I DON’T NEED A MEDICAL DEGREE, I WATCH TV A Thesis Presented to The Graduate Faculty of The University of Akron In Partial Fulfillment of the Requirements for the Degree Master of Arts Elizabeth Shiller August 2018 I DON’T NEED A MEDICAL DEGREE, I WATCH TV Elizabeth Shiller Thesis Approved: Accepted: Advisor Interim Dean, College of Arts and Sciences Dr. Dudley Turner Dr. Linda Subich Committee Member Dean of the Graduate School Dr. Val Pipps Dr. Chand Midha Committee Member Date Mr. Gabriel Giralt Director, School of Communication Dr. Heather Walter ii ACKNOWLEDGEMENTS I would like to thank my advisor, Dr. Dudley Turner, for giving me the guidance and encouragement to see my research as more than just a “graduation requirement.” His passion for teaching has given me a new perspective on education and has inspired me to continue on in my education past the master’s degree level. I would also like to thank my committee members. To Dr. Pipps, thank you for being the friendly face greeting me when I first walked into Kolbe Hall. To Mr. Giralt, thank you for challenging me to open up my way of thinking to consider all different aspects of my focus. I would not be here, completing a thesis without the help and encouragement I received from my committee. Finally, I would like to thank my parents, whom without which, I would’ve quit long before I got to this point. You always believed in me and kept me grounded while I achieved my goals. I appreciate every opportunity you gave me and I will always remember to read the question, answer the question, and check my answer. iii ABSTRACT TV has become a part of our daily lives. Studies have linked TV viewing with skewed versions of reality. People who view a lot of television tend to believe what they see and take the content for fact. This study used this idea to explore the effects viewing fictional medical shows have on doctor-patient communication. This study also looked at whether these same shows teach viewers enough about medicine to be considered entertainment-education. Participants from the Northeast Ohio region were given a survey to measure their TV viewing habits along with their opinions about their doctors. Results suggested that viewers do not believe the shows are meant to be educational, although they do feel like they can perform basic medical procedures. Viewing these shows also had little effect on doctor-patient communication, but the participants did believe that the doctor knows best. Keywords: Cultivation Theory, Entertainment-Education, doctor-patient communication, television, medical show iv TABLE OF CONTENTS LIST OF TABLES vii CHAPTER I. INTRODUCTION 1 II. LITERATURE REVIEW 4 a. Entertainment- Education 4 b. Cultivation Theory 6 c. Mean World Syndrome 8 d. Medicine on TV 9 e. Doctor-Patient Communication 12 f. Patient Expectations 13 g. The Gap 15 III. METHODOLOGY 18 a. Instruments 18 b. Procedures 19 IV. RESULTS 21 a. Research Question 1 22 b. Research Question 2 23 c. Hypothesis 24 V. DISCUSSION 26 a. Limitations 29 b. Further Research 30 c. Conclusion 31 v REFERENCES 33 APPENDICES 38 APPENDIX A: IRB Approval Form 39 APPENDIX B: Questionnaire 41 APPENDIX C: Informed Consent Form 45 vi LIST OF TABLES Table Page 1: Viewing Medical Shows and TV Medicine 23 2: Viewing Medical Shows and Medical Procedures 24 3: Viewing Medical Shows and Doctor-Patient Communication 25 7 CHAPTER 1 INTRODUCTION Imagine that you are sitting in a crowded room when suddenly you feel this intense pain in your chest. You begin to panic and clasp your chest. You know that you are healthy because you take care of yourself, so why is this happening to you? It’s getting harder to breathe. You start gasping and fall to the ground. Everyone immediately starts to panic. The woman sitting next to you starts crying and shouts “Somebody call 911! Somebody call a doctor!” Out of the corner of your eye you see a man rushing over to you. “I’m a doctor, let me help,” he says calmly. In the midst of the panic, you recognize that you are probably having a heart attack because one of the patients on the Scrubs episode you watched last night, had a heart attack with the same symptoms. You also remember that the patient didn’t make it. Do you push the doctor away because you are certain that his actions are futile, or do you let the guy with the medical degree help you? Attaining an advanced degree of any kind is a lengthy process. It requires education and experience. Becoming a medical physician usually means having to endure eight years of schooling, three to seven years of residency training and passing state exams. As long as they are practicing, physicians must keep their licenses and certifications up to date. (Lindberg, 2012; Medical Education, 2017). If they are 1 specialists, then that would mean more schooling, training and exams on top of what they’ve already