Medical Teacher
ISSN: 0142-159X (Print) 1466-187X (Online) Journal homepage: http://www.tandfonline.com/loi/imte20
Using feature films as a teaching aid with medical students Josep E. Baños & Fèlix Bosch To cite this article: Josep E. Baños & Fèlix Bosch (2015) Using feature films as a teaching aid with medical students, Medical Teacher, 37:9, 883-884, DOI: 10.3109/0142159X.2014.970997 To link to this article: http://dx.doi.org/10.3109/0142159X.2014.970997
Published online: 16 Dec 2014.
Submit your article to this journal
Article views: 128
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View Crossmark data
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=imte20 Download by: [117.253.233.200]
Date: 05 October 2015, At: 02:52
2015, 37: 883–887
Letters to the Editor
Downloaded by [117.253.233.200] at 02:52 05 October 2015
Standardized Patient Training: Using ANGER to quickly evoke anger in standardized patients Dear Sir During clinical skill tests, Standardized Patient (SP) trainers typically encounter challenges in rapidly inducing the emotions suitable for such examinations. During the examination, testing interpersonal and communication skills is timeconsuming, and probably extremely repetitive, having to be conducted many times in a day. Therefore, the accuracy and consistency of the performance are the main factors of its fairness and impartiality. During SP recruitment, the presence of some special characteristics, such as being voluntary and willing to serve, is considered in addition to the usual characteristics such as being enthusiastic in helping others, punctual, trustworthy, sophisticated, respectful, and communicative and cooperative (Rosebraugh et al. 1997). Given all the characteristics considered when recruiting the SPs, it is sometimes extremely difficult for the SPs to perform in an appropriate mood during the examinations after a training course lasting 1 or 2 h. Most SPs are not professionally trained actors; they sometimes have extremely few effective strategies or programs for the cultivation or training of the mood (Rosebraugh et al. 1997). Besides Asians and Asian Americans often experience culturally-specific challenges in relation to emotional intelligence. SP trainers should handle stressful situations that can make the difference between being assertive versus reactive, and poised versus frazzled. A stage actor may seem extremely similar to an SP who faces the medical students. Five continuous steps are followed to evoke reasonable and adequate anger in an SP. In the acronym ANGER, the five letters stand for the following: A, the anticipated doctor failing to show; N, nonstop changing of medical personnel; G, getting worse with treatment; E, erring in finding suitable solutions; and R, repeating treatments and tedious procedures. Through ANGER, the trainer can quickly trigger the bad mood in the SP. If done accurately, training SPs is not as difficult or time-consuming as it may seem. This approach may effectively and rapidly elicit the required emotions in patients and can serve as an assist for trainers. ISSN 0142-159X print/ISSN 1466-187X online/15/090883–2 ß 2015 Informa UK Ltd. DOI: 10.3109/0142159X.2014.993956
Chia-Shen Liao, Department of Curriculum Design and Human Potentials Development, National Dong Hwa University, Hualien, Taiwan Ming-Chen Hsieh, MD, MMedEd, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan; Department of Medical Education, Buddhist Tzu-Chi General Hospital, Hualien, Taiwan; School of Medicine, Tzu Chi University, Hualien, Taiwan; Department of Curriculum Design and Human Potentials Development, National Dong Hwa University, Hualien, Taiwan. E-mail: [email protected]
Reference Rosebraugh CJ, Speer AJ, Solomon DJ, Szauter KE, Ainsworth MA, Holden MD, Lieberman SA, Clyburn EB. 1997. Setting standards and defining quality of performance in the validation of a standardized-patient examination format. Acad Med 72:1012–1014.
