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Saturday, July 9 • 08:30 - 10:00
Session 3B: Comics as Medical Education

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Linda Raphael: “Comical Stages” in Medical Education

The first time I presented on teaching comics and medicine was the inaugural Graphic Medicine Conference in London, 2010. Not only did I meet the terrific gang who have become mainstays of the Graphic Medicine community, but I learned about texts I did not know, and began to develop some theoretical concepts about graphic texts. Although I was prepared to push on this year with another theoretical paper, building on some ideas I have presented before, the Commix class I am teaching has led me to think about stages in medical education seen through the lens of graphic texts. As it turns out, the MS IV elective, who is not a course on graphic texts, has revealed some impirtant matters about the way a graphic text may intersect with medical-student stages. The particular text is canonical in the world of Graphic Medicine - Brian Fies' Mom's Cancer. The text is often discussed in tersm of patients, families, and the behaviour of medical professionals - this look at it will be from the perspective of the graduating medical students.

Mónica Lalanda: Comics specifically designed to educate medical students: do they work?

Teaching ethics and communication to medical students has traditionally proved to be difficult and it is well known that the level of empathy in medical students drops faster and deeper than that of any other University students. This has been the topic for many articles and studies. At the end of my Masters Degree in Bioethics I dedicated my dissertation to research on the use of comics in medical education. I studied what has already been done using by authors such as MK Czerwiec, Michael Green and Ian Williams and was tremendously inspired by them and their achievements. Being both an illustrator and a doctor with specialized training in medical ethics, I decided to move from pure research into action. I teamed up with the Department of Ethics and Communication at Zaragoza University Medical School (Dr Altisent and Dr Delgado) and their research team on the development of the comic as a tool to transmit specific areas of their program. We chose "Confidentiality and Medical Secrecy" which is part of Year 3 syllabus. I designed a six-part comic and then we divided the class into two random groups, using the comic in one of them and the traditional case-based lecture on the other one. The seminar was organized in three parts: personal review of the comic in paper; student discussion of the cases with teacher as moderator; and a short creative exercise where students drew their own comic on a confidentiality case. We then used three different tools to measure the achievement of both groups: a student satisfaction survey, resolution of a practical case before and after the teaching and the MCQ exam results on those questions related to confidentiality. We confirmed our hypothesis that comics is an excellent tool to educate medical students on certain issues. During the first term of this school year, we've continued our innovative project and used a specifically designed four-part comic for Year 4 medical students on the area of "The Ethics of Prescription". We then assessed their achievement with a practical case and the results have also been excellent.

Ciril Horjak: Endodontocomix

In 2012 I and my dentist friend Rok started working on a novel idea. We decided to make a short comic book about an endodontic procedure. Our aim was to make an easy-to-read booklet in which the stages of the procedure would be explained. Three years later, the 80-page book was finished. We decided to call it ENDODONTOCOMIX. The book was thoroughly tested with the patients and dental specialists. The drafts and final versions of the book were tested in one Slovenian and one international dentist's conference. I will present the story of how our comic book was made. We gave a lot of thought to the format and number of panels in a page. Since I knew the comic would feature many scenes from the dental surgery, we made a 3D model of the dentist's chair, light and tools. Renderings were used as a blueprint for final drawings. Characters were designed in such a way that that are easily recognizable. The character of Dr Greta (the main dentist in the comic book) is made out of oval forms while the microbes have clawed hands. Contrast between soft and sharp has been used to render the figure of dentist as pleasant as possible. The story is divided into two parts, one for each operation. It has been test-read for a number of times to ensure good comprehension by the patients. To our surprise, Endodontocomix turned out to be a success with Slovenian edition being sold out. It has been translated into Dutch and Croatian languages. Rok and I met though working for Student radio in Ljubljana. I would like to suggest that at University campuses like Dundee, with top graduate and postgraduate studies in comics and in medicine (with teachers like Sue Black), medicine students should mix with art students. In the future many interesting collaborations between comics and medicine can provide us with interesting and useful stories.

Sarah McNicol: “I can’t talk to you, but this is what I’m feeling”: exploring alternative patient roles through heath education comics

Traditionally in healthcare interactions, the doctor, or other healthcare worker, and the patient occupy distinct roles, with former usually being viewed as being in a more powerful position as they have control over what advice and medical treatment is made available (Stoeckle 1987). Drawing on findings from a recent Wellcome Trust-funded study of the social and emotional impacts of health education comics (McNicol, 2015), in this presentation I will explore how, through becoming an active participant in the reading experience (Rosenblatt 1994) and reading from a critical stance (McLaughlin and DeVoogd 2004), comics readers have the potential to subvert traditional clinical hierarchies as well as other conventional patient roles. While many types of resource can empower patients by providing independent access to health information, I argue that comics can challenge traditional roles in deeper ways, by increasing patients’ self-awareness of their actions and responses; the ways in which they manage their condition; and their relations with other “actors” on a variety of “stages”, including clinical settings. For example, a patient might use comics to model consultation “scripts”; or to find a way to move the discussion to something not identified as significant by the clinician, but important to their life, perhaps something that is difficult to express verbally. In addition, comics may offer a means to explore potential conflicts between roles extending beyond clinical settings, for example, the role of patient and the role of parent. There are, however, some limitations to the use of comics to challenge traditional roles. For instance, in many comics used for this project, medical staff are portrayed as unassailable experts who impart information, making it difficult for the reader to find a space to explore alternative configurations of power.

avatar for Michael Green

Michael Green

Professor, Departments of Humanities and Medicine, Penn State College of Medicine
Michael Green is Professor and Vice Chair, Department of Humanities, Penn State College of Medicine. He is a physician, bioethicist, and comics scholar, and is Guest Editor of the Graphic Medicine section of the Annals of Internal Medicine. He is part of the editorial collective of... Read More →

avatar for Ciril Horjak Horowitz

Ciril Horjak Horowitz

Director/Artist, Ciril Horjak, s. p.
Comics, Educational comics
avatar for Monica Lalanda

Monica Lalanda

Spanish Health Service
I am an emergency medicine doctor, illustrator and author of a comic book of medical ethics called "Con-Ciencia Médica". I have one husband, two kids and no dogs. www.concienciamedica.com @mlalanda (Twitter is a real joy)

Sarah McNicol

Sarah McNicol is a research associate at the Education and Social Research Institute, Manchester Metropolitan University. She has a background in information studies and has carried out research into the impacts of reading comics, in particular on patients and family members.
avatar for Linda Raphael

Linda Raphael

Professor/Dierctor of Medicine and Humanities, George Washington University
The first time I presented on teaching comics and medicine was at the inaugural Graphic Medicine Conference in London, 2010. Not only did I meet the terrific gang who have become mainstays of the Graphic Medicine community, but learned about texts I did not know, and began to develop... Read More →

Saturday July 9, 2016 08:30 - 10:00 BST
Lecture Theater 2

Attendees (7)