharmacology. The use of virtual worlds is detailed to introduce this new approach to teaching. The increasingly important area of the social aspects of pharmacology is also considered in two sections, one devoted to social pharmacology and the other to the use of learning based on social services to improve understanding of this important area. Finally, the use of Objective Structured Clinical Evaluation in pharmacology allows to know how this approach can help to better evaluate clinical pharmacology students. In conclusion, this article allows to know new pedagogical methods resources used in some Spanish universities that may help to improve the teaching of pharmacology.

Professionalism, Ethics, and Realism of Television Medical Dramas as Perceived by Saudi Medical Students

Objectives

Since their debut, medical dramas have been popular, particularly among medical students. This study examined how much time medical students spend watching medical TV shows and their impressions of the shows' professionalism, ethics, and realism.

Methods

A survey on medical students' medical drama viewing behavior and perceptions with regard to bioethics was given to 341 first- to fifth-year undergraduate medical students at a university in Al Majmaah, Saudi Arabia. The poll gathered demographic information, TV medical drama watching habits, bioethical and professional concerns in medical dramas, and the sources of bioethical knowledge.

Results

The most popular medical dramas were The Good Doctor, Grey's Anatomy, and House M.D. Compared with English-language television medical dramas, Arabic ones were less popular. Ninety-one percent of students watched television alone. There was no statistically significant difference in respondents' perceptions of ethics accuracy based on year of study, gender, or whether they discussed it with friends. In comparison to students who had not seen any medical dramas, those who had were more inclined to view them as a credible source of ethical advice (P-value .04).

Conclusions

There is a high interest in medical programs among medical students, and these programs can be used to teach them about the ethical aspects of practicing medicine.

Depiction of nervous system disorders in television medical drama: A content analysis of 18 seasons of Grey's Anatomy

BACKGROUND

Television medical dramas enjoy great popularity among the general public, and can be a source of information and misinformation about medical disorders. Nervous system disorders have always received attention in popular media, yet no studies have been performed to analyze their depiction and accuracy, to our knowledge.

OBJECTIVE

To investigate the representation of neurological and neurosurgical diseases in Grey's Anatomy, one of most popular and longest running primetime medical melodramas in American television.

METHODS

We performed a quantitative and qualitative content analysis of depictions of nervous system disorders in all 18 seasons of Grey's Anatomy, in addition to investigating the medical accuracy and the global quality of the portrayed medical content.

RESULTS

A total of 285 depictions were identified in 314 out of 400 episodes (78.5%) of Grey's Anatomy. Most of portrayed characters were males (59.2%), Caucasians (72.6%), and adults (76.4%), with a mean age of 32.6 ± 19.7 years for those mentioned. Most of the portrayals were of acute nature (65.5%), with neurosurgical diseases constituting the majority; 85.6%, while 31.6% depicted neurological diseases, and 19.3% had both. The most common clinical presentations were altered level of consciousness (16.5%) and seizures (14.4%). Traumatic brain injury was the most common portrayed diagnosis (39.3%), followed by brain tumors (13.7%), stroke (8.4%), and spinal injury (8.1%). Management was surgical for the majority of cases (79.6%), while only 17.9% received pharmacotherapy. The prognosis of portrayed cases was generally favorable, as 79.5% showed good/full recovery, while mortality rate was 18.6%. Forty cases (14.0%) were depictions of rare to very rare diseases. As regards to medical accuracy, 74.3% of depictions were deemed accurate within reason, with a mean GQS score of 4.38 ± 1.4. Four clinical trials involving the nervous system have been depicted throughout the show.

CONCLUSIONS

Neurosurgical and neurological diseases were portrayed in most episodes of Grey's Anatomy, with a good quality of its scientific content within reason. This study demonstrated that Grey's Anatomy had a good amount of medical information that could be able to improve the public perception of the specialty. However, there is still a room for significant improvement to acknowledge certain inaccuracies and misrepresentations in future episodes.

Teaching Musculoskeletal Module using dissection videos: feedback from medical students

BACKGROUND AND AIMS

Over the last two decades many medical schools have been exploring alternatives to hands-on cadaver dissection in teaching anatomy. This study aimed at reporting medical students' feedback on using dissection videos in teaching anatomy of the musculoskeletal system.

