Videotaped Patient Stories: Impact on Medical Students' Attitudes Regarding Healthcare for the Uninsured and Underinsured

Abstract

The attitudes of medical students toward the current United States healthcare system are not well described in the literature. A graded survey was developed to assess awareness and motivation toward the care of the uninsured and underinsured as well as the impact of a video intervention on these attitudes. The survey, which showed good internal consistency (Cronbach’s alpha = 0.85), was administered before and after viewing a collection of videotaped patient stories. Although a spectrum of beliefs emerged from the analysis of survey responses, some common attitudes were identified. Eighty-five percent of respondents either agreed or strongly agreed that medical care should be provided to everyone, regardless of their ability to pay. In addition, 66% indicated they would be willing to forgo a portion of their income to provide care to those who do not have access to healthcare services. These values were strongly correlated with increasing respondent age and primary care specialty choice (p<0.01). The video intervention did not heavily influence student responses, perhaps due to a ceiling effect created by the large number of students who were already sympathetic toward the underserved. Overall, this data reflects that United States medical students recognize a need to provide care to the underserved and are willing to make personal sacrifices to meet that need.

Digital storytelling in health professions education: a systematic review

“…The purposes for using digital storytelling in HPE were eclectic and included the teaching of: (a) clinical skills [ 21 , 22 ]; (b) diversity, oppression, and social justice issues [ 23 ]; (c) concepts related to general patient support or person- patient-, and family-centered care [ 24 – 26 ]; (d) care provision for marginalized and underserved populations [ 27 ]; (e) transitions from student to working professional as well as development of professional identity [ 28 , 29 ]; (f) intergenerational learning or social topics related to aging [ 30 , 31 ]; (g) palliative care concepts [ 9 ]; and (h) care provision for those with chronic health conditions [ 32 – 35 ].…”

“…Five (31.3%) of the 16 studies concentrated on health professionals’ learning from listening to authentic patients’ digital stories [ 22 , 27 , 28 , 34 , 35 ]. Fenton [ 34 ] reported how a patient’s digital story increased nursing students’ understanding of a young person’s perspective of living with cancer and provided them with information about effective communication skills.…”

“…Fenton [ 34 ] reported how a patient’s digital story increased nursing students’ understanding of a young person’s perspective of living with cancer and provided them with information about effective communication skills. Conversely, the other four studies reported that patients’ digital stories had minimal impact on health professionals’ understandings or knowledge of the given topics [ 22 , 27 , 28 , 35 ]. That said, the authors highlighted that patients’ digital stories evoked emotional reactions among students that motivated them to potentially take action on the topics in future.…”

“…That said, the authors highlighted that patients’ digital stories evoked emotional reactions among students that motivated them to potentially take action on the topics in future. For example, Bruno et al [ 27 ] found that patients’ digital stories did not heavily influence medical students’ attitudes towards patients who are underserved, as the majority of the students were already sympathetic to this population. Nonetheless, the digital stories used in the study did increase students’ reported desires to provide care to underserved patients in future [ 27 ].…”

“…For example, Bruno et al [ 27 ] found that patients’ digital stories did not heavily influence medical students’ attitudes towards patients who are underserved, as the majority of the students were already sympathetic to this population. Nonetheless, the digital stories used in the study did increase students’ reported desires to provide care to underserved patients in future [ 27 ]. Taylor and Hutchings [ 22 ] also found that midwifery students did not acquire new breastfeeding knowledge from women’s digital stories on their breastfeeding experiences, but that the stories taught students how to better support breastfeeding women and evoked emotions among them to improve and advocate midwifery practice in regards to breastfeeding.…”