- Research article
- Open Access
- Open Peer Review
Exploring the value of qualitative research films in clinical education
© Toye et al. 2015
- Received: 5 December 2014
- Accepted: 19 November 2015
- Published: 27 November 2015
Many healthcare professionals use both quantitative and qualitative research to inform their practice. The usual way to access research findings is through peer-reviewed publications. This study aimed to understand the impact on healthcare professionals of watching and discussing a short research based film. The film, ‘Struggling to be me’ portrays findings from a qualitative synthesis exploring people’s experiences of chronic pain, and was delivered as part of an inter-professional postgraduate e-learning module. The innovation of our study is to be the first to explore the impact of qualitative research portrayed through the medium of film in clinical education.
All nineteen healthcare professionals enrolled on the course in December 2013 took part in on-line interviews or focus groups. We recorded and transcribed the interviews verbatim and used the methods of Grounded Theory to analyse the interview transcripts.
Watching and discussing the film became a stimulus for learning : (a) A glimpse beneath the surface explored a pro-active way of seeing the person behind the pain (b) Pitfalls of the Medical Model recognised the challenge, for both patient and clinician, of ‘sitting with’ rather than ‘fixing’ an ill person; (c) Feeling bombarded by despair acknowledged the intense emotions that the clinicians brings to the clinical encounter; (d) Reconstructing the clinical encounter as a shared journey reconstructed the time-constrained clinical encounter as a single step on a shared journey towards healing, rather than fixing.
Films portraying qualitative research findings can stimulate a pro-active and dialectic form of knowing. Research-based qualitative films can make qualitative findings accessible and can be a useful resource in clinical training. Our research presents, for the first time, specific learning themes for clinical education.
- Qualitative research
- Chronic pain
- Professional-patient relations
- Personal narratives
How can qualitative research findings be used in clinical education? One of the difficulties of evaluating the impact of qualitative research is that findings provide an interpretation, rather than neatly packaged facts. This creates a danger that qualitative findings are side-lined for more tangible forms of ‘factual’ knowledge. We aimed to explore the impact of a short film portraying qualitative research findings on healthcare professionals who watched it. Appraisal of research impact tends to focus on measurable outcomes [1, 2]. Our construction of impact resonates with Parsons and colleagues; ‘impact might be a subtle shift in viewers’ perspectives’ which may usefully inform therapeutic encounters. Parsons and colleagues highlight the issue – what is the nature of impact in qualitative research? In their evaluation of an arts installation to portray the experience of homelessness, Parsons, Hues & Moravac explore how the audience interacts with research findings portrayed in art . Similarly, we aimed to explore how viewers constructed meaning from the film, rather than to identify specific outcomes.
Our study is underpinned by a constructivist philosophy of knowing the world . Although there are diverse ways of knowing , evidence-based medicine has a strong strand of objective modes of knowledge, or Episteme. Greenhalgh invites us to challenge accepted ways of knowing, by asking ‘what is this knowledge we seek to exchange?’ . Other relevant forms of knowledge include Phronesis - an intuitive, tacit or practical wisdom . It may be more useful to consider knowing as a dialectic, rather than linear process [5, 7]. Central to dialectic theory is the idea that tension between different ideas can create innovative ways of thinking . This is in line with ‘situated judgement’  or tacit knowledge  and resonates with anthropological texts that support the re-enactment of knowledge . Within this dialectic framework, knowing can be conceptualised as a dynamic process that occurs at the interface between research findings and audience.
The use of artistic media (such as film or drama) to present findings, lends itself to an interactive, or dialectic, style of learning [11–19]. Performing qualitative findings, aims to evoke, provoke and stimulate ideas , rather than present facts, and can be powerful because it facilitates emotional engagement beyond that from reading reports [1, 2]. Performative methods have been used in clinical education to facilitate learning through dialogue [2, 20–22], and to develop empathetic understanding [15, 16, 23, 24]. Through film, viewers can access different perspectives in a safe environment and explore their own clinical practice. Existing reviews suggest that there is a paucity of research exploring film as a dissemination mode [25, 26–27].
We aimed to understand the impact on healthcare professionals of watching and discussing a short film that portrays the findings from a qualitative systematic review of patients’ experience of chronic musculoskeletal pain. Specifically, to explore how viewers constructed meaning from the film.