METHODS

Dissection videos were used to teach the anatomy of the musculoskeletal system for third year medical students. At the end of the module, feedbacks from medical students were reported using a questionnaire designed for this purpose. Statistically valid responses were considered for 284 students.

RESULTS

Around 60% of the students enjoyed learning anatomy by watching dissection videos but the majority - mostly non-Jordanian - thought that the duration of the videos should be shorter. 83% (236/284)of the students enjoyed the presence of an instructor to guide them through the video and 85% (241/284) wanted to discuss the content with the instructor after watching. Most of the students liked to have access to the videos at any time in an open lab policy. Only 23% (66/284) of the students - mostly Jordanian - were willing to completely replace cadaveric prosections with dissection videos. Most of the students found that dissection videos helped them to understand anatomy lectures in a better way and in memorizing anatomical details. A significantly higher percentage of Jordanian students preferred watching dissection videos at home and preferred dissection videos to replace traditional anatomy lab sessions.

CONCLUSIONS

In the light of our present findings, using dissection videos as a teaching method of anatomy was well received by students. However, it seemed that the students wanted dissection videos to be integrated with using cadaveric prosections rather than replacing them.

TV medical dramas: health sciences students' viewing habits and potential for teaching issues related to bioethics and professionalism

BACKGROUND

Medical dramas have been popular since their inception, especially among medical students. We hypothesized that the recent increase in the availability of TV medical series through online streaming platforms has probably changed health science students' viewing habits as well as the representation of bioethical conflicts and health professionals.

METHODS

We invited undergraduate students of medicine, nursing, and human biology to complete a self-administered questionnaire about their viewing habits and perceptions of the depictions of bioethical issues and professionalism in TV medical series.

RESULTS

Of the 355 respondents, 98.6 % had watched TV in the last year, 93.5 % watched TV series, and 49.6 % watched medical dramas more than once a week. The most-viewed medical dramas were The Good Doctor, House MD, and Grey's Anatomy. The most-remembered bioethical topics were medical errors, inappropriate professional behaviors, and death. Most students considered that ideals of professionalism were depicted positively and professionals were portrayed as intelligent, professionally qualified, and competent.

CONCLUSIONS

Medical dramas are very popular with health science students and are potentially useful as teaching tools for discussing issues related to bioethics and professionalism.

I'm No Superman: fostering physician resilience through guided group discussion of Scrubs

BACKGROUND

Almost half of trainees experience burnout during their career. Despite the Accreditation Council on Graduate Medical Education (ACGME) recommendation that training programs enact well-being curricula, there is no proven method of addressing this difficult topic.

METHODS

We created a curriculum addressing physician resiliency and well-being, designed for an Internal Medicine Residency Program. This curriculum utilized episodes from a medical television series, Scrubs, to facilitate a monthly, 1-h faculty guided discussion group. We collected informal feedback and abbreviated Maslach Burnout Inventories (aMBI) monthly and conducted a formal focus group after 6 months to gauge its effectiveness.

RESULTS

The curriculum was successfully conducted for 12 months with each session averaging 18-20 residents. Residents reported high satisfaction, stating it was more enjoyable and helpful than traditional resiliency training. 19 of 24 residents (79 %) completed a baseline aMBI, and 17 of 20 residents (85 %) who attended the most recent session completed the 6-month follow-up, showing a non-significant 1-point improvement in all subsets of the aMBI.

CONCLUSIONS

This novel, low-cost, easily implemented curriculum addressed resiliency and burn-out in an Internal Medicine Residency. It was extremely well received and can easily be expanded to other training programs or to providers outside of training.

Accuracy of Urologic Conditions Portrayed on Grey's Anatomy

Despite the common prevalence of urologic diseases, studies have demonstrated that the general public often has little knowledge or insight into the field of urology or the role of an urologist. In this study, we investigated the context, frequency, and accuracy of urologic conditions on the television series Grey's Anatomy. We reviewed episodes from the first 15 seasons. Episodes with urologic references were then screened and the urologic conditions, outcomes, and treatments were recorded. We identified a total of only 21 urologic events across 15 seasons and 342 episodes of Grey's Anatomy. A total of 52% (11/21) of the conditions were related to external male genitalia. The portrayal of these conditions and the associated treatments were considered to be medically accurate within reason 62% (13/21) of the time. There is significant room for improvement to increase the portrayal of common urologic conditions and malignancies to improve the public's awareness and perception of our specialty.

