Film-Based Medical Education and Social Justice Course: Effects on Alexithymia and Empathy in Medical Students

Official title

Effect of a Film-Based "Medical Education and Social Justice" Elective on Medical Students' Alexithymia Levels and Empathy Skills: A Nonrandomized Controlled Pretest-Posttest Study

Overview

This study will examine whether a 14-week elective course that uses films and guided discussion on social justice in health care can improve medical students' empathy skills and reduce alexithymia (difficulty recognizing and describing emotions). Approximately 50 volunteer medical students will participate. Students who choose the elective course will form the intervention group, and students who do not take the course will form a comparison group. All participants will complete the same questionnaires/assessments at the beginning and at the end of the semester. The main goal is to compare changes in empathy and alexithymia scores between the two groups.

Detailed description

This is a prospective, nonrandomized controlled pretest-posttest study conducted at Canakkale Onsekiz Mart University Faculty of Medicine. Participants are volunteer medical students (≥18 years). The intervention group consists of students who enroll in the elective course, and the comparison group consists of students from the same student population who do not enroll during the same period.

Data will be collected at two time points: baseline prior to the start of the elective period (T0) and immediately after the end of the elective period (T1, approximately 14 weeks later). At each time point, participants will complete the study instruments administered in a standardized manner. In the intervention group, reflective journals will also be collected throughout the course period to support qualitative interpretation of findings.

The primary analysis will compare within-group change from T0 to T1 and between-group differences in change scores. Descriptive statistics will summarize participant characteristics. Depending on data distribution, paired tests and independent-group tests (or their nonparametric equivalents) will be used for continuous outcomes. Multivariable models may be used to adjust for baseline differences (e.g., class year) if imbalance is observed. Missing data will be handled using a predefined approach (e.g., complete-case analysis with sensitivity checks). No clinical procedures or medical treatments are involved.

Interventions

• Behavioral Film-Based Medical Education and Social Justice Elective
  A 14-week elective course (approximately 2 hours/week) using selected films/film clips with structured group discussion and reflective activities/journaling.

Primary outcome measures

• Toronto Alexithymia Scale (TAS-20) Total and Subscale Scores (Change) [Time frame: Baseline (T0) and end of course (T1, approximately 14 weeks)]
• Scenario-Based Empathy Skills Total Score and Rubric Subscores (Change) [Time frame: Baseline (T0) and end of course (T1, approximately 14 weeks)]
• Jefferson Scale of Empathy S(tudent)-Version [Time frame: Baseline (T0) and end of course (T1, approximately 14 weeks)]

Secondary outcome measures (3)

• Association Between Change in TAS-20 and Change in Empathy Score [Time frame: From baseline (T0) to end of course (T1, approximately 14 weeks)]
• Jefferson Scale of Empathy - Student Version (JSE-S) Subscale/Factor Scores (Change) [Time frame: Baseline (T0) and end of course (T1, approximately 14 weeks)]
• Association Between JSE-S Score and Scenario-Based Empathy Skills Score (Convergent Validity) [Time frame: Baseline (T0) and end of course (T1, approximately 14 weeks)]

Eligibility criteria

Inclusion criteria

• Enrolled medical student at Canakkale Onsekiz Mart University Faculty of Medicine, registered in Year 1, 2, or 3 during the study period.
• Age 18 years or older.
• Provides written/electronic informed consent after being informed about the study.
• For the intervention arm: enrolled in the elective "Film-Based Medical Education and Social Justice" course.
• For the control arm: from the same academic year/cohort during the same period and not enrolled in the elective course.
• Willing and able to complete both baseline (T0) and end-of-course (T1) assessments (has sufficient cognitive/communication ability to complete questionnaires).

Exclusion criteria

• Does not provide consent or withdraws consent at any stage.
• Younger than 18 years.
• Does not complete at least one of the two assessments (T0 or T1).
• Leaves critical sections of the questionnaires/assessments largely blank (e.g., substantial missing items on TAS-20 or incomplete scenario responses preventing scoring).
• Duplicate/duplicate submission (more than one form from the same participant for the same assessment).

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Allocation

Non-randomized

Model

Parallel assignment

Masking

Single blind

Primary purpose

Other

Study locations

Turkey (Türkiye) · 1 center

• Faculty of Medicine — Çanakkale

Publications

• Bagby RM, Parker JD, Taylor GJ. The twenty-item Toronto Alexithymia Scale- I. J Psychosom Res. 1994;38(1):23-32. PMID: 8126686. doi: 10.1016/0022-3999(94)90005-1. Law M, Kwong W, Friesen F, Veinot P, Ng SL. The current landscape of television and movies in medical education. Perspect Med Educ. 2015;4(5):218-224. doi: 10.1007/s40037-015-0205-9. Lumlertgul N, Kijpaisalratana N, Pityaratstian N, Wang

Identifiers

NCT: NCT07399366 · 2025-YÖNP-0418

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