Case Report

By Dr. P Ravi Shankar , Dr. Abner James , Dr. Ramanan Balasubramanium
Corresponding Author Dr. P Ravi Shankar
American International Medical University, Beausejour Road - Saint Lucia
Submitting Author Dr. P Ravi Shankar
Other Authors Dr. Abner James
American International Medical University, Department of Basic Medical Sciences, - Saint Lucia

Dr. Ramanan Balasubramanium
American International Medical University, Department of Basic Medical Sciences, - Saint Lucia


Activities, Caribbean, disability, movie screening

Shankar P, James A, Balasubramanium R. Obtaining a clearer perspective on the differently abled: a case study from a Caribbean medical school. WebmedCentral MEDICAL EDUCATION 2018;9(7):WMC005499

This is an open-access article distributed under the terms of the Creative Commons Attribution License(CC-BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Submitted on: 03 Jul 2018 06:19:16 AM GMT
Published on: 03 Jul 2018 06:19:34 AM GMT


Movies are used in medical schools for a variety of purposes ranging from learning of professionalism, public health, drug dependence, disability among others. In a medical school in Aruba, Dutch Caribbean movies and activities were used to strengthen learning of communication skills, empathy, professionalism, and death and dying. American International Medical University in Saint Lucia admits students for graduate courses in medicine and nursing. Recently innovations have been carried out to the basic sciences curriculum. A movie screening and activity was used at the institution to provide a clearer perspective about the differently abled. The movie ‘My left foot’ was screened followed by group activities and presentations. Participant feedback was obtained using a simple questionnaire and noting the degree of respondents’ agreement with a set of eight statements. The mean score was 33.9 (maximum score 40). Student feedback about the session was positive. Similar sessions can be considered in future and could be expanded to involve all basic science students.


Medical schools around the world are incorporating learning of the humanities into the undergraduate medical curricula using various modalities like theater, literature, philosophy, theater and the arts.1 Movies have been used for a variety of purposes in undergraduate medical education. In a medical school in Brazil, scenes from movies were used to teach about substance use disorders.2 Thirty-nine scenes from 27 Brazilian movies were used. In a medical school in New Zealand movies were used to support learning of public health.3 Student attitudes toward this intervention was positive. In Slovenia, movies were used to teach professionalism to fourth year medical students.4 The authors concluded that the controlled environment of the movies provided opportunities for students to explore their values, beliefs and attitudes toward different aspects of professionalism.

Movie screening and activities in OCMS

Movie screening and activities have been used in an offshore Caribbean medical school (OCMS) in Aruba to strengthen the learning of communication skills, empathy, professionalism and provide a greater understanding of death and dying.5 OCMS usually admit three intakes of students in January, May and September. American International Medical University (AIMU) is an OCMS located in Saint Lucia admitting students mainly from India, Nigeria and other countries to the undergraduate medical (MD) program. The school follows a traditional discipline-based basic sciences curriculum. Recently, however a number of modifications have been carried out including introduction of a health humanities module, conducting sessions on critical appraisal of scientific literature, use of online modules and organ system-based sequencing of the fourth semester.6

Educating medical students about disability

A variety of approaches have been used to educate medical and health students about disability. A selected group of medical students participated in sea voyages of about 5 to 7 days with sailors with disabilities ranging from cerebral palsy, loss of sight, loss of limbs and paraplegia.7 Several training programs in the United States either use disabled standardized patients or patients who are normal but portray patients with disabilities.8 The authors of an article published in 2011 describe the advantages, challenges and the practical issues involved in running such programs. A systematic analysis of the use of movies in medical education published in 2012 listed 76 articles.9 The majority of the studies were from the United States and a variety of issues were explored using movies. Most interventions used clips from movies rather than complete feature length movies. Movie screening and activities have not been previously conducted at AIMU. The present study was conducted to obtain participant feedback about the activity.      

Movie screening and activity at the institution

On 21st June 2018, a movie screening and activity was conducted for fourth semester basic science medical students at AIMU. The objectives of the session were to introduce students to the challenges of the ‘differently abled’, and examine how being differently abled impacts on the person personally and in his/her relationship with their family, community and society. The session also facilitated exploration of the impact of poverty and socioeconomic deprivation on the situation of the differently abled and changes in conditions for them during the last five decades.

Movie My left foot

The 1989 movie ‘My left foot the story of Christy Brown’ was screened. The movie narrates the story of the Irish writer and painter, Christy Brown who was born with cerebral palsy and could control only his left foot. He was born into a poor working class family but eventually becomes an acclaimed painter and writer. The screening was followed by activities. The 18 fourth semester students were divided into four small groups. Each group was provided with a specific activity which they completed with reference to the screened movie and to the online library and the internet when required. Table 1 show the activities used during the session. The groups presented their activities to the larger group and the facilitators provided their inputs as and when required. The first and second authors were the facilitators for the session.

Participant feedback

Participant feedback about the session was obtained. No personal identifiable information was collected. Respondents’ agreement with a set of eight statements was measured using a Likert type scale. Some statements were negatively worded to avoid response bias. Table 2 shows the questionnaire used to obtain student feedback.

