Activity: Cinemeducation

Transversal Skills:

Creative and critical thinking

Learning to learn

Interpersonal and socio-emotional skills

Teaching- Learning Approach:

Cinemeducation

Miller Pyramid

(More information)

Learning outcomes

By the end of the activity, students should be able to:

Understand the fundamental principles of bioethics and their application in the context of the pandemic
Analyse and evaluate ethical challenges and dilemmas arising from the pandemic, such as resource allocation, triage decisions, and vaccine distribution
Develop critical thinking skills to examine the ethical implications of public health measures implemented during the pandemic, such as quarantine, lockdowns, and contact tracing
Explore the role of healthcare professionals in balancing individual rights and public health interests during a pandemic
Foster empathy and compassion towards individuals and communities affected by the pandemic, considering the ethical dimensions of providing adequate care and support
Discuss the ethical responsibilities of healthcare professionals in communicating information and addressing misinformation during a public health crisis
Reflect on personal and professional values, ethical frameworks, and decision-making processes in the context of bioethics and the pandemic
Understand the ethical dilemmas faced by healthcare professionals when making decisions about hospital supplies, such as personal protective equipment (PPE) and Intensive Care Unit (ICU) resources and prioritization
Identify and understand the physical and mental health challenges faced by healthcare professionals during the pandemic, including burnout, fatigue, and emotional distress
Analyse the ethical implications of the increased workload and limited resources on healthcare professionals’ ability to provide quality care during the pandemic

As regards transversal skills, students should be able to:

Interpersonal and socio-emotional skills:

Express ideas clearly and fluently
Share information in an organized and interesting way
Share an analysis of the main message to interpret, synthesise and/or evaluate the meaning of the content in order to draw a logical conclusion about the topic
Perform tasks efficiently and carefully
Work cooperatively with others

Critical and creative thinking:

Identify and deal creatively with unexpected, unforeseen, and complex situations that can be exploited, and evaluate different solutions
Collectively analyse complex systems; think of how systems are embedded within different domains (society, environment, economy, etc.) and different scales (local to global); and deal with uncertainty
Acquire, process, produce, and evaluate information critically and from the perspectives of different fields and decisions, taking into account both individual and community perspectives

Learning to learn:

Identify learning outcomes, relate them to prior knowledge, and manage her/his own learning process
Have the capacity for self-assessment
Plan, monitor and assess one’s understanding and performance on a certain task
Use prior knowledge to plan a strategy for approaching a new task, and transfer what they have learned from one context to another, or from a previous task to a new task

Brief description of the activity

The main objective of this teaching activity is to prepare future health professionals for situations that involve the entire planet, covering global challenges and complex bioethical issues raised by the pandemic, as well providing students with the necessary context and background to enable them to discuss these subjects from different perspectives.

Activity plan: step by step

Before the activity

1. Cinemeducation as a learning methodology.

In the extensive and varied landscape of the use of TV and movies in health sciences education, pedagogical proposals include many activities such as discussion groups and problem-based learning; however, there is a lack of systematization in the description and development of these activities. This theoretical-methodological approach on the use of films for teaching health sciences students does not stem from film criticism or scholarly studies of art or communication. Rather, it is grounded in Cinemeducation; in other words, it is based on the application of entire films, fragments of films, or TV series for specific purposes in medical education.

Cinemeducation goes much further than simply presenting a film in class. It is based on a rigorous methodology that requires a sequence of steps to be followed before, during, and after the class based on the activity.

Firstly, a proposal: we need to go beyond the discussion of the accuracy of cinematic representations without comparing reality to fiction and focus our analysis on the complexity of the situations. While evaluating the medical accuracy of audiovisual representations can be a starting point, it is crucial to recognize that cinema and TV series are an art forms that often takes creative liberties for storytelling purposes. Instead of getting caught up in the realism versus fiction debate, we should delve into the intricate layers of the situations presented. By doing so, we can explore the nuanced dynamics, ethical dilemmas, emotional complexities, and broader societal implications that these situations encompass. This approach allows us to critically analyse the narratives, character development, and the underlying themes within the context of the film, and draw meaningful insights that can inform our understanding of real-world scenarios. By focusing on the complexity of these cinematic situations, we can extract valuable lessons, provoke thoughtful discussions, and gain a deeper appreciation for the artistry and impact of filmmaking as a tool for exploration and reflection.

