Utilizing Television Clips for Graduate Medical Education Anti-racist Curricula: An Acceptability Study.

Introduction Racism is a pervasive social problem that influences medicine, highlighting the need for interventions. One promising educational technique, referred to as edutainment, utilizes clips from television shows as an instructive strategy. The objective of this study was to examine the acceptability of edutainment around anti-racist curricula for residents. Methods We conducted a survey of underrepresented in medicine (URM) medical faculty to inform content for subsequent focus groups with medicine, psychiatry, and pediatrics residents. For the survey, URM faculty were randomly assigned to view four of eight clips and responded to close- and open-ended items. Focus group participants viewed selected clips and provided feedback. All study procedures occurred in 2020-2021. We calculated descriptive statistics for close-ended survey items and employed thematic analysis for open-ended items and focus group transcripts. Results Twelve URM faculty completed the survey. Feedback was uniformly positive so we included all eight clips in the resident focus groups. For each of the three participating specialties, we conducted two focus groups (2-11 participants each, total n=25) with participants viewing four of the eight clips. Analysis of focus group transcripts found that participants were receptive to the edutainment approach. Feedback as to the realism and acceptability of certain clips differed by specialty. Triangulation of survey and focus group results found differences in the acceptability of specific clips between residents and faculty. Conclusion Edutainment with medical television shows may be a promising avenue for anti-racist curricular content for residents. The educational methods described here are being incorporated into a multi-pronged, hospital system wide graduate medical education anti-racist curriculum.

Impact of Medical TV Shows on the Surgical Knowledge of Non-Healthcare Students of Lahore, Pakistan.

Purpose: A popular genre of television shows is medical dramas. Although the primary objective of watching these shows is entertainment, acquiring medical knowledge is a passive by-product. Surgical procedures constitute a large part of the storyline of these shows. This could either serve as a source of medical knowledge or provide false information, the effect being especially important in individuals with no prior medical exposure. This study assesses the impact medical TV shows can have on the surgical knowledge of non-healthcare students and the difference in knowledge between different demographic groups (among those with relatives in the medical community and those without). Methods: A cross-sectional study was conducted among the non-healthcare students of Lahore, Pakistan. A self-administered questionnaire was used containing socio-demographic factors (age, gender, educational discipline), history, and hours of medical TV shows watched. It also contained ten questions each with a score of 1 to assess surgical knowledge. Data were analyzed using SPSS v.26. Results: Among the 1097 respondents, 450 (41%) had a history of watching medical TV shows. The majority, 319 (29.1%), had seen these shows for < 24 hours. The mean score of all respondents was 5.79 out of a maximum score of 10. Respondents with a history of watching medical TV shows were more knowledgeable than those who did not (p < 0.001). Similarly, respondents with a history of watching more hours of medical TV shows were more knowledgeable than those who watched for a lesser number of hours (p < 0.001). Respondents with relatives in the healthcare profession were also more knowledgeable than those without (p = 0.049). Conclusion: If properly developed, while maintaining their primary entertainment value, medical TV shows can also be used as efficient learning tools. Quality controls must also be applied to minimize the risk of false information.

The Reality of Medical Reality Television: Analysis of Physician Demographics, Trauma, and Cardiopulmonary Resuscitation (CPR) Characteristics.

Background Television and media have a profound effect on viewers' understanding and interpretation of the world we live in. Reality television can be even more influential to viewers given its depiction of "real life". Materials and methods Every episode (n=46) was analyzed from five medical reality television shows. Hopkins, Boston Med, NY Med, Vanderbilt MDs, and Lenox Hill were selected based on criteria requiring the show to be a reality show or docuseries that recorded unscripted patient interactions in the inpatient setting or emergency department.  Results Of the 185 physicians shown on medical reality television, most were male (76.8%), white (80.0%), and surgeons (62.2%). Of the 417 patients shown on television, 72 patients had a traumatic mechanism of injury. Traumatic mechanisms included injury due to motor vehicle accident (29.2%), firearm (26.4%), cutting/piercing (12.5%), fall (12.5%), and fire/flame/hot substance (6.9%). Twenty-two of the 417 patients required cardiopulmonary resuscitation (CPR). Seven patients (31.8%) experienced cardiac arrest due to a traumatic mechanism of injury. Conclusions There was an overrepresentation of male physicians, white physicians, and surgeons on medical reality television compared to current demographic data on physicians (p<0.01). Traumatic mechanisms of injury by firearm, cutting/piercing, fire/flame/hot substance and traumatic causes of cardiac arrest were over-represented on television compared to current trauma and CPR registry data (p<0.01). This skewed "reality" of medicine as a non-diverse landscape riddled with trauma has the potential to profoundly impact viewers' understanding of medical professionals and the medical field.

