Cinemedicine: Using movies to improve students' understanding of psychosocial aspects of medicine

Cinemeducation improves early clinical exposure to inborn errors of metabolism

Cinemeducation is an effective tool to help students develop humanistic skills. However, there was a need for more studies to find out if this can also be utilized to improve the interest and satisfaction of students learning about rare diseases such as the inborn errors of metabolism. The aim was to introduce cinemeducation as part of early clinical exposure and teach first-year MBBS students in the Department of Biochemistry about inborn errors of metabolism. This was a quasi-experimental, cross-over study involving 100 MBBS students. Movie clips prepared from Lorenzo's Oil (for Lipid metabolism) and Extraordinary Measures (for Lysosomal Storage Disease) and corresponding paper-based cases; questionnaires and feedback forms were validated by expert group review. Students' academic performance was improved in the groups where the Extraordinary Measures movie was used for cinemeducation. Still, this effect was not observed when the movie Lorenzo's Oil was used. Both learners and facilitators were satisfied with cinemeducation. Cinemeducation was effectively introduced to teach inborn errors of metabolism in the Department of Biochemistry topic-dependent manner.

"Cinemeducation" as a teaching-learning tool in Community Medicine for Phase II MBBS students

Background

Many public health topics in the subject of Community Medicine have a psycho sociocultural aspect to them, and these are taught by traditional methods like didactic lectures with little or no interaction of faculty and students. This limits the comprehensive understanding of the students regarding sensitive issues. There is a felt need to improve the knowledge and understanding of many of these competencies among students through available cinema movies addressing these concepts.

Objectives

1. To assess effectiveness of "Cinemeducation" as a tool to teach identified competencies in Community Medicine subject. 2. To assess perception of students for "Cinemeducation" to enhance learning and communication skills.

Methodology Study Design

Nonrandomized intervention study.

Setting

Department of Community Medicine, Government Medical College, Pali, Rajasthan.

Participants

Year 2 from 2020 Batch.

Sample Size

159 students.

Sampling

Complete enumeration.

Intervention

All 159 students were divided into two groups and alternately shown movies, Toilet-Ek Prem Katha, Padman, Outbreak, and Steel Magnolias, or exposed to didactic lecture and were assessed using pre- and post-tests and student satisfaction and self-confidence in learning scale.

Results

The post-test scores of cinemeducation showed an improvement by a mean of 1.88 ± 0.7 points. The self-confidence and learning scale showed that 86% of students agreed that cinemeducation was better than didactic lectures. The mean satisfaction index of cinemeducation as a teaching-learning method was 97.6. Three out of the four movies addressed the competency well, and the difference between the pre- and post-test scores was statistically significant following cinemeducation as compared to lectures.

Conclusions

As the student correlates real-life situations in movies like Toilet-Ek Prem Katha, Outbreak, and Padman, they definitely understood the topic better with cognitive scores showing an increase.

The Effect of Teaching Professionalism by Using Real Lifetime Scenarios in Undergraduate Medical Students: An Educational Trial

Introduction

The objective of this research is to evaluate the effect of teaching professionalism by real lifetime scenario to undergraduate MBBS medical students.

Methods

This comparative quasi-experimental trial was conducted in OBS/GYN department from May 2019 to Jan 2020. The final year MBBS students of Shalamar Medical and Dental College, Lahore, who attended the clinical rotation of Gynae OBS were enrolled in the study using consecutive sampling. Each batch consists of 15 students. The first two batches were taken as active control, whereas the third batch was taken as an interventional group. The certified faculty in medical education assessed professionalism by using P-MEX at the start and end of the rotation in the gynae ward. P-MEX data are presented as mean and standard deviation. The comparison between the two groups was done using independent sample t-test, and pre- and post-comparison within group was done by paired sample t-test. P-value less than 0.05 was considered as significant.

Results

Among the 45 students, 28(62.22%) were male and 17(37.78%) were female. Age and gender were statistically similar in both groups. The average total score, at the start of the rotation of the intervention group was 1.95±0.294, whereas the active control group was 2.23±0.31. At the end of the rotation, the average total score of the intervention group was 3.22±0.48 and active control was 2.56±0.53. Pre- and post P-MEX score was statistically significant with P<0.001.

Conclusion

This research showed that the teaching of professionalism using real lifetime scenarios led to statistically significant improvement of professionalism in the form of P-MEX mean score among final MBBS students.

