The European Journal of Humour Research

Vol 10, No 1 (2022)

The use of humour in medical education: students’ perspective

Rim Taleb,Hadi Itani,Sanaa Itani,Rayane Salameh,Aya Ramadan,Khaled Sidani

Abstract

In early 20th century, Sir William Osler supported the use of humour as an efficacious tool in medical education, which continues to be used today. Despite the abundance of literature delineating this important role, it is often overlooked among medical students. A descriptive cross-sectional study was planned where a total of 295 medical students from the pre-clerkship and clerkship phases at Beirut Arab University Faculty of Medicine were included in the study. A questionnaire was distributed among the participants assessing their perception on the use of humour in medical education. Data were collected, entered, and analysed on SPSS software version 23.1. Results with p-value < 0.05 were considered statistically significant. The majority of participants agreed to the implementation of humour in medical education. They supported different forms of humour to be used, and considered mockery, sarcasm, the instructor appearing as a performer, and humour that is irrelevant to the course as inappropriate. Inappropriate humour distracts attention and disrupts the formal atmosphere. Our findings suggest that medical students’ opinions on using humour in medical education are supportive. The findings of this study might be of benefit to assist teachers in using humour to improve the attendance and interest of the students in the class and create an environment conducive to optimal student learning.



References

Atir, S. (2010). Memory for Information Paired with Humorous, Relevant Jokes. Unpublished thesis. New Haven, CT: Yale. University Senior thesis.

Baid, H. & Lambert, N. (2010). ‘Enjoyable learning: The role of humour, games, and fun activities in nursing and midwifery education’. Nurse Education Today 30 (6), pp. 548-552. doi: https://doi.org/10.1016/j.nedt.2009.11.007.

Banas, J. A., Dunbar, N., Rodriguez, D. & Liu, S. J. (2011). ‘A review of humor in educational settings: Four decades of research’. Communication Education 60 (1), pp. 115-144. doi: https://doi.org/10.1080/03634523.2010.496867.

Berk, R. (2009). ‘Derogatory and cynical humour in clinical teaching and the workplace: The need for professionalism’. Medical Education 43 (1), pp. 7-9. doi: https://doi.org/10.1111/j.1365-2923.2008.03239.x.

Berk, R. A. (2000). ‘Does humor in course tests reduce anxiety and improve performance?’ College Teaching 48 (4), pp. 151-158. doi: https://doi.org/10.1080/87567550009595834.

Berk, R. A. (2001). ‘The active ingredients in humor: Psychophysiological benefits and risks for older adults’. Educational Gerontology 27 (3–4), pp. 323-339. doi: https://doi.org/10.1080/036012701750195021.

Berk, R. A. (2007). ‘Humor as an instructional defibrillator’. The Journal of Health Administration Education 24 (2), pp. 98-116.

Bieg, S. & Dresel, M. (2018). ‘Relevance of perceived teacher humor types for instruction and student learning’. Social Psychology of Education 21 (4), pp. 805-825. doi: https://doi.org/10.1007/s11218-018-9428-z.

Carlson, K. A. (2011). ‘The impact of humor on memory: Is the humor effect about humor?’ Humor: International Journal of Humor Research 24 (1), pp. 21-41. doi: https://doi.org/10.1515/HUMR.2011.002.

Davis, J. R. & Arend, B. D. (2012). ‘Facilitating seven ways of learning: A resource for more purposeful, effective, and enjoyable college teaching’, in Stylus Publishing. doi: https://doi.org/10.1177/1045159514547700.

De Brito, C. M. D., da Silveira, R., Mendonça, D. B. & Joaquim, R. H. V. T. (2016). ‘Humor and laughter in health promotion: A clown insertion experience in the family health strategy’. Ciencia e Saude Coletiva 21 (2), pp. 553-562. doi: https://doi.org/10.1590/1413-81232015212.00982015.

Felson, B. (1987). ‘Humor in medicine’, in Seminars in Roentgenology 22 (3), pp. 141-143. doi: https://doi.org/10.1016/0037-198X(87)90025-3.

Fitzpatrick, R. R. (2010). The Impact of Integrated Humor Memory Retention and Recall Aspects of Adult Learning. Doctoral dissertation, Texas A&M. University.

Fortson, S. B. & Brown, W. E. (1998). ‘Best and worst university instructors: The opinions of graduate students’. College Student Journal 32 (4), pp. 572-576.

Fterniati, A., Archakis, A. & Tsakona, V. (2015). ‘Scrutinizing humorous mass culture texts in class: A critical language teaching proposal’. Humor: International Journal of Humor Research 4 (1), pp. 28-52.

Gal, B., Rubio, M., Iglesias, E. & González, P. (2018). ‘Evaluation of participatory teaching methods in undergraduate medical students’ learning along the first academic courses’. PLoS ONE 13 (1), pp. 1-8. doi: https://doi.org/10.1371/journal.pone.0190173.