accomplished. There are many methods used in education like lectures, e-learning, experiential learning, and narratives. Narratives tend to utilize stories that blend fact with fiction to translate the lesson. But this method isn’t just used in the classroom, it is applied outside the classroom as well. Television and radio shows use a technique known as entertainment-education (EE). This is when the show intentionally targets the audience with an entertaining story that has a deeper educational meaning. EE can expand to all genres, topics and media. This technique teaches lessons by having the characters in the stories learn the lessons (Singhal & Rogers, 2004). Sesame Street and 16 and Pregnant are examples of EE. Sesame Street is a fictional show designed to help children learn preschool concepts like sharing, counting and the alphabet (Jin, 2006). 16 and Pregnant is a reality TV show that looks at teen pregnancy and what it is like to be in that situation. The show, though deemed controversial, has led to a spike in Google searches about birth control, abortion and condom usage (Kearney & Levine, 2014). People can become educated by watching these shows for their entertainment value. Singhal, Cody, Rogers, and Sabido, (2004) stated that there is already substantial evidence that says that EE has been effective in helping people lead healthy lives. But has it improved communication with health care providers? 2 Since EE programs base their educational content on accurate information, viewers are inclined to believe what they watch. If EE is found in both fictional and nonfictional programs, how would a viewer know when the information in the episode was real or an exaggeration. This poses the question: should you believe everything you see on TV? This study explored whether or not viewing medical shows affected peoples’ expectations of their physicians. These medical shows were fictional, but the medicine was based on reality. These shows even employed medical consultants to ensure the medicine was as accurate as possible. Grey’s Anatomy had a medical producer, Linda Klein, who brought in real surgeons to help stage and act in surgery scenes. She also had the cast train with real doctors and had them watch videos of procedures to make sure they were prepared (Burns, 2017). Because of this, would a person viewing these shows, perceive them more as EE rather than as fiction, substituting what they learned on television for real knowledge? Mark Twain, in the late 1800s, once said “Be careful about reading health books. You may die of a misprint” (Taylor & Forhan, 2013, para.8). This quote is as relevant today as it was back then. 3 CHAPTER 2 LITERATURE REVIEW Entertainment-education Singhal and Rogers (1999) have defined entertainment education as purposefully embedding educational messages into entertaining media in order to increase audience knowledge about an issue or to persuade a change in attitude or behavior. These programs can be found in a wide range of media genres and formats. They are useful for promoting public health because they engage viewers in ways that news and public affairs programs can’t, delivering messages about educational issues, and persuading against destructive habits. As an example of EE showing the destructiveness of unhealthy habits, the reality show My Strange Addiction takes someone with a highly destructive habit, such as tanning every day or eating Brillo pads, and gets them the help they need, all while showing the audience how harmful the habit is (My Strange Addiction). My Strange Addiction, along with Sesame Street and 16 and Pregnant are examples of whole programs that entertain while educating. There are individual episodes in sitcoms and TV shows that act as EE. For example, Glee and The Fosters addressed the topic of mass shootings after the Sandy Hook, Connecticut shooting and the Orlando nightclub shooting. Although both shootings in the purely fictional TV shows took place in a school setting, they were relevant and educated viewers on the topic. 4 EE is useful in that it engages the audience. The characters in the story either directly relate to the audience or indirectly make the audience reflect on their own lives (Quintero Johnson, 2011). People have a tendency to learn through experience, whether direct or indirect. Often this learning occurs when observing someone else’s experiences (Stinson & Heischmidt, 2012). EE can function as a kind of informal instruction. This informal learning is unplanned and in most cases vicarious. In fields such as medicine, experiential learning, or learning by doing and practicing, is essential. EE isn’t going to be effective in this instance, and some of the diagnostic medical situations that appear in primetime medical television shows are incomplete, incorrect or completely unrealistic (Jubas & Knutson, 2013).