The transfer and retention of information by the public through medical dramas and crime shows on television.

Ever since television has been around, it has become increasingly popular in the public’s everyday life. We look to it as an entertainment source through fictional stories and an information source through documentaries and game shows. However, researchers are becoming increasingly interested in the idea that fictional stories can also be an avenue through which the public retains information, particularly medical dramas and crime shows. With the increase of popularity in these types of programs, the idea is becoming a more important one that may need to be addressed. Medical dramas were a hit from the very first episodes (Davin, 2003). Grey’s Anatomy is about 5 medical interns and their personal and professional journeys at a fictional hospital, Seattle Grace. House M.D. is based on a male doctor who has undergone some medical issues himself and follows his lack of moral and ethical values when it comes to diagnosing patients. He has a general mistrust in human beings and will do whatever he has to treat his patient. From 2006 -2007, these two shows ranked 7th and 9th respectively in the top primetime television shows (Czarney et al., 2008). Looking at these results and more, it can be seen how popular medical dramas are becoming. With both types of shows, medical and criminal, the increasing popularity has led to the increase in similar shows being aired. CSI, one of the most well known and most watched criminal dramas on television first aired on CBS in 2000 (Brewer & Ley, 2010). The show is about a team of forensic scientists that use DNA evidence to solve crimes. During its 9th season, it was the 2nd highest rated show on television. The enormous initial popularity led to two spin-off shows, CSI: Miami, which premiered in 2002 and CSI: New York, first shown in 2004. CBS has also released a number of other crime shows including, Without a Trace (2002), NCIS (2003) and Cold Case (2003). Other networks have jumped on this bandwagon, such as FOX debuting Bones in 2005 (Brewer & Ley, 2010). With an increase in the number of medical and criminal dramas currently on television and the enormous popularity of these shows, it has been wondered whether the public gather information from this particular source, if they retain it and the effect it may have on everyday life.

Ever since the rising popularity of medical dramas, research has gone into how this can affect the self-perceived knowledge of the public. These shows may not intend to relay medical and health care information but they have been shown to do so. An original thought was that the public is a mindless sponge that takes up any information that is thrown at them. This has been shown to be incorrect. Through her research Davin (2003) has found that television viewers are complex, insightful people that can interpret material as it is shown to them. She has even found that the public has made some very interesting, unexpected interpretations. With this revelation, the theory that people take in medical dramas as fact is not necessarily a vital problem but it is something that can be looked at to see if it can become a problem or even to use it to an advantage. Davin (2003) conducted research on the effect of ER on the public’s intake of medical and health related knowledge. It was found that viewers found ER not only an entertaining show but also as a reliable source of information. Brodie et al. (2001) has also conducted research on the effectiveness of ER as a source of information. The survey included questions based on where the public received a lot of their health care information and media was towards the top of the list, along with health care providers. One of the most interesting results that were found had to do with the retention of information presented in the show. A vignette was selected about emergency contraception. The whole interaction in the episode went for only 3 minutes. Participants were questioned on their knowledge of emergency contraception before the episode, directly after, and again 2 months later. It was found that directly after the show, the subjects had 17% increased awareness on the topic but after 2 months, that level had decreased to the same amount of understanding they had displayed before the episode was aired. This does not give scientists confidence in the public’s ability to retain information from medical dramas but it has to be kept in mind that this experiment was conducted only using a 3 minute clip from one episode. If it had been a long running storyline that was frequently discussed by the characters, there may have been more success with the retention of information. This research study also looked at the viewer’s desire for various storyline topics.

As medical dramas are thought of as entertainment, one would think that viewers would prefer to see more plot lines that were based around the characters’ relationships. This was not necessarily the case. Interest in health-related storylines was reported as well as interest in relationship-based plots (Brodie et al., 2001). An interesting result was that, young, non-white and less-educated viewers had more interest in the health-related scenarios. This is not particularly surprising as they are the ones that may find it hard to gain this kind of information elsewhere, so ER was a major health information source for them. From the survey, 51% of regular viewers commented that they talked to family and friends about the health issues that were raised on the show. This in itself is a great way to spread information and also to increase discussion amongst the public to gain awareness of various issues. A third of the participants even said that ER had helped them make health care choices. This could be a great avenue for increased knowledge and awareness about major and even minor health care issues but it could also lead to the spread of misinformation and inaccurate views on health care and the health care system.