The Depiction of Medical Errors in a Sample of Medical Television Shows

Background: Medical errors and adverse events may affect up to 7.5% of hospitalizations, although observational studies suggest the numbers could be even higher. Previous studies have shown that medical television (TV) shows may be a major driver when it comes to a patient’s medical knowledge and perspectives.

Methods: Six episodes from the first season of eight medical TV series were analyzed by four reviewers. Demographics of the healthcare provider responsible for the error, demographics of the victim, type of error, setting of error, level of disability, and reporting of the error were recorded. Data was compared with event rates from US hospitals.

Results: A total of 242 medical errors (average 6.4/hr) were included in the analysis. The healthcare provider responsible for the error was often an attending physician (55.8%), while victims were often White (73.6%), males (55.0%), aged 16-44 years (50.8%). Errors in diagnosis (28.9%) and operative errors (19.4%) were most common. Compared with data from US hospitals, TV series depicted more errors in diagnosis (p<0.001) and fewer operative errors (p<0.001). The most common levels of disability following medical errors were emotional trauma (37.6%) and temporary injury (30.2%). Emotional trauma was significantly overrepresented and temporary injuries were underrepresented (p<0.001). Error was not reported to the victim in 49.2% of events.

Conclusion: There were multiple discrepancies between errors depicted on TV and US hospital data. This may lead to viewer fear and anxiety that results in delays in seeking medical care and increased medicolegal cases. Healthcare systems should attempt to reduce the incidence of medical errors and adverse events by ensuring competencies of their providers, instituting methods of risk analysis and prevention, and training providers on methods of proper error disclosure.

Midwifery students' views and experiences of birth on mainstream factual television

OBJECTIVES

To investigate midwifery students' experiences of viewing childbirth on mainstream factual television and to explore implications for student career intentions and potential pedagogical uses of television excerpts in midwifery education.

DESIGN

Twenty-two undergraduate midwifery students at one of two universities took place in focus groups between February and June 2019. Ethical approval was obtained at both sites. Thematic analysis was employed to generate key themes from the data.

SETTING

Two UK universities based in the East Midlands and East Yorkshire regions of England.

PARTICIPANTS

Twenty-two midwifery students at any stage of their studies.

FINDINGS

Researchers generated four key themes from the data a) Changed Perspectives on Televised Childbirth, b) Representations of Midwives and Social Implications, c) Representation of Childbirth and Social Implications and d) The Role of Televising Childbirth in Midwifery Education.

KEY CONCLUSIONS

Midwifery students often experience a change of perspective on birth on television as they acquire new knowledge and skills. They recognise the potential social implications of how childbirth and midwifery are represented on television. Pedagogical use of televised birth has potential benefits but needs further investigation in the context of midwifery education.

IMPLICATIONS FOR PRACTICE

Midwifery students are likely to begin their studies with pre-existing views and experiences around how birth is represented on mainstream factual television. They may need support to reflect on these to consider their expectations of the profession, to effectively support childbearing women and to potentially influence future production of media images of childbirth.

Changing the channel on medical ethics education: systematic review and qualitative analysis of didactic-icebreakers in medical ethics and professionalism teaching