Cine Medicine in Indian Scenario: A SWOT Analysis

Cinema has the ability to convey important messages in an engaging and interesting manner. Cine medicine also known as cinema medicine or Cinemeducation has the potential to teach medical students and healthcare professionals about various aspects of medical conditions and illnesses. It is an innovative approach that can enhance empathy among the students and understanding toward patients with various medical conditions. Indian cinema has played a significant role in promoting health awareness and educating people about various medical conditions. Cinemeducation/Cine medicine can be instrumental in inculcating ethics and professionalism among budding clinicians. Of late, medical educationists have understood its importance and have introduced this innovative method in teaching not only medical humanities but medicine per se. This article aims to summarize the strengths, weaknesses opportunities, and threats analysis of the cine medicine along with reviews of Indian cinema for emphasizing the medical condition depicted in these cinemas/movies.

Cinemeducation: A mixed methods study on learning through reflective thinking, perspective taking and emotional narratives

INTRODUCTION

Cinemeducation describes the use of film in medical education. The M23 Cinema (M23C) comprises a film screening and subsequent discussion with experts, affected persons and the audience. Previous research suggests that participating in cinemeducation may affect emotions and attitudes. This study aimed to establish a conceptual framework and explore when learning takes place, how learning occurs and what participants learn during the M23C.

METHODS

Informed by focused literature searches, discussions of the authors and the research results, a conceptual framework of the M23C was developed, comprising three dimensions (five distinct phases, learning methodology and potential impact). A mixed method study was undertaken, employing an exploratory sequential design. Initially, the qualitative component was conducted by interviewing everyone involved, comprising focus groups, expert interviews, a group interview and one narrative interview. All qualitative data were analysed using qualitative content analysis. The qualitative findings were used to inform the development of a survey among the participants of M23C evenings. The survey results were analysed descriptively. The findings generated by both data sets were integrated using the "following a thread" protocol and visualised by joint displays.

RESULTS

In total, 15 participants in M23C courses, six members of the current and two of the former organising committee, two experts, two affected persons and the initiator of the M23C were included in the qualitative component (n = 28). A total of 503 participants responded to the survey. The qualitative data confirmed the relevance of the five phases and participants described reflective thinking, perspective taking and emotional narratives as the three dimensions of how they learned during the M23C. Participants reported a change in attitudes, enriching their knowledge, experiencing empathy and learning about other health professions.

DISCUSSION

Our findings suggest that the M23C as a cinemeducation course provides a unique learning environment in the training of health professionals.

Animating Clinical Ethics: A Structured Method to Teach Ethical Analysis Through Movies

Movies can serve valuable didactic purposes teaching clinical ethics to medical students. However, using film sequences as means to develop critical thinking is not a straightforward task. There is a significant gap in the literature regarding how to analyse the ethical content embedded in these clips systematically, in a way that facilitates the students' transition from anecdotal reflections to abstract thinking. This article offers a pedagogical proposal to approach the ethical analysis of film sequences in a systematic fashion. This structured stepwise method encourages students to identify the main ethical problem of a selected scene and to reflect on the theoretical principles involved, emphasizing the application of these norms and values in a contextually situated analysis. We believe this method in film studies both reinforces the students' comprehension of the theoretical framework of an ethical topic, and casts light on its pertinence and limitations under the circumstances of the scene, thus proving a constructive tool to strengthen the bridge between the theoretical teaching of clinical ethics and clinical practice.

Coda and Catharsis: Exploring the Emotional Challenges and Coping of Junior Palliative Physicians Through Cinematic Reflection

Background: There has been little research on reflective tools for junior doctors, whom may have encountered challenges working in palliative care whereby grief and losses are high. This is a qualitative study aiming to firstly explore the emotional challenges of junior doctors and secondly whether the movie is an effective reflective tool. Setting/participants: 32 junior doctors rotating through the palliative care unit were recruited and underwent a combined movie screening with a focus group discussion after. Results: Emotional challenges highlighted were (1) lifting the veil of death (2) impeded call of action (3) manifesting inner fatigue. Majority found the movie relatable to their clinical practice and felt that the focus group discussion was helpful. Conclusion: Junior doctors do have certain emotional challenges during their palliative care posting. Having a movie session combined with a focus group discussion is a reasonable method to help them reflect about their challenges.