2. Define the audiovisual material according to the learning outcomes

The first step of a cinemeducation activity involves selecting an appropriate case and audiovisual material that aligns with the defined learning outcomes. This crucial step requires careful consideration of the curriculum and desired educational objectives. Regarding this particular activity, the case should be relevant to the topic of bioethics and the pandemic, providing a compelling scenario that raises ethical dilemmas and challenges faced by healthcare professionals. The audiovisual material, which could include movie or TV series clips, should effectively portray the ethical issues at hand and stimulate critical thinking and reflection among the participants.

Other elements to take into consideration:

Empathetic elements and humanized characters,
Stimulate analysis and critical thinking,
Controversial phrases or situations to stimulate debate,
Relevant to the area of study and have a clear real-world application,
Relate to prior knowledge,
Stimulate group work.

When seeking these resources, there are two primary avenues to consider. Firstly, one can turn to bibliographic databases such as Google Scholar or Pubmed, which serve as comprehensive collections of scholarly materials, including references to audiovisual works. These databases offer a wealth of information, including citations, abstracts, and sometimes even full texts, enabling researchers to locate relevant audiovisual resources and delve deeper into their content. Additionally, a widely-used platform for finding audiovisual resources is IMDb (Internet Movie Database). IMDb is a popular online database that catalogues a vast range of films, TV series, and other audiovisual productions. It provides extensive information about cast and crew, plot summaries, ratings, and user reviews, serving as a go-to resource for both casual viewers and dedicated researchers. Moreover, IMDb allows users to search for specific audiovisual resources using keywords. This powerful feature enables to easily find movies, TV shows, episodes or documentaries related to the topics of interest.

Regarding the depiction of the COVID-19 pandemic in medical dramas, the following clips are proposed for the teaching activity:

Fragment	Main issue	TV series (Season and Episode)	Description	Clip duration (Min)
1	Misinformation	Grey’s Anatomy (S17E12)	A young patient with COVID-19 refuses treatment because he doesn’t believe the pandemic is real	5’40’’
2	Shortages of healthcare supplies, including personal protective equipment	Grey’s Anatomy (S17E01)	A shortage of masks means they must be disinfected and reused	4’11’’
3	Shortages of hospital resources, death of patients, dying patients accompanied through video calls	Chicago Med (S6E01)	A COVID-19 patient dies because no ventilator is available; His wife accompanies him through a video call because no visitors are allowed in the COVID-19 wing	5’50’’
4	Psychological effects of the pandemic on healthcare workers	The good doctor (S4 E6,8,9)	A physician struggles to cope with her experiences in the ICU during the pandemic	10’20’’

Things to take into account prior to the activity:

Context. There is no prior limitation of the number of students, but take into account that each group must have a small number of participants (-20 students)
Materials necessary for its implementation. To present the audiovisual fragments, you will need appropriate screening equipment. This can include a projector, a large screen or display, and a sound system to ensure optimal audiovisual quality during the screening sessions
Human resources necessary for its implementation. One person/teacher must moderate all groups. If there is a large number of groups, you can think about having more than one teacher or split the work sessions on different days

During the activity

In a typical 2-hour class, the aims and procedures of the study are explained first, and then it’s time to show the clips with scenes from the episodes of the medical dramas. After viewing each fragment, a semi-structured discussion can be held to resolve doubts about relevant aspects of the episode and to analyse the main topics covered in the scene.

Standard sequence of a 2-h cinemeducation teaching activity

Stage and duration

Objectives and development

– Introduction

(15 min)

To introduce the learning objectives of the session, the content and approach, and the limitations of the activities included

Preintervention assessment

(10 min)

To assess students’ prior knowledge and preparation through a 10-question multiple-choice test

Film viewing (30 min)

To critically view the fragment, focusing on the learning objectives

Timeline debriefing and discussion

(40 min)

The timeline should help to centre the discussion, summarising and reviewing relevant aspects of the plot. Then, the discussion takes place to deliberate on the material viewed, focusing on the learning objectives

Postintervention assessment

(10 min)

To assess students’ knowledge through a 10-question multiple-choice test (the same one used in the preintervention assessment)

Open-essay questions

(10 min)

Qualitative approach (optional)

Learning achievement survey

(5 min)

To gather information about students’ opinions regarding their learning through a structured questionnaire. The items consist of rating statements on Likert scale ranging from 1 (totally disagree) to 5 (totally agree)

These stages and durations are orientative; the activity should be adapted to the circumstances of the class (i.e. time constraints, teachers’ experience and skills, students’ situations within the trajectory of their studies, etc.). When it is impossible to dispose of two hours for this teaching activity, the qualitative questionnaires can be eliminated, and/or the length of the videoclip or the debate can be reduced.