Some viewers have been known to diagnose themselves based on what they’ve seen on various medical dramas. This has led to increased number of patients misdiagnosing themselves and causing unnecessary worry, one particular patient using Casualty as a reference to their symptoms (Davin, 2003). A particular study (Gordon et al., 1998) looked at how British medical dramas presented cardiopulmonary resuscitation (CPR) and the effect that had on the public’s attitudes and expectations of CPR. An important fact to note is that the study found that television was one of the participants’ primary sources of information about CPR. This is not necessarily a bad thing as the study found that the dramas had a 25% success rate, which was very realistic compared to real-life CPR scenarios. It also noted how realistic British dramas were compared to American dramas when it came to CPR. A false presentation was shown to give unrealistic ideas of survival after CPR to patients and their friends and families. The misinformation presented about this particular issue could be very detrimental when people are undergoing CPR, whether it is on the street or in the hospital. An unrealistic idea that survival with CPR is guaranteed could be emotionally damaging to those involved.

The results found in these studies have shown that although the public may not take-in everything they see without evaluation and consideration, some information presented can be taken very seriously and has the possibility to alter the public’s perception of health care in an unrealistic and misinformed way. It is very important that medical dramas have a high level of accuracy in their major storylines.

Health care information is not the only aspect of medical dramas that can influence the public’s perception. The ethics presented in these shows can also have a major effect on how much trust is put into the health care system by the public. Czarney et al. (2010) found that the ethics portrayed in medical dramas have an influence on people’s beliefs and practices. It was also found that as consent is one of the most represented ethical practices in both Grey’s Anatomy and House M.D., the possible distortion of this practice could lead to a mistrust in both doctors and health care systems.

Czarney et al. had previously conducted a study in 2008 that looked at how medical and nursing students were affected by the viewing of popular medical dramas. The programs mentioned above were the two most viewed medical dramas by this group of students. Both programs have an abundance of ethical issues presented throughout the series. A few issues are of particular concern, such as the portrayal of lying to potential organ donors to receive consent, lying to patients to receive consent, or not even informing patients of treatment plans to avoid the rejection of consent (Czarney et al., 2008). The research conducted by these authors was based on a web-based survey emailed to a group of medical and nursing students from a university. Their study showed that the students thought the ethical issues presented were adequately accurate. It was also thought that the medical dramas were an insignificant source of information about bioethics. Although Czarney et al. (2008) found some very heartening information, the limits to their research may limit the credibility of the findings. Limitations such as only one university was surveyed and also students who don’t watch television are less likely to complete the survey added to the fact that the study was looking at educated students, particularly mindful of the bioethics area, and not of the general public. Despite this, the research does provide promising ideas that the public won’t just believe everything they see on television. Although the majority of these people won’t have been taught about bioethical concepts, they do have the capacity to understand the regulations doctors and hospitals put in place to avoid unethical situations and possible legal problems.

Medical dramas are not the only television show that has the potential to transfer information and affect the everyday life of the public. Criminal dramas such as CSI focus their episodes around the collecting and analysis of DNA evidence and often use it to solve crimes. Each episode shows the processes used to collect DNA from crime scenes and the technology and methods used to analyze it and match it to their suspect. Through this, there is the very likely possibility that the public will retain that information with the belief that it increases their knowledge on DNA. Brewer & Ley (2010) conducted a particular study that did find that increased viewing of crime shows increased the public’s self-perceived knowledge on both DNA and DNA evidence. Unlike medical dramas, crime shows do not have the luxury of factual accuracy. To maintain the entertainment value of these shows, accuracy of the forensic science is decreased dramatically. However, the presentation of this incredibly inaccurate information may not lead to a big a problem as inaccurate medical dramas as the use of DNA evidence and forensic science is not something that is encountered in everyday life. Although, there is one particular area that is thought to have a connection with the perception gained from watching criminal dramas. If an individual were to sit on a jury, their opinion of the case and defendant may be altered depending on the presentation of DNA evidence by either representation.

This idea has been named the “CSI effect” and a basic definition is “a growing public expectation that police labs can do everything TV labs can” (Cole, 2013, pp. 2). Another definition that pinpoints the problem with jurors states, “prosecutors worry that the shows taint the jury pool with impossibly high expectations” (Cole, 2013, pp. 2). Whether or not the “CSI effect” exists has yet to be proven but with the stylized and enhanced capabilities of forensic science being shown frequently to the masses, it is understood how this could be a very worrying idea. With the use of forensic evidence rising dramatically in the US justice system, it must be determined if these shows do have an impact on the country’s jurors having an incredibly high expectation of DNA evidence. Brewer & Ley (2010) conducted a study looking at how the viewing of these shows has affected jurors’ decision-making process. They found that although there was no significant link there was a slight positive correlation between conviction and the presentation of DNA evidence by the prosecution. Although, it was also found that there was no association between no DNA evidence being presented and acquittal of the defendant. Even though there are high possibilities of inaccurate criminal dramas affecting people’s expectations of DNA evidence, there has been no solid proof that the “CSI effect” exists. One must also remember how good the introduction of DNA evidence to the justice system has been. Many wrongly accused people have been exonerated through the use of DNA analysis after their court cases were held (Brewer & Ley, 2010).