Originating research and film
We obtained ethical approval from The Medical School Research Ethics Committee (MSREC), School of Medicine, Cardiff University. Participants were sent written information about the study, and offered an opportunity to discuss the study with SJ or FT. They then signed a consent form, which was returned by post. This was signed by SJ and a scanned pdf final version was emailed back to the participant. In addition at the beginning of each focus group video call, SJ asked if everyone was happy for the video call to be recorded and for their contribution to be used for the study.
Nineteen qualified healthcare professionals undertaking an inter-professional postgraduate, level 7 (MSc level), e-learning module were recruited into the study. The sample was predominantly General Practitioners (eleven) and also included three nurses, three pharmacists, one physiotherapist and one psychiatrist. All worked in the UK, mostly within the Primary Care setting, or in partnership with it. All had an interest in chronic pain management. The film was delivered as part of the evidence based 'Bio-psychosocial' module. As the group included a single physiotherapist and psychiatrist, we do not identify participants by professional grouping to maintain participants’ anonymity.
Four focus group interviews, and two individual interviews with participants who were unable to attend a focus group, took place on ‘Oovoo’ (a video chat application that allows you to make verbatim recordings). It could be argued that there are methodological limitations for interviewing participants on-line that go beyond the technical considerations. This online method, although allowing us to access diverse geographical locations throughout the UK (including Scotland and Northern Ireland), was likely to have had an effect on the performative aspects of the interaction. For example, participants were instructed to indicate, non-verbally, if they want to contribute to a particular line of discussion and not to interrupt or talk at the same time as someone else. In addition to this, body language was obscured because the screen only showed participants faces. However, despite the possible disadvantages, we wanted to explore the film’s impact in a specific educational setting where it was being used as part of e-learning Masters Module. As the film was a compulsory part of the module and its assessment this allowed a unique opportunity to explore its impact in clinical education. FT observed that this online method seemed to downplay potential power-play between professional groups. For example, it was very difficult for her to identify specific professionals, whereas this might have become much clearer in a face-to-face meeting. This may also have been because participants were enrolled together on the same educational course. We used a combination of focus group and individual interviews as two participants were unable to attend online groups. Although we recognise that group and individual methods will each create a different form of data, for the purposes of analysis we treated each transcript the same, focusing on the content of each transcript. Although we identified similar themes across data collection methods, a limitation may be that we have not fully considered the influence of context.
This study was set within a constructivist Grounded Theory framework , taking the stance that knowledge is not ‘discovered’ but co-constructed. We aimed to explore the construction of knowledge when healthcare professionals watched the film, and therefore our study is strongly influenced by narrative thinkers, such as Frank [6, 31]. However, our analytic focus is on thematically coding interview content with the aim of developing a conceptual model that describes the co-construction of meaning between viewers and the film. We recognise that attending primarily to content can obscure the researchers role in data co-construction, and we therefore made every effort to combine our coding with ‘close analysis’ of each case: For example, by utilising extended exemplars, attending to the motives and silences of each speaker and playing attention to the details of telling and to choices of words. We also recognise that as researchers we played a significant role in the construction of the narrative, and made every effort to create a space where participants felt free (and safe) to discuss areas of learning from the film.
Thematic coding involves an iterative process of constantly comparing data, codes and categories within and across cases, and moving from an initial tentative category towards progressively abstracted theoretical categories that are grounded in the data. Our approach to research quality, outlined by Toye and colleagues in a recent BMC publication , strongly resonates with Eakins and Mykhalovskiy’s concept of ‘substantive judgement’ . Thus whilst we report aspects of method to serve as a ‘positioning device’  that allow the reader to understand our analytic context, our primary focus was the rigour of our conceptual analysis: (a) we used constant comparative methods (b) we collaboratively challenged analytic decisions during the coding process, and (c) use extended narrative exemplars that allow the reader to judge our analytical decision making.
We identified four related conceptual categories: (a) a glimpse beneath the mask; (b) pitfalls of the medical model; (c) bombarded by despair; (d) reconstructing the clinical encounter as a shared journey. We use interview excerpts to illustrate these categories and refer to the woman in the film as ‘Sarah’. We have used pseudonyms for participants to demonstrate that we compared themes across dataset, whilst retaining participant anonymity.
A glimpse beneath the surface
Sonia (individual interview): I think one of the main themes [in the film] for me is how experiencing chronic pain like this changes you into being somebody who you weren’t before . . . issues around your sense of self identity and the loss of your old self, the loss of . . . very important things in your life . . . . you imagine that you would be somebody and . . . have feelings of who you ought to be . . . and that difference can be very wide and it can be a bridge that's very, very difficult to, to cross.
