Lights, camera, medical education

Cinemeducation: a comprehensive guide to using film in medical education

Matthew Alexander, Patricia Lenahan and Anna Pavlov, editors

Radcliffe; 2006.

For several decades, medical educators have used film to introduce complex topics; the practice is so well entrenched that “Motion pictures as topic” has been a medical subject heading since 1999. Medline currently indexes almost 6000 articles on this subject dating back to the late 1940s. Historians, too, have focused on individual films to highlight social perceptions of medicine determined by period and place. 1^,2 Some exploit cinema to teach clinical skills: how (or how not) to behave at the bedside. 3 Other movie-buffs have analyzed “the doctor” or “the nurse” as seen in the movies. 4^,5

This guide, part of the Radcliffe series on applications of medical humanities to clinical learning, fits the genre with a pragmatic twist: It identifies short film clips designed to support “cinemeducation”— a word and method coined by editor Matthew Alexander.

The editorial team consists of three family therapists — two psychologists and a social worker — with input from 26 other psychologists, behavioural scientists and family physicians. All are American, with the exception of a sole Brazilian; most of the contributors train residents in family medicine. Unlike a scholarly treatise, this book is predominantly an annotated index.

Following celebrity endorsements in two forewards, 30 short chapters are devoted to different themes, including chronic illness, sexual behaviour, aging, substance abuse, research and error. In a paragraph or two, the clinical problem is outlined, then subheads introduce specific, related keywords exemplified by the scenes selected.

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Image courtesy of Radcliffe

The plot and main actors of every film are summarized briefly at its first mention; a single movie can be used in several different chapters. Each clip is similarly described and located precisely within the film (minutes and seconds). In this manner, 125 films are parsed for 400 scenes, ranging from 1 to 6 minutes. Most are of the Hollywood variety, and were released since 1980. Questions for discussion accompany each film clip. The consistency and concise descriptions are admirable, but, sadly, the year of release is not supplied.

A few chapters break from this format. One discusses aspects of technology. Another attempts evaluation of cinemeducation with a 10-year retrospective survey of physicians who had been exposed to films in residency. The response rate was 60 per cent, but a fifth of the responses were excluded because the respondents could not recall the use of films. The remaining 48 per cent found the method memorable, fun, and effective; however, they thought it would benefit from more context and amplification.

Appendices point to similar resources and more films.

This book will best serve educators involved in family medicine or clinical psychology. The same film clips could apply elsewhere in medical education and beyond, but the static, chapter format conspires against tapping into that wider applicability: the selected rubrics will not match needs of educators in other disciplines.

In contemplating the future of cinemeducation, the editors propose a solution to this problem of accessibility: a collaborative database website that would identify more specific scenes for teaching (p. 199). Individual scholars and nonprofit organizations are already embarking on these tasks.6^,7 Indeed, such a website already exists: the ever-growing and searchable Literature, Arts, and Medicine Database, founded in 1993, holds annotations of at least 224 films, older classics and new films (http://litmed.med.nyu.edu/). Cinemeducation alludes to this database cryptically offering only its URL without actually naming it (pp.199, 236). Similarly the vast Internet Movie Database can easily be exploited in a similar manner, although its focus is not primarily medical (www.imdb.com/).

One is left with the impression that the field of cinemeducation is becoming crowded and competitive. Nevertheless, few other resources provide such precise location of clips, or as many useful questions for triggering meaningful discussion. Perhaps the book’s greatest asset is that it serves as an inspiration and a reminder that even short film segments are a vivid adjunct to learning.