Medical and criminal dramas both have different effects on the public but can we trust them? Through Davin’s (2003) study of ER, it was found that doctors were a part of the writing team and were regularly found on the set supervising the filming. The medical equipment used is genuine and the storylines are even based on stories reported by medical professionals. The actors familiarize themselves with real casualty procedures to make their television performances more authentic. It was also shown that ER and other medical dramas could help prepare people going into hospital, whether they are patients or friends and family. Viewers can get an idea on what to expect and reduce panic and worry when they are in that situation (Davin, 2003). Criminal dramas on the other hand are very fictionalized. The procedures shown have a very basic accuracy to them and are stylized and glamorized extensively. For example, in television shows, the time it takes for forensic scientists to analyze a DNA sample is considerably faster than any laboratory in the real world (Cole, 2013). As well as conducting the experiments in the lab, such as analyzing a perfume sample collected from the air, the very small forensics team also gets to go out and catch the perpetrator. The samples they do analyze always help them get their guy, and are usually always a very good DNA match (Cole, 2013). Few viewers would know that a forensics team is usually made up of many people each doing their own part and none of them would have the time or training to go into the field to arrest the criminal. The attainment of DNA samples from a crime scene is usually a lot more difficult than presented and the sample would only be a partial match if it matched at all. There will always be misleading facts in medical dramas to help the story along but generally, accuracy is of great importance to these shows to create credibility. However, criminal dramas cannot do without the inaccuracy. No one would continue watching if they had to see everything that took place in a forensics lab, and the time took to do it.

An idea has been brought forward that medical and criminal dramas should be regulated, either by policymakers or public officials (Brodie et al., 2001). This would not be a feasible or intelligent approach. Although, it would be beneficial to only transfer accurate information through these shows, this is not realistic. The reason the public pay such attention to these shows is because they are stimulating, interesting and entertaining. With the removal of all inaccurate information the storylines would become less compelling and no one would continue to watch these shows, eliminating a great resource, at least for the transfer of health care information. The number of shows that have medical professionals on their writing teams and on the sets could probably be increased but the promotion of this idea is the extent to which the government should have a say. The directors and production teams of medical and criminal dramas should be able to keep their right to entertain and not have regulations forced upon them. Medical dramas are currently a great information source and should be used to the health systems advantage and crime shows are a great entertainment source.

It has been shown that the public does take in information from both these kinds of shows. It has also been shown that the viewers don’t believe everything they see, so the inaccuracies that are presented in each episode aren’t necessarily taken as fact. Until a problem has been proven to exist, such as a dramatic, uncontrollable number of hypochondriacs or the “CSI effect”, these shows cannot be seen as a major problem that needs to be fixed.

References

Brewer, PR & Ley, BL, 2010 ‘Media Use and Public Perceptions of DNA Evidence’, Science Communication, vol. 32, no. 1, pp. 93 – 117.

Brodie, M, Foehr, U, Rideout, V, Baer, N, Miller, C, fournoy, R & Altman, D, 2001 “Communicating Health Information Through the Entertainment Media”, Health Affairs, vol. 20, no. 1, pp. 192 – 199.

Cole, SA, 2013 “A surfeit of science: The “CSI effect” and the media appropriation of the public understanding of science”, Public Understanding of Science, vol. 0, no. 0, pp. 1 -17.

Czarney, MJ, Faden, RR, Nolan, MT, Bodensiek, E & Sugarman, J, 2008 “Medical and Nursing Students’ Television Viewing Habits: Potential Implications for Bioethics”, American Journal of Bioethics, vol. 8, no. 12, pp. 1 – 8.

Czarny, MJ, Faden, RR & Sugarman, J, 2010 “Bioethics and professionalism in popular television medical dramas”, Journal of Medical Ethics, vol. 36, pp. 203 – 206.

Davin, S, 2003 “Healthy viewing: the reception of medical narratives”, Sociology of Health & Illness, vol. 25, no. 6, pp. 662 – 679.

Gordon, PN, Williamson, S & Lawler, PG, 1998 “As seen on TV: observational study of cardiopulmonary resuscitation in British television medical dramas”, BMJ, vol. 317, pp. 780 – 783.

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