As medical ethics and professionalism education continues to equip medical students and residents with long-lasting tools, educators should continue to supplement proven teaching strategies with engaging, relatable, and generationally appropriate didactic supplements. However, popular teaching aids have recently been criticized in the literature and summative information on alternatives is absent. The purpose of this review is to evaluate and assess the functional use and application of short form audiovisual didactic supplements or "icebreakers" in medical ethics and professionalism teaching. A systematic review of both the medical and humanities literature (i.e., PubMed/MEDLINE, Cochrane Library, and JSTOR) was conducted from inception to August 1, 2019. Final articles were subjected to a qualitative appraisal and thematic analysis. Thirteen articles were included for final analysis. Sixty-nine percent (n = 9) of the studies were published after 2000. Two studies were qualitative, one study was quantitative, and the remaining articles were commentaries. Short form audiovisual media was most popular outside of the United States (n = 10). Sixty-nine percent (n = 9) of articles advocated for self-contained media in the form of trigger films or short films/videos, while the remaining articles (n = 4) discussed the use of TV/film clips. Producibility of media was exclusive to short/trigger films. Nine themes were identified in the content analysis: adaptability, conversation catalyst, effective, engaging, nuance, practice, producibility, real, and subject diversity. The three most common themes in descending order of frequency were: conversation catalyst, realness, and adaptability. Trigger films represent an effective and unique pedagogical strategy in supplementing current medical ethics and professionalism teaching at the medical school level.

Teaching medicine with the help of "Dr. House"

TV series such as “House MD”, “Grey´s Anatomy” or “Emergency Room” are well perceived by medical students. Seminars featuring medical TV series such as “House MD” might serve as door-opener to attract medical students to learn more about rare diseases. The TV series “House MD” is troublesome for the main character Dr. House is an excellent diagnostician but at the same time a rather misanthropic person. Therefore, lecturing medicine with the help of “House MD” requires constant evaluation. From 2008 to 2016 we are using the well-known TV series “House MD” continuously to attract medical students and teach them about rare diseases as well as diagnostic strategies. We collected from 213 students a detailed questionnaire assessing their learning experience. 76.6% of our students (n = 157) reported to watching medical dramas on a regular basis. The Dr. House seminar was compared to traditional seminars and our students reported an improved learning effect (69.9%), better concentration (89.7%), higher motivation to participate (88.7%), and more fun (86.7%) (all p<0.001). The students see Dr. House’s behavior quite critically. Likert assessment on a 5-point scale identified strong disagreement with Dr. House´s interpersonal skills in dealing with his colleagues (median = 1) and patients (median = 1). At the same time, the students strongly agreed with his outstanding diagnostic (median = 5) and therapeutic capabilities (median = 4). Medical students visiting a Dr. House teaching seminar are highly motivated to learn more about rare diseases. They were positively influenced by TV series such as Dr. House to improve their diagnostic and clinical skills. At the same time, they are critical enough not to see Dr. House as a role model for their own personality. Well performed medical TV shows such as Dr. House can successfully be used in an educational setting to motivate medical students to come into seminars to learn more about rare diseases.

Hospital doctors' Opinions regarding educational Utility, public Sentiment and career Effects of Medical television Dramas: the HOUSE MD study

OBJECTIVES

To evaluate the opinions of practicing clinicians on medical television dramas and the effects these series have on society as well as their own practice.

DESIGN, SETTING AND PARTICIPANTS

Observational study using a structured questionnaire disseminated among doctors of all grades and specialties at one tertiary centre and two large secondary care district general hospitals in Wales, United Kingdom. Three hundred and seventy-two questionnaires were distributed over a 3-month period, with 200 completed questionnaires received (response rate, 54%).

MAIN OUTCOME MEASURES

Frequency and reasons for watching these programs, and opinions regarding realism, educational value and public perception, evaluated by doctors' grades and specialties. Identification of work practice with any observed traits in fictional doctors was also analysed.

RESULTS

65% of doctors surveyed admitted to watching these programs on more than one occasion. Junior doctors (interns and resident medical officers) were more regular viewers. Most doctors who admitted to watching medical dramas did so for entertainment purposes (69%); 8% watched for educational purposes and, of these, 100% watched House MD, 82% felt that these dramas were unrepresentative of daily practice, and 10% thought that they accurately portrayed reality. Most of the positive responses were from junior doctors. 61% of doctors identified some aspect of their clinical practice with another doctor (fictional or non-fictional; most junior doctors identified with a fictional doctor, compared with non-fictional role models for more senior practicing clinicians.

CONCLUSIONS

This survey shows that a large body of the medical workforce watches medical television dramas and that such programs exercise a growing influence on the practice of junior doctors, particularly those in physicianly specialties. The reasons for certain role model selections remain unknown and may require further evaluation.