Using feature films as a teaching aid with medical students Dear Sir Feature films are powerful tools for conveying information, as they introduce characters, plots and events in a convincing way. As also happens in novels, many of them often deal with human beings, especially with the consequences of disease, such as suffering, emotions, ethical dilemmas or social conflicts. Many authors have discussed using feature films as teaching aids with medical students in fields such as clinical microbiology, pharmacology, bioethics, medical ethics, the doctor–patient relationship, preclinical and clinical research, mental illness, drug addiction, palliative care, medical professionalism and social conflicts in medical care (Darbyshire & Baker 2012). In our experience, the use of this teaching aid with undergraduate students of biomedicine can help them learn about subjects might otherwise be difficult to understand using traditional teaching approaches. For those interested in using feature films in their regular teaching, we would like to recommend some basic principles (Alexander et al. 2005). To find the most useful film for teaching purposes, it is advisable to read the available information regarding the film (reviews, interviews, etc.) and to watch it critically a number of
883
Downloaded by [117.253.233.200] at 02:52 05 October 2015
Letters to the Editor
times. This strategy enables the teacher to take useful notes and determine if its content matches with students’ knowledge. While it is important is to recognize the factual mistakes of the film, we consider that, sometimes, plausibility may be better than accuracy. The best films for medical education are those that are focused on a few critical and concrete points rather that those with a vague plot. However, it is recommended that the film not only considers medical aspects, but also social and humanistic aspects of diseases. Once the film is chosen, set up the activity in the classroom like any other of the syllabus. This should include the definition of educative objectives, a general introduction of the activity, the preparation of some points to spark debate and the establishment of realistic assessments. Regarding this last item, teachers should also aim to measure the contribution of the activity to the improvement of students’ knowledge, as there is a lack data regarding this aspect in medical literature. In summary, we would highlight the importance of choosing an appropriate film, the need for careful planning and an adequate assessment of students following the activity. More research evidence is needed to clarify the actual value of using feature films in the training of medical students. Josep E. Ban˜os and Fe`lix Bosch, Universitat Pompeu Fabra, CEXS, Dr. Aiguader 88, Barcelona 08003, Spain. E-mail: [email protected]
Declaration of interest: The authors report no conflicts of interest.
References Alexander M, Lenahan P, Pavlov A. 2005. Cinemeducation. A comprehensive guide to using film in medical education. Oxford: Radcliffe Publishing. Darbyshire D, Baker P. 2012. A systematic review and thematic analysis of cinema in medical education. Med Humanit 38:28–33.
Exploring the lack of interest in geriatric medicine
expressed the belief that older patients often do not fully recover, and often get well enough to be discharged to a different environment only then to come back to hospital shortly after (‘‘a vicious circle, it wasn’t achieving much’’). In the second theme, being a ‘‘general doctor’’, participants reported that geriatricians needed to remain very general in terms of their medical and clinical knowledge. Participants regarded this as negative because they saw it as challenging: geriatricians are ‘‘not specialised in a system. You are specialised in seeing patients who are old. So you need to know about everything in older people’’ and the branch of medicine was described as ‘‘vague’’. In the third theme, Understaffed and overworked, doctors typically described geriatric wards as ‘‘massively unsupported’’, so junior doctors felt they ‘‘had no idea what we were doing. . .. as far as we knew, we were resuscitating everyone, treating everyone fully, everyone was for escalation to HDU [High Dependency Unit] to ITU [Intensive Care Unit]’’. Overall, even those interested in the speciality were grappling with negative beliefs, in keeping with previous findings regarding the low prestige of geriatrics. Our findings indicate that junior doctors may need focused training that equips them with an understanding of the unique value in maintaining a broad knowledge base in order to treat older patients in geriatrics as well as how geriatrics can improve patients’ quality of life. We believe that without addressing the beliefs of junior doctors with training and education, it becomes more likely that today’s junior doctors will not become tomorrow’s geriatricians. Rajvinder Samra, Primary Care and Public Health, School of Public Health, Imperial College London, London W6 8RP, UK. E-mail: [email protected] Amanda Griffiths, Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham NG8 1DD, UK Tom Cox, Department of Organizational Psychology, Centre for Sustainable Working Life, Birkbeck, University of London, London WC1E 7HX, UK Declaration of interest: The authors report no conflicts of interest.
Dear Sir There is an increasing need for geriatricians to take care of the growing older patient population, but the appeal of geriatric medicine in the UK is lower than most other specialties (McNally 2008). Experience as a junior doctor may affect career decisions to pursue geriatric medicine, but these have been largely ignored in favour of medical students’ beliefs (Chro´inı´n et al. 2013). We interviewed 22 junior doctors (75% participation rate) at an English teaching hospital on whether they intended to pursue a career in geriatric medicine. Descriptions as to why geriatric medicine did or did not appeal to participants were then explored and this resulted in three main themes. In the first theme, limited capacity of geriatricians to make a difference, participants described various ways in which they thought geriatric medicine achieved less than other disciplines. Some participants 884
References Chro´inı´n DN, Cronin E, Cullen W, O’Shea D, Steele M, Bury G, Kyne L. 2013. Would you be a geriatrician? Student career preferences and attitudes to a career in geriatric medicine. Age Ageing 42:654–657. McNally SA. 2008. Competition ratios for different specialties and the effect of gender and immigration status. JRSM 101:489–492.