Josh (focus group 2). . . . A sense of loss of identity disconnected from herself, powerlessness that she felt and that sense of not knowing who she was anymore and the identity she'd forged . . . about who she was [now] slipped through fingers somehow . . . and it that was the heaviness I think . . . it felt very, very universal sentiment potentially . . . . Accentuated when it’s made part of your every living, breathing moments . . . . We’ve all had to think about our bodies at certain times you know so it's that identification in that regard I think. If that makes sense?
Sheila (focus group 1): I was very struck how her pain seemed to really affect her identity as a person and I don't think that I had . . . I kind of had reflected on that in the past, but not as quite much as with that film.
Grace (focus group 4): I think I was just a bit surprised she was very embarrassed by her pain . . . [she was] quite ashamed I think. I suppose I never looked into that side of things . . . I didn't expect that from the patient it's just not something I'd thought in depth about before . . . I just thought . . . that struck a chord with me.
Deena (focus group 3) It was like getting a glimpse into many such patients I have seen . . . the most frightening thing was when she said, 'people can't really see this pain' . . . and this is so true because they come into your consulting room with a smiling face and, and you know, with make-up and everything and you tend to have this prejudice say, thinking ‘oh this is one of those heart sink patients’ . . . my outlook is changed . . . I felt really you know, good watching the video because it really helped me to you know, to understand these kind of patients better.
I can now see her struggle to perform pain
Marion (focus group 4): Many patients they put on a mask especially for those around them because they don't want them to see how they're feeling and they don't want to focus on their pain on a daily basis. So it is kind of almost like putting your make-up on every morning.
Deena (focus group 3): The demeanour of a patient when they come in, like when she was in front of the [mirror] putting make-up on, and how she was trying to justify, ‘that’s just part of how we present ourselves to people’ - that doesn't mean she is not in pain. And that is so important I think to understand, because sometimes we discuss patients, we say ‘oh she came in with back pain but I don't think she's really in pain’ you know . . . but really even if somebody is in pain and distress, [it] doesn't always have to be in how they present themselves and I think that came as a huge surprise to me.
Christopher (focus group 2): If I could just make a cold, cold clinical observation, but there really was an incongruity between the symptoms and life that the lady portrayed verbally and what she was actually doing in the video. She was able to walk on the promenade she was able to go to the coffee shop, she was able to mobilise without apparent difficulty, travel on a bus, she was well presented and able to care for [herself] . . . . there is a little bit of a mismatch . . . the language and the behaviour were slightly out of sync.
Christopher (group 2): [I was] trying to justify myself because I feel a bit uncomfortable I have to say in myself in saying that it seemed odd that she was loading the car, but it is the fluidity of how she loaded the car, does that make sense?
Clara (focus group 4): I've often been surprised if I try and get them to score their pain . . . often their scores are very different to what I think they're going to be especially in the ones that are quite [mmm] you know by looking at them you wouldn't think that they were in pain . . . .they're not showing that they’re in pain. So when they say that they've got an 8/10 score it often it still surprises me, so I think . . . to be asking more searching questions would perhaps give us a clearer idea of exactly [mmm] what their quality-of-life is and how much pain they're actually in.
Deena (focus group 3): I think it [has] actually given a good sort of addition to my toolbox . . . because once you understand your patients, it’s so much easier . . . sometimes all they want is to be listened to . . . listen to what they have to say . . . what they want is empathy and understanding and to recognise their problem as a valid problem . . . it has really helped me . . . Recently you know, I was in the clinic and I actually had a patient coming, with long-standing pain and all I did was listen to her . . . she just got up and said that ‘this is the first time I really felt you know, heard and thank you and she said ‘I'm feeling already a better person’. I just thought that was amazing.
The challenge of clinical time constraints
Sonia (individual interview): I think as a clinician [you] focus straightaway on . . . a biological type approach to it. I think some of the psychological feelings get more brushed over perhaps . . . very often there is not the space in the consultation . . . we're immediately trying to deal with the problem; listen, deal with the problem, make a . . . printout prescription.
Graham (individual interview): The problem is, to discuss patients feelings and views and thoughts and so on is very very time consuming, now how do you organise that in general practice with 10 min consultation? . . It's far easier to reach for the prescription pad and say ‘try this’.
Graham (individual interview): it’s certainly the way forward because, this type of investment [in time] is like an insurance policy you know, you pay into today to gain something tomorrow the more you invest in time and assessment today hopefully you will have a better results in the future and less chronicity, less healthcare costs, less consultations . . . we must find a way of concentrating this more.