The current landscape of television and movies in medical education

BACKGROUND

Using commercially available television and movies is a potentially effective tool to foster humanistic, compassionate and person-centred orientations in medical students.

AIM

We reviewed pedagogical applications of television and movies in medical education to explore whether and why this innovation holds promise.

METHODS

We performed a literature review to provide a narrative summary on this topic.

RESULTS

Further studies are needed with richer descriptions of innovations and more rigorous research designs.

CONCLUSION

As we move toward evidence-informed education, we need an evidence- based examination of this topic that will move it beyond a 'show and tell' discussion toward meaningful implementation and evaluation. Further exploration regarding the theoretical basis for using television and movies in medical education will help substantiate continued efforts to use these media as teaching tools.

Life imitating art: depictions of the hidden curriculum in medical television programs

BACKGROUND

The hidden curriculum represents influences occurring within the culture of medicine that indirectly alter medical professionals' interactions, beliefs and clinical practices throughout their training. One approach to increase medical student awareness of the hidden curriculum is to provide them with readily available examples of how it is enacted in medicine; as such the purpose of this study was to examine depictions of the hidden curriculum in popular medical television programs.

METHODS

One full season of ER, Grey's Anatomy and Scrubs were selected for review. A summative content analysis was performed to ascertain the presence of depictions of the hidden curriculum, as well as to record the type, frequency and quality of examples. A second reviewer also viewed a random selection of episodes from each series to establish coding reliability.

RESULTS

The most prevalent themes across all television programs were: the hierarchical nature of medicine; challenges during transitional stages in medicine; the importance of role modeling; patient dehumanization; faking or overstating one's capabilities; unprofessionalism; the loss of idealism; and difficulties with work-life balance.

CONCLUSIONS

The hidden curriculum is frequently depicted in popular medical television shows. These examples of the hidden curriculum could serve as a valuable teaching resource in undergraduate medical programs.

Are surgeons happy in practice? Examining a quarter-century of Alberta's surgical graduates

Every year, hundreds of new surgeons graduate from residency programs across Canada. Much time and effort is spent on preparing these surgeons for independent practice, but there is little literature about the career trajectories of surgeons after they finish training and enter practice. We surveyed all surgeons graduating from the residency programs of a single Canadian medical school over 25 years (1985–2010). Most respondents rated their job satisfaction as high/very high and indicated they would still pursue a residency in surgery and/or their specialty if they had it to do over again. This commentary discusses important information about where our graduates go and what their careers are like, challenging existing stereotypes about careers in surgery. Our survey findings should be communicated to students interested in careers in surgery.

Twelve Tips for teaching medical professionalism at all levels of medical education

Review of studies published in medical education journals over the last decade reveals that teaching medical professionalism is essential, yet challenging. According to a recent Best Evidence in Medical Education (BEME) guide, there is no consensus on a theoretical or practical model to integrate the teaching of professionalism into medical education. The aim of this article is to outline a practical manual for teaching professionalism at all levels of medical education. Drawing from research literature and author's experience, Twelve Tips are listed and organised in four clusters with relevance to (1) the context, (2) the teachers, (3) the curriculum, and (4) the networking. With a better understanding of the guiding educational principles for teaching medical professionalism, medical educators will be able to teach one of the most challenging constructs in medical education.

[Physician's role in "medical drama" pitfall? Reflection of stereotypical images of doctors in context of contemporary doctor's series]

In contemporary U.S. doctor's series, the characters are usually represented by good-looking or typical character actors. The aim of our pilot study was to investigate whether the long-term impact of this format on German television viewers could have an influence on the choice of doctor in Germany. Two different groups of people anticipating TV consumption patterns were questioned: a first group of younger adults who knew theTV series was asked to judge their doctor choice using a web-based survey tool with respect to three criteria (sympathy, expertise and own treatment preference). The second group of adults beyond the 40th year of life who need not know theTV series were shown photos of the serial figures. Study participants should select the "doctor" of which they would most likely want to be treated and this based on two predetermined reasons (sympathy or expertise). Our results indicate that stereotypical images of doctors found high approval only in the first group of people, while the participants in the second group decided in majorityfora more realistic representation of average appearance.