No full-text available
To read the full-text of this research,
you can request a copy directly from the author.
Go Home, Med Student: Comics as Visual Media for Students' Traumatic Medical Education Experiences
Abstract
A comic created by a medical student allows the reader to share the student's own unique perception of the medical education experience. Through the process of comic creation, medical students have opportunities to gain insight into how their relationships with patients and supervising physicians have shaped the physician they will become. The comic itself can be a safe space for expression and provides an opportunity for students and educators to share experiences.
... In other words, comics tend to emerge as an option that can merge text and image with emotion and fun and thereby appeal to different senses. [1][2][3][4] The utility of comics in the delivery of medical education can be explained in different ways, namely mediation of varied emotional states upon errors made while diagnosis, highlighting illustrations about the good and bad practices of medicine (viz. doctor-patient interaction), strategies to prevent or correct errors and enabling medical students to acknowledge their involvement in medical or evidence-based research, apart from educating the learners. ...
... doctor-patient interaction), strategies to prevent or correct errors and enabling medical students to acknowledge their involvement in medical or evidence-based research, apart from educating the learners. [1,3,4] In addition, the comics have found immense scope in the communication of health messages as well and thus have been envisaged. Further, these are wonderful tools to provide relevant information about experiencing an illness and to teach students observational skills. ...
... Further, these are wonderful tools to provide relevant information about experiencing an illness and to teach students observational skills. [4,5] Moreover, as comics can be accessed by medical students via different media (such as online publications, and paper media), it creates an opportunity to teach complex topics and create awareness about stigma/discrimination and inequalities in health. [5,6] It is quite important to realise that the effectiveness of comics depends not only on what is being evident but also on what is inferred. ...
The medical knowledge is extremely vast and continues to advance with each day making it extremely challenging for medical students. One of the innovative teaching-learning methods has been the use of comics in the field of delivering medical education and for improving patient care. The utility of comics in the delivery of medical education can be explained in different ways, namely mediation of varied emotional states upon errors made while diagnosis, highlighting illustrations about the good and bad practice of medicine, etc. Like any intervention, even the use of comics in medical education and clinical practice has its own challenges. To conclude, the integration of comics in medical education and patient care is an innovative approach to strengthen the overall process of curriculum delivery. The need of the hour is to understand its scope and then use in relevant settings to make it more effective and beneficial to different stakeholders.
Los cómics han constituido y constituyen un recurso didáctico ampliamente empleado en los procesos de enseñanza-aprendizaje en diversidad de contextos educativos. En este artículo se presenta una revisión sistemática a nivel internacional de la literatura científica que relaciona la lectura de cómics con su empleo educativo para identificar su diversidad de usos. Tras la realización de una búsqueda documental de artículos científicos al respecto en la Web of Science y Scopus en base a una serie de criterios se determinó trabajar con un conjunto de 46 artículos publicados en el periodo 2010-2022. Estos fueron analizados conforme a ocho variables. Los resultados muestran que se produce un uso diverso de los cómics: se demuestra que los cómics son ampliamente aceptados como estrategia didáctica en las aulas, pero se observa, al tiempo, que predomina su lectura sobre su creación, el soporte digital se ha impuesto sobre el soporte en papel y la lectura predominante es académica. Es posible concluir que el empleo de los cómics produce muchos y notables resultados educativos. Sin embargo, se podría hacer un uso de los mismos más crítico, abordando en mayor medida la diversidad social para evitar la reproducción de estereotipos.
There is an increasing use of graphic novels and comics (GnCs) in medical education, especially—but not only—to provide students with a vicarious learning experience in some areas of clinical medicine (palliative care, difficult communication, and rare diseases). This scoping review aimed to answer questions about how GnCs are used, the theories underlying their use, and the learning outcomes. Twenty-nine articles were selected from bibliographic databases and analyzed. A thematic analysis revealed four many themes: learning outcomes, students’ reactions, theories and methods, and use of GnCs as vicarious learning. GnCs can support the achievement of cognitive outcomes, as well as soft skills and professionalism. The reactions were engagement and amusement, but drawing comics was also perceived as a protected space to express concerns. GnCs proved to be a possible way to provide a vicarious experience for learning. We found two classes of theories on the use of GnCs: psychological theories based on the dual concurrent coding of text and images and semiotics theories on the interpretation of signs. All the studies but two were single arm and observational, quantitative, qualitative, or mixed. These results suggest that further high-quality research on the use of GnC in medical training is worthwhile.
Background
Various trainings are designed to educate nurses to become simulation educators. However, there are no good strategies to sustain their learnings and keep them engaged. We developed a series of 10 interactive digital storytelling comic episodes ‘The Adventures of Super Divya (SD)’ to strengthen simulation educator’s facilitation knowledge, skills, confidence, and engagement. This endline evaluation presents results on the change in knowledge after watching the episodes and retention of that knowledge over 10 months.