Pitfalls of the medical model
This theme describes how watching the film encouraged participants to explore the pitfalls of the biomedical model. Firstly, the challenge of the mind-body dualism, and secondly, the challenge of not being able to diagnose and fix a problem.
The challenge of breaking down the dichotomy of mind and body
Graham (individual interview): This film has tended in a way to detach itself from the highly technical nature [of pain science] and concentrate on personal side of [pain experience] . . . a collaborative approach to patients in chronic pain . . . it is very important to remind ourselves that despite the technicalities involved is very much a personal aspect and it's very easily forgotten . . . with the evolution of biopsychosocial principles I think the biomedical side still predominates.
Cathy (focus group 3): I thought it was useful that she was actually verbalising the kind of stigma associated with having a psychological distress, I mean it's a lot more acceptable in our society to have some kind of physical problem, physical ailment.
Grace (focus group 4): Yeah when she described the broken arm you know she's in the car park and she describes the fact that she was so pleased she almost enjoyed having a broken arm because people could see that there was something wrong with her and she could justify you know how, how she was feeling.
Jenny (focus group 1): The terminology . . . psychiatric and psychological . . . have a stigma attached to them that is not intended, and that was one of the things that I took from the video . . . we accept that patients with long term pain will have a psychological component to it but actually labelling it as that . . . can be quite negative . . . make sure that you are actually speaking in the right language to the patient . . . because I thought actually we are all guilty of it.
The challenge of ‘sitting with’ (not fixing)
Josh (focus group 2): What [the film] highlighted for me as a clinician is the uncomfortableness when you don't know what to do and how to stay with the patient despite that . . . and I suspect that was more about the clinician's uncomfortableness because it's very difficult to sit with someone when they’re pain and just listen and be there and not necessarily rush to fix.
Andrew (focus group 3): It’s something that isn't taught . . . through medical school . . . the model really is assessment, diagnosis, treatment and improvement and I think doctors do find it difficult to acknowledge, it's not ingrained into us to tell a patient [that] we can't [treat] . . . to improve . . . . and I think our own inadequacies sometimes come through and actually a ‘heart sink’ patient is more a reflection of our own vulnerabilities and inadequacies in dealing with that.
Josh (focus group 2): [be] very self-aware when you're thinking about doing tests . . . I think sometimes in chronic pain doctors are doing the tests for themselves not for the patient. because again with that kind of, that uncomfortableness with not be able to fix or do something . . . sometimes questioning . . . what am I trying to achieve with this really . . . is there another agenda behind it? And I think that does happen it is lot.
Feeling bombarded by despair
Kelly (focus group 3): Well, I mean there is an empathy . . . It was really not so much about the pain, so much, so much as there was an overall emptiness you felt a lot of empathy for [her] really . . . one wondered whether the pain had just taken the place of a social life, any meaning and purpose, any, any connection with anything really . . . it would be overall emptiness was what came through quite strongly and, and as I say very difficult to sort of work on that, because it was almost like being bombarded by despair.
It produced quite lot of intense emotions in me
Jenny (focus group 1): I actually felt really quite depressed myself by the time I had finished watching it . . . because it did actually take it you through all the emotions that she was experiencing . . . I felt quite depressed myself when I finished it.
Kelly (focus group 3): That quiet despair about where do you start with that lady . . . . yeah, despair is your first thing, where on earth do you start to begin?
Cathy (group 3): I thought it was a really good educational tool . . . . Doctors are incredibly resistant to the thought they might be having an emotion about their patients. . . I would certainly find it very useful, very easily you get them to talk about their emotions, which they would normally attribute to the patient . . . that I thought, was excellent.
I’ve used the phrase detached empathy
Christopher (focus group 2): I think I had a very professional reaction to it . . . it was trying to listen to the person . . . sort of empathise . . . . [but] almost protected professionally . . . trying to see where that person was coming from but not letting it become too personal . . . I've used the phrase detached empathy.
It was a bit uncomfortable listening to the things she said
Sheila (focus group 1): I think that the only thing that surprised me was how irritated I felt when she said ‘I felt I was pushed from pillar to post’ . . . I really thought about that for a long time and thought ‘am I irritated because I want to be defensive of the healthcare profession and that we are genuinely trying to do our best? . . . yes the services aren't maybe as good as we would want them to be. . . [but] you do want to defend your own [laughs].