China’s evolving residency training Dear Sir Home to one fifth of the world’s population, China has an aging demography. In order to meet the increased demand
ISSN: 0142-159X (Print) 1466-187X (Online) Journal homepage: http://www.tandfonline.com/loi/imte20
Using feature films as a teaching aid with medical students Josep E. Baños & Fèlix Bosch To cite this article: Josep E. Baños & Fèlix Bosch (2015) Using feature films as a teaching aid with medical students, Medical Teacher, 37:9, 883-884, DOI: 10.3109/0142159X.2014.970997 To link to this article: http://dx.doi.org/10.3109/0142159X.2014.970997
Published online: 16 Dec 2014.
Submit your article to this journal
Article views: 128
View related articles
View Crossmark data
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=imte20 Download by: [117.253.233.200]
Date: 05 October 2015, At: 02:52
2015, 37: 883–887
Letters to the Editor
Downloaded by [117.253.233.200] at 02:52 05 October 2015
Standardized Patient Training: Using ANGER to quickly evoke anger in standardized patients Dear Sir During clinical skill tests, Standardized Patient (SP) trainers typically encounter challenges in rapidly inducing the emotions suitable for such examinations. During the examination, testing interpersonal and communication skills is timeconsuming, and probably extremely repetitive, having to be conducted many times in a day. Therefore, the accuracy and consistency of the performance are the main factors of its fairness and impartiality. During SP recruitment, the presence of some special characteristics, such as being voluntary and willing to serve, is considered in addition to the usual characteristics such as being enthusiastic in helping others, punctual, trustworthy, sophisticated, respectful, and communicative and cooperative (Rosebraugh et al. 1997). Given all the characteristics considered when recruiting the SPs, it is sometimes extremely difficult for the SPs to perform in an appropriate mood during the examinations after a training course lasting 1 or 2 h. Most SPs are not professionally trained actors; they sometimes have extremely few effective strategies or programs for the cultivation or training of the mood (Rosebraugh et al. 1997). Besides Asians and Asian Americans often experience culturally-specific challenges in relation to emotional intelligence. SP trainers should handle stressful situations that can make the difference between being assertive versus reactive, and poised versus frazzled. A stage actor may seem extremely similar to an SP who faces the medical students. Five continuous steps are followed to evoke reasonable and adequate anger in an SP. In the acronym ANGER, the five letters stand for the following: A, the anticipated doctor failing to show; N, nonstop changing of medical personnel; G, getting worse with treatment; E, erring in finding suitable solutions; and R, repeating treatments and tedious procedures. Through ANGER, the trainer can quickly trigger the bad mood in the SP. If done accurately, training SPs is not as difficult or time-consuming as it may seem. This approach may effectively and rapidly elicit the required emotions in patients and can serve as an assist for trainers. ISSN 0142-159X print/ISSN 1466-187X online/15/090883–2 ß 2015 Informa UK Ltd. DOI: 10.3109/0142159X.2014.993956
Chia-Shen Liao, Department of Curriculum Design and Human Potentials Development, National Dong Hwa University, Hualien, Taiwan Ming-Chen Hsieh, MD, MMedEd, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan; Department of Medical Education, Buddhist Tzu-Chi General Hospital, Hualien, Taiwan; School of Medicine, Tzu Chi University, Hualien, Taiwan; Department of Curriculum Design and Human Potentials Development, National Dong Hwa University, Hualien, Taiwan. E-mail: [email protected]
Reference Rosebraugh CJ, Speer AJ, Solomon DJ, Szauter KE, Ainsworth MA, Holden MD, Lieberman SA, Clyburn EB. 1997. Setting standards and defining quality of performance in the validation of a standardized-patient examination format. Acad Med 72:1012–1014.