Assessment of effectiveness of Cinemeducation as a tool to impart communication skills among the MBBS 1st Professional students

Background: Improvements in healthcare providers’ communication skills have been linked to more effective healthcare delivery, improved patient compliance, better patient and provider satisfaction, and fewer lawsuits. Cinemeducation is a relatively new method of medical education where movies or movie clips are used to stimulate discussions and reflections, which is a part of an active learning process. Hence, the present study was undertaken. Methods: We conducted an educational research, mixed method study among the MBBS 1st Professional students. A pre & post test to assess the knowledge and attitude of the students about the importance of communication skills in doctor-patient relationship. Students wrote the reflection and feedback after watching the movie clip. Quantitative analysis was done using paired t test by SPSS v. 20. Qualitative data analysis was done by two investigators independently. Results: The pre & post test for knowledge was statistically significant while communication skill attitude scale score for both positive & negative was not significant. Conclusion: The student’s knowledge improved significantly after the sessions on communication skills, while negligible change in attitude was observed. Reflective writing by the students shows that cinemeducation can be used as one of the tool for teaching communication skills to the medical students.

Cinemeducation in medicine: a mixed methods study on students' motivations and benefits

BACKGROUND

Cinemeducation courses are used to supplement more standard teaching formats at medical schools and tend to emphasise biopsychosocial aspects of health. The purpose of this paper is to explore why medical students attend the cinemeducation course M23 Cinema (M23C) at LMU Munich and whether a film screening with a subsequent expert and peer discussion benefits their studies and their future careers as medical doctors.

METHODS

An exploratory sequential mixed methods study design was used. Qualitative research, i.e. three focus groups, four expert interviews, one group interview and one narrative interview, was conducted to inform a subsequent quantitative survey. Qualitative data was analysed using qualitative content analysis and quantitative data was analysed descriptively. The findings were integrated using the "following a thread" protocol.

RESULTS

In total, 28 people were interviewed and 503 participants responded to the survey distributed at seven M23C screenings. Participants perceive the M23C as informal teaching where they learn about perspectives on certain health topics through the combination of film and discussion while spending time with peers. The reasons for and reported benefits of participation varied with educational background, participation frequency and gender. On average, participants gave 5.7 reasons for attending the M23C. The main reasons for participating were the film, the topic and the ability to discuss these afterwards as well as to spend an evening with peers. Attending the M23C was reported to support the students' memory with regards to certain topics addressed in the M23C when the issues resurface at a later stage, such as during university courses, in the hospital, or in their private life.

CONCLUSIONS

The M23C is characterised by its unique combination of film and discussion that encourages participants to reflect upon their opinions, perspectives and experiences. Participating in the M23C amplified the understanding of biopsychosocial aspects of health and illness in students. Thus, cinemeducative approaches such as the M23C may contribute to enabling health professionals to develop and apply humane, empathetic and relational skills.

From Sully to Nightingale: Critical Thinking Through Esthetic Learning

BACKGROUND

Nursing faculty continually seek new teaching strategies to promote prelicensure nursing students' critical thinking. Students construct new knowledge through experience. Esthetic learning methodologies involve gaining knowledge and insight through emotive, firsthand experiences. The esthetic experience of watching a movie, coupled with reflective journaling, has been used with health care students to promote learning. However, little is documented in the literature on its use with nursing students or its influence on the formulation of critical thinking skills.

METHOD

This descriptive qualitative study explored the impact of watching the movie, Sully, followed by structured reflective journaling on critical thinking of prelicensure nursing students.

RESULTS

Themes were identified which demonstrated students' insights into the components of critical thinking and expert thinking.

CONCLUSION

Esthetic learning is a promising teaching approach that addresses multiple ways of knowing, thereby enhancing students' learning about critical thinking in a prelicensure education program. [J Nurs Educ. 2021;60(5):281-285.].

Quantifying the Impact of the Grain-for-Green Program on Ecosystem Health in the Typical Agro-Pastoral Ecotone: A Case Study in the Xilin Gol League, Inner Mongolia