Michelle (focus group 2): I actually felt quite uncomfortable in, in some parts of it and I think that’s coming from the point of view of, you know, as clinicians we [are] striving and we like to think that we think we are doing the best for our patients, but when you hear it raw in that way and that's actually the way that patients are thinking, I find it, some bits quite difficult to listen to.
Reconstructing the clinical encounter as a shared journey to healing
The final theme describes how participants made sense of what they had learnt from watching and discussing the film. Sense came from reconstructing the clinical encounter as a step on a shared journey towards healing, rather than focusing on an immediate biomedical fix.
We are going to chip away at this in bite-sized chunks
Michelle (focus group 2): See it as a journey rather than ‘this is my one chance at this and I have to get it all done in one go’ . . . if that's a sort of agenda that’s set with the patient from the start, then you both have a more realistic expectation of where things are going to take you.
Josh (focus group 2): I think it's really useful having the 10 min in that regard because so much the time it's about moving away from that place of stuckness and creating a little bit of momentum . . . success sometimes is just getting out of bed and getting dressed you know and those little tiny bite sized chunks, recognising those as success and you can come back and say yes, that’s great you know you did that’, building on that momentum . . . you know it's the first bits of movement you know when you're pushing a car . . . [its] the first movement that is the hardest one, and then it builds.
This is a journey to healing not fixing
Dahlia (focus group 4): Interestingly it wasn't as though she [Sarah] was hopeful that her pain would resolve or improve it was more the fact that she learnt that she would have to move on through her pain . . . focus on the things she enjoys . . . focus on the things that she would get more out of which I think were interesting elements which you could pass on to people as well.
Sonia (individual interview): Recognise what strength the person has to be able to make that effort, that it could be an enormous effort to have to make . . . we should recognise that and congratulate them on doing what they can to try and help themselves. . . give a sense . . . that people have achieved something. Because I think everybody needs encouragement and we encourage and support all the time in, in life. But sometimes you know people continue to need encouragement and you have to have some sort of sympathetic joy with people who are obviously struggling, from the point of view of understanding where they're coming from.
Summary of findings – conceptual model
We aimed to understand the impact on healthcare professionals of watching and discussing a short film that portrays the findings from a qualitative systematic review of patients’ experience of chronic musculoskeletal pain. Specifically, to explore how viewers constructed meaning from the film. Our findings support the usefulness of films that portray qualitative research findings for clinical education. Watching and discussing the film ‘Struggling to be me’ stimulated new areas of learning: (a) a glimpse beneath the surface explored a more pro-active way of seeing the person behind the pain (b) pitfalls of the Medical Model recognised the challenge of ‘sitting with’ rather than ‘fixing’; (c) Feeling bombarded by despair acknowledged the intense emotions that the clinicians brings to the clinical encounter; (d) Reconstructing the clinical encounter as a shared journey reconstructed the time-constrained clinical encounter as a single step in a shared journey towards healing.
People perform a picture of themselves to others  and performance is central to the experience of chronic pain . Watching the film encouraged participants to recognise that appearances can be deceiving, and to see the value of delving beneath the surface. The film supports an embodied approach to healthcare that seeks the human aspects of patients’ experience . Embodiment focuses on what is unique about this illness for this person. The theory of embodiment [36–41] is rooted in the thinking of Merleau-Ponty who breaks down the dualism of mind and body and focuses on integrating mind and body; we do not have a body, we are a body . However, illness forces us to become aware of our body and thus creates a dualism that does not truly exist [36, 42].
Our findings suggest that qualitative films can stimulate a form of clinical knowledge that recognises the importance of the human story. It is through stories that people construct the their own sense of personal identity, and by listening to these stories we can understand people’s response to conditions that threatens this [6, 37, 43]. Self-Discrepancy Theory  incorporates three constructs related to personal identity that may underpin stories of illness:  Actual Self - ‘your representation of the attributes that someone (yourself or another) believes you actually possess;  Ideal Self - ‘your representation of the attributes that someone (yourself or another) would like you, ideally, to possess’;  Ought Self - your representation of the attributes that someone (yourself or another) believes you should or ought to possess’. Discrepancies between actual, ideal and ought selves can lead to powerful emotions that we cannot understand without hearing a person’s stories. Watching and discussing the film encouraged participants to attend to potential threats to patients’ personal identity, and to invest clinical time to explore these losses with them.
