Medical knowledge is extremely vast and continues to advance with each day, making it extremely challenging for medical students. Further, as every learner differs from another, it becomes quite essential that teaching–learning sessions are organised in such a way that it meets the need of different types of learners.[1] In other words, it means employing a combination of a wide range of innovative teaching–learning methods (such as problem-based learning, flipped classrooms, brainstorming, case-based learning, and team-based learning) and not restricting to only didactic lectures. The adoption of different methods plays a crucial role in enabling deep learning and aiding students to attain the learning competencies.
One of the innovative teaching–learning methods has been the use of comics in the field of delivering medical education and improving patient care.[2] It will not be wrong to state that the use of comics as an authentic approach to medical education delivery might not be very popular amongst the general population; nevertheless, its utilisation and integration into medical education have significantly increased in the last decade.[1,2] In fact, comics are no longer a tool just for entertainment but have also immense potential to advance medical education and benefit students as well as augment patient care.[2] In fact, when compared with standard text-based printed material, comics appeal to us on the emotional plane and thus augment learning.[2,3] Moreover, as comics tend to provide both visual and textual information, they significantly augment student engagement, which cannot be accomplished with text alone. In other words, comics tend to emerge as an option that can merge text and image with emotion and fun and thereby appeal to different senses.[1–4]
The utility of comics in the delivery of medical education can be explained in different ways, namely mediation of varied emotional states upon errors made while diagnosis, highlighting illustrations about the good and bad practices of medicine (viz. doctor–patient interaction), strategies to prevent or correct errors and enabling medical students to acknowledge their involvement in medical or evidence-based research, apart from educating the learners.[1,3,4] In addition, the comics have found immense scope in the communication of health messages as well and thus have been envisaged. Further, these are wonderful tools to provide relevant information about experiencing an illness and to teach students observational skills.[4,5] Moreover, as comics can be accessed by medical students via different media (such as online publications, and paper media), it creates an opportunity to teach complex topics and create awareness about stigma/discrimination and inequalities in health.[5,6] It is quite important to realise that the effectiveness of comics depends not only on what is being evident but also on what is inferred.[3–6]
In general, comic books act as a platform for the students as well as for the healthcare professionals to understand the inner feelings by establishing a connection at an emotional level with the patients.[2] Further, comics have proved to be of utility in the patients who lack access to the expertise of the doctors. These comics have helped patients to understand and accept their specific illnesses and they feel more confident to interact about the same with their treating physicians.[3,4] Moreover, upon reading some of the comics, the treating physician can get deep insights into the emotional state, and this will enable them to plan and deliver care with more empathy.[5,7]
Specific evidence is available to suggest that comics have been immensely successful in creating awareness amongst the general population about non-communicable diseases, mental disorders, sexually transmitted infections, substance abuse, etc.[7–9] The utility in some of these illnesses is quite good as patients do not find it comfortable to communicate about them freely.[7,8] Comics have been used to highlight narratives of patients and use the same for the sake of prevention of cancer in developed nations. At the same time, comics have been employed to train medical residents about different aspects of patient safety and thereby improve the quality of care.[10] In another setting, comic books were utilised to run an obesity prevention programme, and they delivered encouraging results.[11]
Owing to the very fact that the presentation of ideas and messages in the form of comics simplifies the overall message, in the testing times of the on-going severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) disease (COVID-19) pandemic, comic was employed to spread the message of why a distance of 2 m should be maintained between two individuals and how it can interrupt the chain of transmission of the infection.[12] On a similar note, comics have been extensively used to spread awareness about different issues of public health concern.[9] Comics have been used as a tool to teach internal medicine residents about the need and ways to ensure patient safety in hospital and domiciliary settings.[10] In another setting, comics were used as an innovative strategy to reduce obesity amongst the general population and the results of the study provided encouraging results.[11]
Like any intervention, even the use of comics in medical education and clinical practice has its own challenges. The first and foremost challenge is that comics are generally looked upon as just a source of humour and entertainment and not as a tool that can be used in a serious profession like medicine.[4,6] This outlook has to change as there are multiple incidents across the globe, suggesting the use and application of comics in strengthening the delivery of medical education. Further, as the use of comics in medical education in various settings is still finding its feet, a lot of research needs to be done to precisely understand the scope of them in improving diagnostic skills, or enhancing empathy, or improving doctor–patient communication.[7–9] As rightly said, comics are indeed new in medical education; nevertheless, encouragement of proper research is expected to provide us with all the evidence in the due course of time to proactively support the practice.[7,8]
To conclude, the integration of comics in medical education and patient care is an innovative approach to strengthen the overall process of curriculum delivery. The need of the hour is to understand its scope and then use in relevant settings to make it more effective and beneficial to different stakeholders.
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8. Dworkin MS, Peterson CE, Gao W, Mayor A, Hunter R, Negron E, et al. Efficacy of a food safety comic book on knowledge and self-reported behavior for persons living with AIDS. PLoS One 2013;8:e72874
9. Araya B, Pena P, Leiner M. Developing a health education comic book: The advantages of learning the behaviours of a target audience. J Vis Commun Med 2021;44:87-96
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11. Branscum P, Sharma M, Wang LL, Wilson BR, Rojas-Guyler L. A true challenge for any superhero: An evaluation of a comic book obesity prevention program. Fam Community Health 2013;36:63-76
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