Gentilhomme, Y. (1992). 'Humor: A didactic adjuvant’. Humor: International Journal of Humor Research 5 (1–2), pp. 69-90. doi: https://doi.org/10.1515/humr.1992.5.1-2.69.

Gironzetti, E. (2019). ‘Book review: Villy Tsakona and Jan Chovanec (eds.), The Dynamics of Interactional Humor: Creating and Negotiating Humor in Everyday Encounters’. Discourse Studies 21 (2), pp. 216-218. doi: https://doi.org/10.1177/1461445618817961.

Goldstein, D., Hahn, C. S., Hasher, L., Wiprzycka, U. J. & Zelazo, P. D. (2007). ‘Time of day, intellectual performance, and behavioral problems in Morning versus Evening type adolescents: Is there a synchrony effect?’ Personality and Individual Differences 42 (3), pp. 431-440. doi: https://doi.org/10.1016/j.paid.2006.07.008.

Goodboy, A. K., Booth-Butterfield, M., Bolkan, S. & Griffin, D. J. (2015). ‘The role of instructor humor and students’ educational orientations in student learning, extra effort, participation, and out-of-class communication’. Communication Quarterly 63 (1), pp. 44-61. doi: https://doi.org/10.1080/01463373.2014.965840.

Gostick, A. & Christopher, S. (2008). The Levity Effect: Why It Pays to Lighten Up’. Wiley and Sons.

Harden, R. M. & Crosby, J. (2000). ‘AMEE guide no 20: The good teacher is more than a lecturer – The twelve roles of the teacher’. Medical Teacher 22 (4), pp. 334-347. doi: https://doi.org/10.1080/014215900409429.

Harden, R. M. & Davis, M. (1995). ‘The core curriculum with options or special study modules’. Medical Teacher 17, pp. 125-148.

Hecht, L., Buhse, S. & Meyer, G. (2016). ‘Effectiveness of training in evidence-based medicine skills for healthcare professionals: A systematic review’, in BMC Medical Education Vol. 16, 103. BioMed Central Ltd. doi: https://doi.org/10.1186/s12909-016-0616-2.

Jayasuriya-Illesinghe, V., Nazeer, I., Athauda, L. & Perera, J. (2016). ‘Role models and teachers: Medical students perception of teaching-learning methods in clinical settings, a qualitative study from Sri Lanka’. BMC Medical Education 16 (1), p. 52. doi: https://doi.org/10.1186/s12909-016-0576-6.

Kellaris, J. J. & Cline, T. W. (2007). ‘Humor and ad memorability: On the contributions of humor expectancy, relevancy, and need for humor’. Psychology and Marketing 24 (6), pp. 497-509. doi: https://doi.org/10.1002/mar.20170.

Liu, Y. P., Sun, L., Wu, X. F., Yang, Y., Zhang, C. T., Zhou, H. L. & Quan, X. Q. (2017). ‘Use of humour in medical education: A survey of students and teachers at a medical school in China’. BMJ Open 7 (11). doi: https://doi.org/10.1136/bmjopen-2017-018853.

Loomans, D. & Kolberg, K. (2002). The Laughing Classroom: Everyone’s Guide to Teaching with Humor and Play (Loomans, Diane). Tiburon: Hj Kamer.

McKeachie, W. & Svinicki, M. (2005). McKeachie’s Teaching Tips: Strategies, Research, and Theory for College and University Teachers. Belmont: Cengage Learning.

Narayanan, S., Shankar, N. & Ananthy, V. (2019). ‘Medical student’s perception to different types of set induction in anatomy lectures’. Anatomy and Cell Biology 52 (3), pp. 296-301. doi: https://doi.org/10.5115/acb.19.016.

Narula, R., Varsha, C., Ashok, A. & Kusum, N. (2011). ‘Humor as a learning aid in medical education’. National Journal of Integrated Research in Medicine 2 (1), pp. 22-24.

Nongmeikapam, M., Sarala, N., Reddy, M. & Ravishankar, S. (2019). ‘Video-assisted teaching versus traditional didactic lecture in undergraduate psychiatry teaching’. Indian Journal of Psychiatry 61 (4), pp. 376-379. doi: https://doi.org/10.4103/psychiatry.IndianJPsychiatry_265_18.

Osler, W. (1920). Obituary. Boston Medical and Surgical Journal 182:232-236 (26 Feb 1920) Retrieved on 31 March 2022 from: https://www.nejm.org/doi/full/10.1056/NEJM192002261820907

Papanna, K. M., Kulkarni, V., Tanvi, D., Lakshmi, V., Kriti, L., Unnikrishnan, B., Akash, S., Tejesh, S. & Sumit Kumar, S. (2013). ‘Perceptions and preferences of medical students regarding teaching methods in a Medical College, Mangalore India’. African Health Sciences 13 (3), pp. 808-813. doi: https://doi.org/10.4314/ahs.v13i3.41.