As this was a feedback of a pilot educational intervention and no personal data was collected ethical exemption was provided by the institutional review board of AIMU. Sixteen of the 18 students (88.9%) participated in the session. Fourteen of the 16 participants (87.5%) completed the questionnaire. The mean ± SD score was 33.9 ± 2.2 (maximum possible score being 40). Table 3 shows the scores of individual statements. Many students wanted a screening of the movie ‘Do no harm’ about suicide among doctors during a later session.

The scores of most statements were high and student opinion about the session was positive. Finding time for this session in a crowded curriculum remains a challenge. This may account for the lower score for statement 8 about similar sessions in the future. AIMU like many OCMS teaches the basic sciences over four semesters of 15 weeks each with the fifth semester concentrating on Introduction to clinical medicine and preparing for standardized exams.      


The session was conducted using logistics available in the school and no extra resources were required. This was a pilot study to examine the feasibility of conducting this type of session at the school. Class sizes at the institution are small. The pilot session went off smoothly and student feedback was positive. Similar sessions exploring other issues can be considered in future. Sessions can be considered for the entire group of basic science students from the first to the fifth semesters.


  1. Ousager J, Johannessen H. Humanities in undergraduate medical education: a literature review. Acad Med. 2010;85:988-98.
  2. Castaldelli-Maia JM, Oliveira HP, Andrade AG, Lotufo-Neto F, Bhugra D. Using selected scenes from Brazilian films to teach about&nb sp;substance use disorders, within medical education. Sao Paulo Med J. 2012;130:380-91.
  3. Gallagher P, Wilson N, Edwards R, Cowie R, Baker MG. A pilot study of medical student attitudes to, and use of, commercial movies that address public health issues. BMC Res Notes. 2011;4:111. doi: 10.1186/1756-0500-4-111.
  4. Klemenc-Ketis Z, Kersnik J. Using movies to teach professionalism to medical students. BMC Med Educ. 2011;11:60. doi: 10.1186/1472-6920-11-60.
  5. Shankar PR, Rose C, Balasubramanium R, Nandy a, Friedmann R. Using movies to strengthen learning of the humanistic aspects of medicine. J Clin Diagn Res 2016;10:JC05-JC07. doi: 10.7860/JCDR/2016/16264.706.
  6. Shankar PR, Dakubo G. Utilizing the curriculum committee to strengthen teaching-learning in a medical school. Education in Medicine Journal (in press). 
  7. Thompson T, Lamont-Robinson C, Williams V. At sea with disability! Transformative learning in medical undergraduates voyaging with disabled sailors. Med Educ. 2016;50:866-79. doi: 10.1111/medu.13087.
    1. Long-Bellil LM, Robey KL, Graham CL, Minihan PM, Smeltzer SC, Kahn P; Alliance for Disability in Health Care Education. Teaching medical students about disability: the use of standardized patients. Acad Med. 2011;86:1163-70. doi: 10.1097/ACM.0b013e318226b5dc.
    2. Darbyshire D, Baker P. A systematic review and thematic analysis of cinema in medical education. Med Humanit 2012;38:28-33. doi:10.1136/medhum-2011-010026



Table 1: Activities used during the session

Group A

What conditions in the movie would you say are associated with poverty and economic deprivation?

In the form of a short sketch (act or play), portray how society in general initially viewed Christy versus how his mother saw him.

Group B

Discuss society's attitude to disability and to the Brown family within this film. How does Christy, Mrs Brown and Mr Brown deal with Irish societal expectations of them?

In this movie, speech is a top priority for Christy to master, in spite of other     disability-related challenges. Why is this so?

Group C

Analyze with reasons whether Christy’s house and the neighborhood were disabled-friendly. How did this impact Christy?

Explore the relationship between the doctor and Christy. How did this influence Christy’s life?

Group D

Examine how Christy overcame various handicaps and limitations to become an accomplished painter.   

Examine how the situation has changed for the ‘differently abled’ in developed and developing nations in the last four decades.

Table 2: Questionnaire used to obtain participant feedback

Student feedback about the movie screening and activities

Indicate your level of agreement with the following statements according to the following scale: 1 = strongly disagree with the statement, 2 = disagree, 3 = neutral, 4 = agree, 5 = strongly agree with the statement. Use whole numbers only

  1. I enjoyed participating in movie screening and activities.
  2. The activity introduced me to social and humanistic issues in medicine
  3. The logistics of the session was to my satisfaction.
  4. I was not satisfied with the dynamics of and interactions with other members of my group.
  5. The movie chosen was appropriate to the theme of being ‘differently abled’.
  6. The facilitators succeeded in creating a friendly atmosphere.
  7.  I am confident of being able to put myself in the ‘shoes’ of a differently abled person
  8. I would like similar sessions in future.

Kindly provide TWO suggestions to further improve the session: 

Table 3: Mean scores of individual statements


Mean score

I enjoyed participating in movie screening and activities.


The activity strengthened my understanding of social and humanistic issues in medicine.


The logistics of the session was to my satisfaction.


I was not satisfied with the dynamics of and interactions with other members of my group.*


The movie chosen was appropriate to the theme of being ‘differently abled’.


The facilitators succeeded in creating a friendly atmosphere.


I am confident of being able to put myself in the ‘shoes’ of a differently abled person


I would like similar sessions in future.


* The reversed score is shown

Source(s) of Funding

There were no sources of funding for this work

Competing Interests

The authors do not have any competing interests to declare. 

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