The film demonstrated that the experience of, and response to, illness is the result of a complex relationship between biological and psychosocial factors . There is a danger that psychosocial factors are ‘grafted onto’ biomedical care . For example, participants suggested the possibility of dealing with the ‘psychological components’ separately. Embodied healthcare requires an understanding that ‘pathos precedes pathology’ (, pp. 137); life going wrong precedes a journey to the doctor. A truly embodied approach moves the clinician beyond an understanding of seeing as a physical act of vision, towards Seeing (with a capital S) that entails an effort to understand patients’ unique qualities. A modern metaphor for embodiment is the central theme in the 2009 film Avatar, ‘I See you’.
The power of the film hinges on making the person’s life ‘morally recognisable’  and entails an ethical responsibility [31, 43]. Scarry argues that we are more likely to cause pain to people that we do not know; trying to ‘imagine other people better’ is therefore an important step towards an ethic that prevents us from (inadvertently or not) harming others . This ethical responsibility can be an emotional experience for the healthcare professional and has a profound implication for clinical education – how do we equip clinicians with these skills? Watching the film ‘Struggling to be me’ encouraged participants to recognise and explore their own emotions. For example, it highlighted that treating patients with chronic, incurable conditions poses unique challenges: How do we balance an approach that embodies the individual with the ‘quiet despair’ that can accompany this; how do we empower clinicians to sit with, and yet not feel a sense of failure?
Medical Humanities focus on the added value of disciplines outside biomedicine for improved healthcare. For example, Charon demonstrates that sitting alongside a patient, although emotional, can have a positive impact on work satisfaction by facilitating clinical partnership and allowing clinicians to be generous with their presence . Likewise, Levinas argues that seeing the ‘Face’ of another can be a positive human experience for both parties; although Seeing the person can impose a burden, this ‘does not limit but promotes my freedom, by arousing my goodness’ (, pp. 200). Sitting alongside a patient frames the clinician as an advocate, rather than adversary. Intuitively, this is likely to have a positive effect on both healthcare professionals and their patients. Our findings support the use of films that portray qualitative research findings to facilitate a collaborative framework that is integral to a Shared Decision-Making Model.2
Our findings suggests that the construction of meaning from the film is firmly aligned with the themes described in the original systematic review [28, 29]. This indicates that the film did made viewers think about the themes as reported in the review. Our findings also support the view that performing qualitative research findings in film can evoke, provoke and stimulate ideas  by facilitating emotional engagement and empathy . We did not explore whether or not reading a written report of the qualitative research would have a similar effect to watching it, and therefore we cannot be sure whether or not the impact of the film was due to the mode of dissemination or its content. It would therefore be useful to explore differences in impact from reading peer reviewed publications and other modes of dissemination. However, the film is short and easily accessible within an educational framework. We also do not know whether it was the discussion or the film per se that facilitated knowing. If we conceptualise knowing as a dialectic, process that occurs at the interface between research findings and audience [5, 7], it seems highly likely that discussing the film (either in the focus groups or individual interviews) played a role in co-constructing knowledge. As such, what we have captured is the construction of meaning, or learning, as developed within the interviews. We see this as strength of performative approaches that encourage participative engagement. More research is needed to research the differential impact of film, written report and discussion. However, our findings demonstrate that watching a ten minute qualitative film, followed by discussion, has a valuable educational potential. Although findings are context specific, we argue that findings are transferable across settings. It would be useful to know if the impact is the same for other groups such as undergraduate medical, nursing or allied health professional students.
Our findings support the view that diverse forms of knowledge are relevant to clinical practice. This is a primary qualitative study exploring the impact on healthcare professionals of watching and discussing a short film that portrays the findings from a qualitative systematic review. Other audio-visual or commercial films could also contribute positively to clinical education. We demonstrate that the impact of qualitative research portrayed in film may be ‘a subtle shift in viewers perspectives’  which encourages healthcare professionals (and others) to recognise the face of others. This subtle shift may be enough to inform more collaborative clinical encounters. Research-based qualitative films can make qualitative findings accessible and can be a useful resource in clinical training. Films that portray qualitative research findings can allow clinicians to recognise the emotions they bring into practice within a safe environment removed from the clinical encounter. Our research presents, for the first time, specific learning themes for clinical education. Importantly, in an educational setting, qualitative films can stimulate a pro-active and dialectic form of knowing, with implications for providing compassionate and person centred care.
We thank the clinicians participating in this study and staff at the medical school who facilitated the project.
We would like to thank the reviewers who took time to review the original and revised manuscript.
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