Parrott, T. E. (1994). 'Humor as a teaching strategy’. Nurse Educator 19 (3), pp. 36-38. doi: https://doi.org/10.1097/00006223-199405000-00017.

Parsons, G. N., Kinsman, S. B., Bosk, C. L., Sankar, P. & Ubel, P. A. (2001). ‘Between two worlds: Medical student perceptions of humor and slang in the hospital setting’. Journal of General Internal Medicine 16 (8), pp. 544-549. doi: https://doi.org/10.1046/j.1525-1497.2001.016008544.x.

Penson, R. T., Partridge., R.A, Rudd, P., Seiden, M.V., Nelson J.E., Chabner, B.A., Lynch, T.J., (2005). ‘Update: Laughter: The best medicine?’. The Oncologist 10 (8), pp. 651-660. doi: https://doi.org/10.1634/theoncologist.10-8-651.

Piemonte, N. M. (2015). ‘Last laughs: Gallows humor and medical education’. Journal of Medical Humanities 36(4), 375–390. https://doi.org/10.1007/s10912-015-9338-4

Qiao, Y. Q., Shen, J., Liang, X., Ding, S., Chen, F. Y., Shao, L., Zheng, Q. & Ran, Z. H. (2014). ‘Using cognitive theory to facilitate medical education’. BMC Medical Education 14 (79). doi: https://doi.org/10.1186/1472-6920-14-79.

Ramesh, N., Varsha, C., Kusum, N. & Narayan Ram. (2011). ‘Depression, anxiety and stress reduction in medical education: Humor as an intervention’. Online Journal of Health and Allied Sciences 10 (1), pp. 1-7.

Riesch, H. (2015). ‘Why did the proton cross the road? Humour and science communication’. Public Understanding of Science 24 (7), pp. 768-775. doi: https://doi.org/10.1177/0963662514546299.

Rosenberg, L. (1989). ‘A delicate dose of humor’. Nursing Forum 24 (2), pp. 3-7. doi: https://doi.org/10.1111/j.1744-6198.1989.tb00817.x.

Sauter, D. A., Eisner, F., Ekman, P. & Scott, S. K. (2010). ‘Cross-cultural recognition of basic emotions through nonverbal emotional vocalizations’. Proceedings of the National Academy of Sciences of the United States of America 107 (6), pp. 2408-2412. doi: https://doi.org/10.1073/pnas.0908239106.

Savage, B. M., Lujan, H. L., Thipparthi, R. R. & DiCarlo, S. E. (2017). ‘Humor, laughter, learning, and health! A brief review’. Advances in Physiology Education 41 (3), pp. 341-347. doi: https://doi.org/10.1152/advan.00030.2017.

Schmidt, S. R. & Williams, A. R. (2001). ‘Memory for humorous cartoons’. Memory and Cognition 29 (2), pp. 305-311. doi: https://doi.org/10.3758/BF03194924.

’Sheldon James, G. & Jacob, J. M. (2016). ‘Humor as a teaching strategy in medical education’. European Journal of Pharmaceutical and Medical Research 3 (7), pp. 419-422.

Teslow, J. L. (1995). ‘Humor me: A call for research’. Educational Technology Research and Development 43 (3), pp. 6-28. doi: https://doi.org/10.1007/BF02300453.

Torok, S. E., McMorris, R. F. & Lin, W. C. (2004). ‘Is humor an appreciated teaching tool? Perceptions of professors’ teaching styles and use of humor’. College Teaching 52 (1), pp. 14-20. doi: https://doi.org/10.3200/CTCH.52.1.14-20.

Tsukawaki, R., Kojima, N., Imura, T., Furukawa, Y. & Ito, K. (2019). ‘Relationship between types of humour and stress response and well-being among children in Japan’. Asian Journal of Social Psychology 22 (3), pp. 281-289. doi: https://doi.org/10.1111/ajsp.12369.

Valentine, L. & Gabbard, G. O. (2014). ‘Can the use of humor in psychotherapy be taught?’ Academic Psychiatry 38 (1), pp. 75-81. doi: https://doi.org/10.1007/s40596-013-0018-2.

Wanzer, Melissa B., Frymier, A. B. & Irwin, J. (2010). ‘An explanation of the relationship between instructor humor and student learning: Instructional humor processing theory’. Communication Education 59 (1), pp. 1-18. doi: https://doi.org/10.1080/03634520903367238.

Wanzer, Melissa Bekelja, & Frymier, A. B. (1999). ‘The relationship between student perceptions of instructor humor and students’ reports of learning’. Communication Education 48 (1), pp. 48-62. doi: https://doi.org/10.1080/03634529909379152.

Ziegler, J. B. (1998). ‘Use of humour in medical teaching’. Medical Teacher 20 (4), pp. 341-348. doi: https://doi.org/10.1080/01421599880779.

Ziv, A. (1976). ‘Facilitating effects of humor on creativity’. Journal of Educational Psychology 68 (3), pp. 318-322. doi: https://doi.org/10.1037/0022-0663.68.3.318.