For this specific activity, the viewing and subsequent discussion stages are structured to focus on individual fragments rather than collectively discussing all of them at once. This approach is adopted to ensure a thorough analysis and meaningful exploration of each fragment on its own merits. By discussing the fragments individually, participants have the opportunity to delve deeply into the specific content, themes, and implications presented in each segment. This focused examination allows for a comprehensive understanding of the complexities and nuances within each fragment, facilitating in-depth discussions and critical reflections.

Key points of the session: Following the viewing of each fragment, a timeline debriefing and brainstorming session will be conducted, with the students taking a central role. During this session, students will be encouraged to share their thoughts, not only on the theoretical questions that the scene evoked, but also their emotions and concerns. Using these inputs, priorities will be established, and a work plan will be developed to guide further research activities.

Role of the students: They have a fully active role in the sessions, actively participating in discussions and contributing their perspectives, insights, and interpretations.

Role of the tutor: Present the work methodology, as well as the audiovisual fragments they are going to watch. Provide guidance and structure to the discussions, steering the conversation towards the intended learning objectives and helping students make connections between the film fragments and the broader educational context. In this session of cinemeducation, the tutor plays a pivotal role in facilitating and guiding the discussions, fostering a supportive and inclusive learning environment. The tutor acts as a facilitator, encouraging active participation from the students, and ensuring that everyone has the opportunity to express their thoughts and opinions.

After the activity

After the activity, it’s time for evaluation and self-reflection. To obtain quantitative data, a pre- and post-questionnaire can be administered, consisting of multiple-choice questions. This allows for the measurement of knowledge acquisition.

In addition to quantitative evaluation, open-essay assessments offer a qualitative approach to gauge students’ understanding, critical thinking, and reflection on the cinemeducation material. By allowing students to express their thoughts in a written format, open-essay questions provide a deeper understanding of their interpretations, emotional responses, and personal reflections related to the themes explored in the films. This qualitative feedback adds richness and context to the evaluation process, capturing the nuances and individual perspectives that may not be captured through multiple-choice questions alone.

Furthermore, a satisfaction survey can be employed to gather feedback on students’ overall experience and perception of the cinemeducation session. This survey assesses aspects such as the relevance of the films, the effectiveness of the discussions, and the overall satisfaction with the learning process. By incorporating students’ feedback and suggestions through the satisfaction survey, educators can continually improve the cinemeducation sessions and tailor them to meet the learners’ needs and expectations.

Evaluation tool

Transversal skills are difficult to evaluate, particularly among big groups of students. Therefore, in this section we propose a tool for students to self-assess the development of these skills. The tool is divided into three dimensions: suitability of the learning activity, level of achievement of learning outcomes, and transferability to professional settings. You can adapt the dimensions and/or indicators that you use according to your teaching-learning context and needs.

Evaluation tool to self-assess the development of skills during the activity

For each of the following statements, select the best answer on a scale from 1 to 4, where 1 means “Not at all” and 4 indicates “Yes, totally”. N/A means “not applicable”.

	1	2	3	4	N/A
DIMENSION 1. Suitability of the learning activity
I found this learning activity adequate in terms of time
I found this learning activity adequate in terms of resources (material resources, physical space, etc.)
I found this learning activity adequate in terms of content
I found this learning activity engaging
I found this learning activity challenging
I found this learning activity disruptive in comparison with other learning methodologies
I found this learning activity useful to learn [add the subject]
I found this learning activity useful to retain knowledge
This learning activity motivated me to deepen my knowledge of [add subject or hard skill]
This learning activity allowed me to feel emotions that would be rather difficult to experience with other learning methodologies
I would recommend this learning activity to others
DIMENSION 2. Level of achievement of learning outcomes
This learning activity helped me to improve…
…my ability to [add a row for each learning outcome of the activity that you performed, both related to hard and transversal skills]
DIMENSION 3. Transferability to professional settings
After this learning activity…
…I will be better able to apply what I learned to my reality (everyday life, classroom, professional life)
…I feel more capable to perform in a professional setting
…I feel I can make better choices regarding professional situations
…I feel more prepared and self-confident to address professional situations
OPEN QUESTION – Use this space to explain whatever you think is remarkable from the learning activity, including strengths, weaknesses, improvements, potential uses, feelings or dilemmas you encountered during the activity.