I read with great interest the article by Khaliq et al on using trigger films to educate undergraduate medical students about the doctor-patient relationship [1]. The authors used Bollywood movie clips with English subtitles.

At the Xavier University School of Medicine (XUSOM), Aruba, Dutch Caribbean, we facilitated movie screening and activities using full-length movie clips once every six weeks among basic science students [2]. In a multiethnic and multilingual country like India, movie clips from various languages can be considered. I agree with the authors that showing full-length movies in a packed medical curriculum may be difficult. Support from the academic leadership to devote protected time for this activity may be required. Trigger films (TF) may be easier to show. However, full-length movies immerse students in the situation depicted. They evoke a stronger emotional response, and viewers live through the experience of the characters. We had used Hollywood movies, and these may be generally shorter in duration than Bollywood productions.

One of the challenges will be the large class sizes. I would be interested in knowing how the authors addressed this issue and initiated small group activity for the large student cohort. It would be helpful to know how many facilitators were present during the sessions and whether the students worked in small groups. Working in small groups and reflecting on the clip shown can strengthen learning. The authors could mention the TF they had used and share the YouTube or other links so that other educators can use these in their sessions. The use of an online quiz is an effective method to promote interaction in large classrooms.

In my recent article, I mention guidelines for facilitating a cinemeducation module [3]. There has been interest in using films in the education of medical students in India recently. India produces the largest number of movies globally and movies can be used to explore different issues in medical and health professions education. Indian language movies can be used to explore issues ranging from lack of toilets, sanitation issues, menstrual hygiene, the patient-doctor relationship, reproductive rights and mental illness among others [4]. A database of Indian language movies/movie clips and the issues they can be used to explore can be created.

Personally, I favour the phrase “patient-doctor” relationship rather than the “doctor-patient” relationship. The patient traditionally has occupied a less prominent place in the relationship and though the doctor is in a more powerful position we need to make the relationship more egalitarian. With increasing education levels and socioeconomic development, patients may want to take a more active role. Every patient regardless of education has a right to full information about their healthcare.

I am also interested in how doctors and medical personnel in the movies and in real life influence each other. A study mentions that early movies portrayed doctors positively, while this has become less common in recent movies [5]. Recent movies portray doctors more negatively and this may adversely affect the patient-doctor relationship. Movies reflect society and reciprocally influence each other in multiple ways. Issues like commercialisation and privatisation of medical education may affect how patients see doctors. Easy access to information and videos and movies in multiple languages also influences patients. Educated patients conduct their research before they meet doctors, and this can also influence their expectations. There is a concern that portrayal of doctors in the movies may be becoming less positive. The increasing use of artificial intelligence (AI) in medicine can change the patient-doctor relationship in several ways. It will be interesting to see how movies tackle this issue and how TF can be used to introduce students to the changes. Interactions between patients and doctors from different ethnicities and cultures are also often portrayed in movies. This is another area to be explored.

This is an important first step. The authors must be congratulated on an important study. TF can be used to address other areas both during the preclinical and during the clinical years. TF can also be used during postgraduate training and continuing medical education.

P Ravi Shankar ([email protected]), IMU Centre for Education, IMU University, Bukit Jalil, Kuala Lumpur, MALAYSIA.

To cite: Ravi Shankar P. Using movies to educate medical students. Indian J Med Ethics. Published online first on November 30, 2024. DOI: 10.20529/IJME.2024.080

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©Indian Journal of Medical Ethics 2024: Open Access and Distributed under the Creative Commons license (CC BY-NC-ND 4.0), which permits only non-commercial and non-modified sharing in any medium, provided the original author(s) and source are credited.