The Depiction of Autonomy and Shared Decision-Making by Children and Adolescents in Medical Television.

Background Many studies have shown the importance of patient autonomy and shared decision-making in medical treatment. However, television (TV) depiction of medicine continues to present a skewed depiction of healthcare and its effects. This has been observed in adult patients but little has been studied in the pediatric population. Methodology This study analyzed the depiction of pediatric patients (7-18 years old) autonomy and their participation in the shared decision-making process in the first season of medical TV dramas that premiered from 1994 to 2017, including ER (1994), Grey's Anatomy (2005), Red Band Society (2014), and The Good Doctor (2017). These shows were scored to record each instance of a medical decision made. Results Of the 238 medical decisions recorded, pediatric patients made a medical decision 61 times (57.5%). A total of 110 instances were omitted due to the patient's inability to give consent, usually due to altered mental status, and 22 instances were omitted due to age being less than seven years. Interestingly, there was an increasing proportion of pediatric patients involved in the decision-making process over time, moving from 17 of 39 medical decisions (43.6%) of patients in ER (1994) to 22 of 33 medical decisions (66.7%) in The Good Doctor (2017) (p = 0.050213). Conclusions The results revealed that TV medical dramas have been including children in their medical decision-making more over time. This has major implications for the way writers structure their shows and how medical providers interact with their patients.

Does the "script" need a rewrite? Is medication advice in television medical dramas appropriate?

WHAT IS KNOWN AND OBJECTIVE: Television medical dramas depict the healthcare industry and draw considerable interest from the public, while pharmacists play an integral part in providing medication-related advice to the public and other health practitioners in real life. The main objective of this retrospective, observational study was to assess the appropriateness of medication advice given in televised medical dramas and how frequently pharmacists were involved in providing the medication advice. METHODS: Show selection was based on fictional series with a medical drama theme and having the highest viewership. Approximately 100 randomly selected hours of five medical television dramas (House, Grey's Anatomy, Nurse Jackie, Doc Martin and Royal Pains) were assessed for the appropriateness of advice given based on the medication indicated, number of safety checks performed, and the level of adherence to standard clinical guidelines. The appropriateness of medication advice was assessed as appropriate, mostly appropriate, partially appropriate and inappropriate using a piloted, 0-6 point scale. Other parameters recorded included patient demographics, health professionals involved, and the categories of medicines. RESULTS AND DISCUSSIONS: Medications were mentioned on 424 occasions (on average four times per hour), including 239 occasions where medication advice was given. A pharmacist was involved in giving medication advice only 16 times (7%). Using the assessment tool, overall, medication advice was deemed to be appropriate 24% of the time, mostly appropriate 34%, partially appropriate 13% and inappropriate 7%. Although the medication advice given was often for the correct indication and the advice somewhat followed clinical guidelines, it frequently omitted adequate safety checks. Doc Martin had the highest mean appropriateness score, whereas House and Grey's Anatomy had the lowest. WHAT IS NEW AND CONCLUSIONS: Medication was often used for the correct indication in television medical dramas; however, key safety checks were frequently omitted and other medication-related advice, including dose, was less reliable and accurate. Pharmacists were rarely involved in providing medication advice. Viewers should not base medication-related decisions solely on what they see in television medical dramas, and any medication-related advice should be interpreted with extreme caution.

Portrayal of medical decision making around medical interventions life-saving encounters on three medical television shows.

INTRODUCTION: Previous literature has shown that patients obtain information about the medical system from television shows. Additionally, shared decision making is regularly cited as the ideal way to make decisions during a medical encounter. Little information exists surrounding the characteristics of medical decision-making, such as who makes the decision, on medical television shows. We evaluate the characteristics of medical decisions in lifesaving encounters on medical television shows and evaluate if these characteristics were different on staged and reality television shows. METHODS: We coded type of medical intervention, patient's ability to participate in decision, presence of patient advocate during decision, final decision maker, decision to use intervention, and controversy surrounding decision on three television shows. Frequencies by show were calculated and differences across the three television shows and between staged (ER) and reality (BostonMed and Hopkins) television shows were assessed with chi-square tests. RESULTS: The final data set included 37 episodes, 137 patients and 593 interventions. On ER, providers were significantly more likely to make the decision about the medical intervention without informing the patient when a patient was capable of making a decision compared to BostonMed or Hopkins (p<0.001). Across all shows, 99% of all decisions on whether to use a medical intervention resulted in the use of that intervention. DISCUSSION: Medical interventions are widely portrayed in the medical television shows we analyzed. It is possible that what patients see on television influences their expectations surrounding the decision making process and the use of medical interventions in everyday healthcare encounters.