A Patient-Narrative Video Approach to Teaching Fibromyalgia

Abstract

Introduction: Although fibromyalgia is one of the most common and clinically important rheumatologic entities, physicians frequently report that their training fails to prepare them to manage this disease. Many medical schools devote insufficient time and attention to the subject of fibromyalgia, resulting in training gaps that can manifest as failures of both knowledge and empathy. There is a need for evidence-based, time-efficient methods for teaching this important subject. We have developed a narrative-driven video presentation for clerkship students and sought to evaluate its impact on fibromyalgia-related knowledge and attitudes. Methods: Fibromyalgia: A Patient’s Perspective (FPP), a 13-minute video, was presented to third-year medical students (N = 54). Surveys of knowledge and attitudes were collected before and after the video. Composite scores, as well as Knowledge and Attitudes subscales, were computed, and paired t tests were used to compare pre/post means for these scales, as well as for individual questions. Mann-Whitney U and Kruskal-Wallis tests were used to identify correlations between survey scores and student sex and specialty of interest. Results: Between pre-experience and post-experience surveys, there were statistically significant differences for 11 of 15 questions (73%). The composite score increased from 3.8 (SD = 0.44) to 4.2 (SD = 0.47) ( P < .0001). Knowledge and Attitude subscale scores also increased, from 4.0 (SD = 0.5) to 4.38 (SD = 0.5) ( P < .0001) and 3.6 (SD = 0.5) to 3.93 (SD = 0.5) ( P < .0001), respectively. Students reported favorable impressions of the video, with 87% agreeing that the video was helpful to learners and 79% disagreeing that a lecture would be preferable to the video. No differences in scores by sex or intended specialty were observed. Conclusion: The FPP video demonstrates promise as a tool for enhancing both knowledge of and positive, empathic attitudes toward fibromyalgia in medical learners. It may serve as a useful resource for educators looking to further develop their clinical pain management curricula.

Technology-delivered undergraduate medical education involving patients and carers: A rapid systematic review

“…Two of the final 20 studies described using “simulated” or “virtual” patients, [39–40] but did not clarify what these terms meant. Two studies described patient-focused videos [26, 38], however a lack of description inhibited establishing whether patients were authentic. The remaining sixteen studies involved authentic patients [22-25, 27-37, 41].…”

“…In one high quality study, students reported positive attitudes towards video libraries featuring authentic patient cases [24]. Another high quality study found 79% of students reported that a 13 minute video of a patient’s perspective of fibromyalgia was superior to a traditional face to face lecture [26].…”

“…Harless and colleagues [23] found patients featuring in video simulations (where actors had experiences of the issues presented) were perceived by students to be realistic. Two high quality studies found improvement in students’ patient-centred attitudes after watching videos of patients discussing their condition or hospital experiences [26, 28] Yoon and colleagues, however, in a high quality study reported traditional “simulated” patients for problem-based learning led to significantly improved attitude towards patients, compared to a video [39]. However, the reporting of the methods by Yoon and colleagues were limited so it is unclear if patients were authentic in either the standardised or video-delivered approach.…”

“…Knight and colleagues, in a high quality study, reported the use of telehealth consultations as an educational tool enhanced students’ learning about telepsychiatry as well as their understanding of consulting practices [33]. Two high quality studies reported improved students’ knowledge of patients’ conditions [26–27]. One high quality study reported no differences in self-reported knowledge about cervical screening when students viewed a video involving patients, versus a video featuring a clinician [31].…”

Practical tips for moving your patient panel online

“…Patients are true experts of their condition(s) and should be empowered to share in the discussion a holistic version of themselves – a version that includes all opportunities and challenges of their daily lives. Patient perspective videos have already been shown to be an effective teaching tool for medical students ( Leeds et al ., 2020 ). As expected, however, the virtual platform physically limits the visibility of the patients.…”