Objectives
The objectives of this pilot study are to: 1) assess the change in knowledge between the baseline and post-episode surveys; and 2) understand the retention of knowledge between the post-episode and the endline survey.
Methods
A human-centred design was used to create the episodes grounded in the lived experience of nurse simulation educators. The heroine of the comic is Divya, a ‘Super Facilitator’ and her nemesis is Professor Agni who wants to derail simulation as an educational strategy inside obstetric facilities. Professor Agni’s schemes represent real-life challenges; and SD uses effective facilitation and communication to overcome them. The episodes were shared with a group of nurse mentors (NM) and nurse mentor supervisors (NMS) who were trained to be champion simulation educators in their own facilities. To assess change in knowledge, we conducted a baseline, nine post-episode surveys and an endline survey between May 2021 and February 2022.
Results
A total 110 NM and 50 NMS watched all 10 episodes and completed all of the surveys. On average, knowledge scores increased by 7–9 percentage points after watching the episodes. Comparison of survey responses obtained between 1 and 10 months suggest that the gain in knowledge was largely retained over time.
Conclusions
Findings suggest that this interactive comic series was successful in a resource limited setting at engaging simulation educators and helped to maintain their facilitation knowledge over time.
Introduction: This study examines differences in students’ perceived value of three artmaking modalities (poetry, comics, masks) and whether the resulting creative projects offer similar or different insights into medical students’ professional identity formation. Methods. Mixed-methods design using a student survey, student narrative comments and qualitative analysis of students’ original work. Results. Poetry and comics stimulated insight, but masks were more enjoyable and stress-reducing. All three art modalities expressed tension between personal and professional identities. Discussion. Regardless of type of artmaking, students express concern about encroachments of training on personal identity but hoped that personal and professional selves could be integrated.KeywordsMedical educationArts in medical educationProfessional identity formationPoetry in medical educationComics in medical educationMask-making in medical educationMedical student wellness
Introduction:
Medical trainees fear disclosing psychological distress and rarely seek help. Social sharing of difficult experiences can reduce stress and burnout. Drawing comics is one way that has been used to help trainees express themselves. The authors explore reasons why some medical trainees chose to draw comics depicting stressful situations that they had never shared with anyone before.
Methods:
Trainees participated in a comic drawing session on stressors in medicine. Participants were asked if they had ever shared the drawn situation with anyone. Participants who had not previously shared were asked what prevented them and why they shared it now. The authors performed content analysis of the responses.
Results:
Of two hundred forty participants, forty-six (19.2%) indicated sharing an experience for the first time. Analysis of the responses revealed dedicated time and space was essential to sharing, trainee insecurity was a barrier, and comics were perceived as a safe way to communicate.
Discussion:
Depicting a stressful situation may be beneficial for trainees who drew an experience they had never shared before. Providing trainees with the opportunity to externalize their experience and create a community for sharing tough experiences may be one way to reduce trainee stress and burnout.
Introduction:
This study examines differences in students' perceived value of three artmaking modalities (poetry, comics, masks) and whether the resulting creative projects offer similar or different insights into medical students' professional identity formation.
Methods:
Mixed-methods design using a student survey, student narrative comments and qualitative analysis of students' original work.
Results:
Poetry and comics stimulated insight, but masks were more enjoyable and stress-reducing. All three art modalities expressed tension between personal and professional identities.
Discussion:
Regardless of type of artmaking, students express concern about encroachments of training on personal identity but hoped that personal and professional selves could be integrated.
Purpose:
Although focused reviews have characterized subsets of the literature on the arts and humanities in medical education, a large-scale overview of the field is needed to inform efforts to strengthen these approaches in medicine.
Method:
The authors conducted a scoping review in 2019 to identify how the arts and humanities are used to educate physicians and interprofessional learners across the continuum of medical education in Canada and the United States. A search strategy involving 7 databases identified 21,985 citations. Five reviewers independently screened the titles and abstracts. Full-text screening followed (n = 4,649). Of these, 769 records met the inclusion criteria. The authors performed descriptive and statistical analyses and conducted semi-structured interviews with 15 stakeholders.
Results:
The literature is dominated by conceptual works (n = 294) that critically engaged with arts and humanities approaches or generally called for their use in medical education, followed by program descriptions (n = 255). The literary arts (n = 197) were most common. Less than a third of records explicitly engaged theory as a strong component (n = 230). Of descriptive and empirical records (n = 424), more than half concerned undergraduate medical education (n = 245). There were gaps in the literature on interprofessional education, program evaluation, and learner assessment. Programming was most often taught by medical faculty who published their initiatives (n = 236). Absent were voices of contributing artists, docents, and other arts and humanities practitioners from outside medicine. Stakeholders confirmed these findings resonated with their experiences.
