Integrating Comics Into Medical Ethics Education: Medical and Physician Assistant Students’ Perspectives

Abstract

Purpose: This study explored comics as a tool for teaching medical and physician assistant (PA) students about end-of-life decision-making and advanced care planning. Method: Using a mixed method convergent design, a survey (consisting of five-point Likert-scale ratings and open-ended questions) was administered to all second-year medical and first-year PA students enrolled in an Ethics and Professionalism at a US medical school. The survey evaluated whether the addition of a comic to assigned readings affected reported student engagement and understanding of the topic and examined students’ attitudes about the use of comics in the classroom. Quantitative results were compared by demographics and open-ended responses were coded and analyzed qualitatively for emergent themes. Results: 145 students responded (83%), and 141 students (81%) were included in the final analysis. The mean engagement score was 3.8 (SD=0.6); and mean understanding score was 3.8 (SD=0.5) where minimum = 1 and maximum = 5. There were no significant differences in understanding or engagement by gender and student type. However, non-whites had higher engagement (p=0.017) and understanding (p=0.034) scores than whites. Qualitative analysis revealed five themes: 1) Comics effectively supplement text readings and can enhance the learning process; 2) Comics facilitate empathy; 3) Comics make the message stick; 4) Comics’ illustration/image quality is of great importance; 5) Comics are a refreshing alternative to traditional medical school media. Conclusion: Contemporary medical and PA students are demanding creative media for learning alongside textbook-based learning. Integrating comics as a supplemental teaching tool in medical education is an innovative way to engage students.