Volume 18 Number 1 Winter/Spring 2001

back

VIDEO MOVEMENT

AN ALUMNA EXPLORES THE POWER OF VIDEO TO MOVE STUDENTS TO LEARN

By Rosanne Spector

IF HER EDUCATIONAL VIDEO makes you cry, Delaney Ruston, MD, considers the lesson a success. * Ruston, class of 1995, has faith in the power of video to teach physicians and medical students, especially when the message makes an emotional impact. Her first educational video, "If She Knew," presents an ethical dilemma Ruston faced while treating a woman with gallbladder cancer. The dilemma: The patient's daughter asked Ruston to refrain from informing her mother -- the patient -- that the cancer had recurred.

Though physicians trained in the United States are educated to share their patients' medical information with them, not all patients and their families are at ease with this practice. For example, many culturally Hispanic people, such as the mother and daughter featured in Ruston's film, prefer that physicians spare patients from upsetting information, Ruston says. "The daughter, Nora, did not want me to tell her mother that she had a recurrence because she was convinced that her mother would die sooner if she knew," says Ruston. "Nora explained to me that because of the body and mind connection, her mother's body would begin failing sooner if her mother knew that she had a terminal condition."

After describing this case, the video reveals how Ruston, the patient and her daughter found a way to resolve the cultural conflict and provides pointers for physicians who may find themselves in a similar situation. One of the video's major messages is that before physicians order diagnostic tests, they should ask patients how much information they would like to be told about the results.

Ruston made the 10-minute video during her primary care residency at UC-San Francisco, 1995-98. Former Stanford resident Maren Monsen, MD, served as a consultant on the project. Filmmaker Monsen, now at Stanford's Center for Biomedical Ethics, "has been a mentor for me from day one of this project," adds Ruston.

When Ruston screened "If She Knew," at UCSF's primary care grand rounds and later at several meetings and conferences, she discovered that the video seemed to move its audience deeply. To Ruston's surprise, it made more than one physician cry.

Though undeniably moving, is the video successful as an educational tool? That's the question colleagues have asked Ruston -- who has discovered that many physicians are skeptical about the value of educational videos in medical training. To better understand this attitude, Ruston has begun a study (funded by a Greenwall Foundation grant) of the use of educational videos in teaching biomedical ethics at U.S. medical schools.

"It makes sense to me that an emotional experience triggered by watching a video will stick with you longer than a dry discussion. I'm very curious to see what others think about this," she says.

Meanwhile, Ruston is producing and directing more educational videos. One project is a series of videos for UCSF's medical ethics program on how physicians can better communicate with patients regarding alternative and complementary medicine. Another project, conducted with her husband Peter Small, MD, an associate professor in Stanford's infectious diseases division, has taken Ruston to The Gambia to shoot footage for a video to inform fellows in infectious disease about research opportunities there.

For more information about any of these videos, contact Ruston at UCSF's Program in Medical Ethics, (415) 502-8275. Or e-mail her at druston@medicine.ucsf.edu. SMD