Conclusions:
This literature is characterized by brief, episodic installments, privileging a biomedical orientation, and largely lacking a theoretical frame to weave the installments into a larger story that accumulates over time and across subfields. These findings should inform efforts to promote, integrate, and study uses of the arts and humanities in medical education.
Background:
To help medical students learn anatomy effectively in limited hours, a regional anatomy book enhancing students' memorization was developed.
Methods:
Only anatomical terms essential for basic cadaver dissection are included along with schematic figures which enable memorization of complicated anatomical structures. Learning comics and comic strips that depict anatomy mnemonics and jokes were appended and sentences were written to be comfortably readable. The electronic book titled "Visually Memorable Regional Anatomy" has been distributed without payment or registration. With the help of 246 volunteer students from three Korean medical schools, the book's learning effects were evaluated.
Results:
These students' book reading led to increase in their anatomy scores, including written examination scores and tag examination scores. It was an encouraging result that almost 20% of students spontaneously read the book no matter who presented their lecture or examination. A webpage version of the book was visited by thousands of users.
Conclusion:
The book with unique features may suggest a new perspective in the field of anatomy learning. After having acquaintance with essential structures from reading the book, students are able to and willing to study more from other resources.
Graphic stories, or adult themed comics, are a popular new cultural trend. Michael J Green and Kimberly R Myers argue that they are also a valuable tool for medicine
Medical student mistreatment has been recognized for decades and is known to adversely impact students personally and professionally. Similarly, burnout has been shown to negatively impact students. This study assesses the prevalence of student mistreatment across multiple medical schools and characterizes the association between mistreatment and burnout.
In 2011, the authors surveyed a nationally representative sample of third-year medical students. Students reported the frequency of experiencing mistreatment by attending faculty and residents since the beginning of their clinical rotations. Burnout was measured using a validated two-item version of the Maslach Burnout Inventory.
Of 960 potential respondents from 24 different medical schools, 605 (63%) completed the survey, but 41 were excluded because they were not currently in their third year of medical school. Of the eligible students, the majority reported experiencing at least one incident of mistreatment by faculty (64% [361/562]) and by residents (76% [426/562]). A minority of students reported experiencing recurrent mistreatment, defined as occurring "several" or "numerous" times: 10% [59/562] by faculty and 13% [71/562] by residents. Recurrent mistreatment (compared with no or infrequent mistreatment) was associated with high burnout: 57% versus 33% (P < .01) for recurrent mistreatment by faculty and 49% versus 32% (P < .01) for recurrent mistreatment by residents.
Medical student mistreatment remains prevalent. Recurrent mistreatment by faculty and residents is associated with medical student burnout. Although further investigation is needed to assess causality, these data provide impetus for medical schools to address student mistreatment to mitigate its adverse consequences.
The authors raise questions regarding the wide-spread calls emanating from lay and medical audiences alike to intensify the formal teaching of ethics within the medical school curriculum. In particular, they challenge a prevailing belief within the culture of medicine that while it may be possible to teach information about ethics (e.g., skills in recognizing the presence of common ethical problems, skills in ethical reasoning, or improved understanding of the language and concepts of ethics), course material or even an entire curriculum can in no way decisively influence a student's personality or ensure ethical conduct. To this end, several issues are explored, including whether medical ethics is best framed as a body of knowledge and skills or as part of one's professional identity. The authors argue that most of the critical determinants of physician identity operate not within the formal curriculum but in a more subtle, less officially recognized "hidden curriculum." The overall process of medical education is presented as a form of moral training of which formal instruction in ethics constitutes only one small piece. Finally, the authors maintain that any attempt to develop a comprehensive ethics curriculum must acknowledge the broader cultural milieu within which that curriculum must function. In conclusion, they offer recommendations on how an ethics curriculum might be more fruitfully structured to become a seamless part of the training process.
A Story about Alzheimer's, My Mother, and Me
- S Leavitt
- Tangles
Leavitt S. Tangles: A Story about Alzheimer's, My Mother, and Me. Calgary, Alberta,
Canada: Freehand Books; 2010.
Swallow Me Whole. Marietta, GA: Top Shelf Productions
- N Powell
Powell N. Swallow Me Whole. Marietta, GA: Top Shelf Productions; 2008.
A ghost of an idea. Penn State Collection of Graphic Narratives
- J Monk
Monk J. A ghost of an idea. Penn State Collection of Graphic Narratives.
https://sites.psu.edu/graphicnarratives/files/2016/08/JMonk-snjl05.pdf.
Published August 1, 2016. Accessed December 10, 2017.
The comics revealing medical school's hidden flaws and hard lessons
- M Green
- K Myers
- D R George
Green M, Myers K, George DR. The comics revealing medical school's hidden
flaws and hard lessons. Atlantic. March 24, 2017.
https://www.theatlantic.com/health/archive/2017/03/medicalhumanities/520623/. Accessed October 3, 2017.