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Scrubs, House, Grey’s Anatomy: Are medical students learning bad habits?

Bad behaviour isn’t cause to ignore these TV shows. Flickr/Number Stumper

Television loves particular careers: detectives, lawyers, forensic experts and, perhaps most of all, doctors. Popular long-running shows such as House and Grey’s Anatomy join a long list of medical programs that have created a fictional world of medicine over the past sixty years.

So is the next generation of doctors watching and learning from medical television shows?

In our study of Australian medical students’ viewing habits, almost all (94%) said they had watched medical shows at some point. House and Scrubs were the most popular and other favourites included Grey’s Anatomy and documentaries such as RPA.

On one level, this isn’t surprising. Many of us enjoy seeing our career on screen, despite – or maybe even because of – the often glamorised and unrealistic images. (Not to mention the all-singing-all-dancing hospital wards we see on Scrubs).

So does it matter what medical students watch? After all, they’re far more likely to pay attention to their clinical teachers than their television counterparts.

Television’s impact on us is limited, but we don’t always realise the influence it can have on us, our expectations and our beliefs about the world.

When it comes to medical television shows, past research has shown there are plenty of negative representations: unprofessional behaviour, gender stereotypes, and a focus on doctors while ignoring other health professionals.

Some studies have even raised the possibility that students may perform techniques incorrectly because of what they’ve seen on television.

There are many examples of unethical behaviour on the shows, particularly around topics of informed consent, confidentiality and misconduct.

These can even seem justified by good outcomes, as is the case in this clip from Grey’s Anatomy, where junior doctors Izzie and Cristina conduct an autopsy on a deceased patient without the family’s consent.

Based on this past research, it might be tempting to forecast doom for the medical profession and leap to conclusions that our future doctors are likely to mimic the unethical behaviours they see onscreen.

Yet our research shows that medical students are critical of these programs. The majority of participants rated the portrayal of ethics-based storylines as poor.

Compared with other sources such as medical lectures, television shows rated very low on the level of influence they had over students on ethical issues.

But the students in our study said the shows mostly handled the portrayal of professionalism well, including ideals such as caring, compassion, respect and integrity. Given the prominence of unprofessional behaviours in these shows, these perceptions may be cause for concern.

When we asked students about role models, though, they preferred the characters known for their caring nature and integrity, such as Allison Cameron on House.

Cameron is serious but has a good rapport with patients. Flickr/Kormachad

Other characters such as Gregory House were chosen as both most and least favourite, possibly because he has both good qualities (skill, intellect) and bad (contempt for patients and, well, everyone else too). Here’s just one example:

No program rated very highly for accuracy. And the beliefs about accuracy of these shows weren’t linked to the student’s year level. This suggests that even students without clinical experience are sceptical of medical programs.

Students may not fully realise the influence these shows have on their own perceptions, but neither are they simply passive consumers of the programs.

The fact that medical programs show bad behaviour isn’t cause to ignore them. It’s precisely because the shows cover such a wealth of topics that may emerge in real-life practice that medical teachers could find it useful to engage with them more closely.

Most students already watch these shows and just over half discuss the portrayed medical and ethical dilemas with their friends and family.

So rather than dismissing the shows as irrelevant or unworthy, teachers could consider showing scenes in classes to provoke debate, teach about particular illnesses and discuss the professional and ethical issues that underpin best medical practice.

Here’s an example from ER, where Carter and Gates have a frank discussion about organ donation.

On-screen ethical dilemmas could be used as a starting point for tutorial discussion of situations that students may face in future.

Storylines about unprofessional behaviour could help teach students about the real-world guidelines set out by their relevant medical association.

Using the television shows may, then, help teach students in a way that doesn’t ignore the potentially significant impact that popular culture can have on their professional development and identity.

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