The Green-for-Grain program (GGP) is the largest environmental restoration program in China. It is effective in controlling land desertification but at the same time is highly affected by regional differences. Ecosystem health, as an important indicator of ecosystem sustainability, can effectively assess the ecological impact of the GGP and provide a basis for follow-up actions. As a typical agro-pastoral ecotone along the Great Wall, the Xilin Gol League has seen increasing land-use intensity, thus, it is crucial to understand the ecological conditions of the region in order to deploy a policy of the GGP in accordance with local conditions. In this study, using remote sensing images and social statistics data from 1990–2015, land-use transformation and the turning point of vegetation coverage was determined. Based on the pressure-state-response (PSR) model, an ecological health evaluation system was constructed to quantify the temporal and spatial variation of ecosystem health. Then, the spatial correlation between the changes in forest and grass coverage, as well as the changes in the ecosystem health index (EHI), was evaluated using GeoDa software. The results showed that (1) grassland was the primary land-use/land-cover (LULC) in the Xilin Gol League. Since 2000, land-use transfer types changed significantly and grassland degradation weakened; landscape connectivity increased, and vegetation coverage increased. (2) Over the past 25 years, the ecosystem in the study area was at a subhealthy level and showed a trend toward a healthy level. (3) The spatial correlation between △Area% (change in forest and grass coverage) and △EHI (change in ecosystem health index) was positive between 2000 and 2015 and the correlation gradually increased, indicating that the GGP did enhance the health of the ecosystem of Xilin Gol. This study provided a specific reference for the evaluation of ecosystem health in the agro-pastoral ecotone of China and a theoretical basis for the implementation of sustainable management policies in the study area.

Cinematographic Habits of Future Spanish Teachers from a Socio-Educational Perspective

One of the key features of today′s society is the role of technology and mass-media. Among these tools, cinema has influenced successive generations more than 100 years. From an educational point of view, it is a resource of high pedagogical value. Moreover, it is present in the daily life of university students who will be the future teachers. Therefore, the aim of this study is to find out the film consumption habits of students in the teacher′s degree in Spanish universities. A quantitative approach was adopted with a survey design, and the national sample was made up of 4659 students. They ware from the different regions of Spain and 58 universities. The questionnaire called Percepciones sobre las potencialidades del cine como recurso didáctico en las aulas de Infantil y Primaria (PECID) was designed ad hoc for this research. The results obtained showed that most students have a weekly habit of consuming films, with fiction being the most popular type of film. Likewise, the viewing of films is preferably done through television and the computer. It can be concluded that this familiarity with cinema outside the university should be complemented with specific training in the teacher′s degree. In this sense, it contributes to an optimal application of cinema.

Creating a Film to Teach Health Professions Students the Importance of Interprofessional Collaboration

Objective. To produce, implement, and evaluate the effectiveness of a film to develop the foundational knowledge and skills of health professions students and teach them the importance of interprofessional collaboration. Methods. An existing interprofessional case study about a Hispanic man suffering from multiple chronic health conditions and the impact his health had on his family served as the basis for the film. To ensure a high-quality production, faculty members partnered with a local theatre company to produce the film. Upon completion, the film was integrated into an annual interprofessional forum and evaluated by both students and faculty members in 2016, 2017, and 2018. Results. The 22-minute film, entitled Meet Fred Santiago: Improving Care Through Interprofessional Collaboration, was shown to 1921 students and 250 faculty members who participated in the interprofessional forum over the three years. Of these, 1858 students and 174 faculty members completed a program evaluation following the forum. The majority (>86%) of student and faculty respondents agreed or strongly agreed that the film presented a realistic view of the challenges faced by people with multiple chronic health problems. The majority of students (>85%) agreed or strongly agreed that the film helped them appreciate the breadth of issues confronting individuals with multiple chronic health problems. Conclusion. The film, Meet Fred Santiago, is an effective tool for introducing health professions students to the complex interrelationship of medical, psychological, and social issues experienced by individuals with chronic health conditions.

Teaching medicine through film: Wiseman's medical trilogy revisited

BACKGROUND

Between the late 1960s and early 1980s, Frederick Wiseman filmed hundreds of hours in an emergency department, intensive care unit and asylum. These films recorded events as they happened without rehearsal and narration.

MAIN BODY

Cinema and Medicine meet each other in feature fiction film and in documentary format. Showing films in hospitals is revealing for both the unexpected audience but also the medical establishment. This paper revisits Wiseman's edited but explicit films and their revelation of the complexity of care in this era in the United States. Although they offer a narrow view of medical institutions and the issue of informed consent later became problematic, the films provide an intriguing glimpse of US healthcare and decision making. These films are largely unknown but would be an invaluable resource in a masterclass on medical ethics in urgent care and end-of-life decisions.

CONCLUSIONS

Despite their flaws, Wisemans' medical films have a significant educational value. Each documentary can be used in a masterclass on medical ethics. The films provide ample opportunities to discuss core issues in healthcare, professional interactions, and decision making in critically ill patients.