Using feature films as a teaching aid with medical students Dear Sir Feature films are powerful tools for conveying information, as they introduce characters, plots and events in a convincing way. As also happens in novels, many of them often deal with human beings, especially with the consequences of disease, such as suffering, emotions, ethical dilemmas or social conflicts. Many authors have discussed using feature films as teaching aids with medical students in fields such as clinical microbiology, pharmacology, bioethics, medical ethics, the doctor–patient relationship, preclinical and clinical research, mental illness, drug addiction, palliative care, medical professionalism and social conflicts in medical care (Darbyshire & Baker 2012). In our experience, the use of this teaching aid with undergraduate students of biomedicine can help them learn about subjects might otherwise be difficult to understand using traditional teaching approaches. For those interested in using feature films in their regular teaching, we would like to recommend some basic principles (Alexander et al. 2005). To find the most useful film for teaching purposes, it is advisable to read the available information regarding the film (reviews, interviews, etc.) and to watch it critically a number of
883
Downloaded by [117.253.233.200] at 02:52 05 October 2015
Letters to the Editor
times. This strategy enables the teacher to take useful notes and determine if its content matches with students’ knowledge. While it is important is to recognize the factual mistakes of the film, we consider that, sometimes, plausibility may be better than accuracy. The best films for medical education are those that are focused on a few critical and concrete points rather that those with a vague plot. However, it is recommended that the film not only considers medical aspects, but also social and humanistic aspects of diseases. Once the film is chosen, set up the activity in the classroom like any other of the syllabus. This should include the definition of educative objectives, a general introduction of the activity, the preparation of some points to spark debate and the establishment of realistic assessments. Regarding this last item, teachers should also aim to measure the contribution of the activity to the improvement of students’ knowledge, as there is a lack data regarding this aspect in medical literature. In summary, we would highlight the importance of choosing an appropriate film, the need for careful planning and an adequate assessment of students following the activity. More research evidence is needed to clarify the actual value of using feature films in the training of medical students. Josep E. Ban˜os and Fe`lix Bosch, Universitat Pompeu Fabra, CEXS, Dr. Aiguader 88, Barcelona 08003, Spain. E-mail: [email protected]
Declaration of interest: The authors report no conflicts of interest.
References Alexander M, Lenahan P, Pavlov A. 2005. Cinemeducation. A comprehensive guide to using film in medical education. Oxford: Radcliffe Publishing. Darbyshire D, Baker P. 2012. A systematic review and thematic analysis of cinema in medical education. Med Humanit 38:28–33.
Exploring the lack of interest in geriatric medicine
expressed the belief that older patients often do not fully recover, and often get well enough to be discharged to a different environment only then to come back to hospital shortly after (‘‘a vicious circle, it wasn’t achieving much’’). In the second theme, being a ‘‘general doctor’’, participants reported that geriatricians needed to remain very general in terms of their medical and clinical knowledge. Participants regarded this as negative because they saw it as challenging: geriatricians are ‘‘not specialised in a system. You are specialised in seeing patients who are old. So you need to know about everything in older people’’ and the branch of medicine was described as ‘‘vague’’. In the third theme, Understaffed and overworked, doctors typically described geriatric wards as ‘‘massively unsupported’’, so junior doctors felt they ‘‘had no idea what we were doing. . .. as far as we knew, we were resuscitating everyone, treating everyone fully, everyone was for escalation to HDU [High Dependency Unit] to ITU [Intensive Care Unit]’’. Overall, even those interested in the speciality were grappling with negative beliefs, in keeping with previous findings regarding the low prestige of geriatrics. Our findings indicate that junior doctors may need focused training that equips them with an understanding of the unique value in maintaining a broad knowledge base in order to treat older patients in geriatrics as well as how geriatrics can improve patients’ quality of life. We believe that without addressing the beliefs of junior doctors with training and education, it becomes more likely that today’s junior doctors will not become tomorrow’s geriatricians. Rajvinder Samra, Primary Care and Public Health, School of Public Health, Imperial College London, London W6 8RP, UK. E-mail: [email protected] Amanda Griffiths, Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham NG8 1DD, UK Tom Cox, Department of Organizational Psychology, Centre for Sustainable Working Life, Birkbeck, University of London, London WC1E 7HX, UK Declaration of interest: The authors report no conflicts of interest.
Dear Sir There is an increasing need for geriatricians to take care of the growing older patient population, but the appeal of geriatric medicine in the UK is lower than most other specialties (McNally 2008). Experience as a junior doctor may affect career decisions to pursue geriatric medicine, but these have been largely ignored in favour of medical students’ beliefs (Chro´inı´n et al. 2013). We interviewed 22 junior doctors (75% participation rate) at an English teaching hospital on whether they intended to pursue a career in geriatric medicine. Descriptions as to why geriatric medicine did or did not appeal to participants were then explored and this resulted in three main themes. In the first theme, limited capacity of geriatricians to make a difference, participants described various ways in which they thought geriatric medicine achieved less than other disciplines. Some participants 884
References Chro´inı´n DN, Cronin E, Cullen W, O’Shea D, Steele M, Bury G, Kyne L. 2013. Would you be a geriatrician? Student career preferences and attitudes to a career in geriatric medicine. Age Ageing 42:654–657. McNally SA. 2008. Competition ratios for different specialties and the effect of gender and immigration status. JRSM 101:489–492.
China’s evolving residency training Dear Sir Home to one fifth of the world’s population, China has an aging demography. In order to meet the increased demand
