In college, I minored in film because I love movies so much. One of my most influential classes was called “Sight, Sound, and Motion”. This class delved into physics on cinema and the way filmmakers manipulate each of these elements to evoke emotions and tell stories. I truly believe this class has made me a better doctor and in the following blog post, I am going to demonstrate how by studying the way films are made and how they can do the same for you.

Sight:

Just as color grading sets the tone in movies, the colors we encounter in healthcare settings can influence patient behavior and perception. Research shows that colors evoke specific emotions and reactions, offering valuable insights into creating healing environments tailored to patients' needs. In one study, people who worked in different colored offices and those in the red office felt as if it was distracting. They preferred the white office, but they actually made less mistakes in the red office [1]. Another found that prison inmates had less episodes of agitation and aggression when their cells were painted pink [2]. Hospital’s are often neutral colors like white, which is interesting because Fairweather et al. found that white prison cells led to more violent reactions than other colored cells [3].

In one study, natural wood was found to lead to less wandering from elderly patients [4]. Gulak et al provides guidelines for psychiatric hospitals and recommends blue and green to create a relaxing and calm environment and warm colors to promote social and physical activity [5]. The color of your scrubs has also been found to be important to patient care. Black scrubs leads to patient’s perceiving their physician as less caring and trustworthy, and they associate them with death [6].

Lighting is very important to the atmosphere of a hospital as well, and patients want hospitals to look good [7]. Patient’s prefer natural light and also windows have been found to lead to shorter lengths of stay and fewer doses of analgesics [8,9].

Sound:

From iconic sound effects to ambient noises, sound plays a crucial role in storytelling – both on screen and in hospitals. Understanding the impact of noise levels on patient experience allows us to create quieter, more calming environments conducive to healing.

Emergency departments are loud. One study out of Australia found that at times, the ED is as loud as a construction site which is 102.8 decibels [10]. The effect of volume on ED patients has not been studied, but ICU studies have found that loud ambient sounds lead to poor sleep [11].

The noise may affect our patients, but it actually doesn’t affect physicians as much. ED physicians have been found to make no more mistakes in loud environments than quiet ones [12]. We intubate just as well in both environments too[13].

On the musical side of sound, physicians feel that ambient classical music improves our performance, and patient families feel more at ease when it is playing in the waiting room [14,15].

Motion and Framing:

Camera angles and framing influence how viewers perceive characters and scenes in movies. Similarly, our body language and positioning during patient encounters can affect the patient-provider dynamic. By adopting a patient-centered approach to communication, we can build trust and rapport with those under our care. Patients want us to sit down more when speaking to them [16]. Sitting and meeting patient’s at eye level has been found to be associated with improved communication and higher patient satisfaction scores [17,18].

Representation and Diversity:

Movies serve as a reflection of the human experience and therefore diversity in media matters. When people see actors that look like them on screen living lives similar to their own, their experience is validated. Similarly, there is a need for diversity in medicine. Diversity in medicine leads to improved educational experiences and also better patient outcomes. Just as we advocate for diversity in medicine, we must strive for inclusivity in the stories we tell on screen. Representation matters, shaping patient outcomes and healthcare disparities [19].

In conclusion, my journey from movie enthusiast to physician has taught me invaluable lessons about the power of storytelling, aesthetics, and representation in medicine. By incorporating insights from film theory into patient care, we can create more compassionate, patient-centered healthcare environments.

Note: Portions of this presentation were inspired by academic sources and personal experiences.

AUTHOR: Fahad Ali, MD, is a fourth-year emergency medicine resident at Brown Emergency Medicine. He is also the current resident Chief of Diversity, Equity & Inclusion.

FACULTY REVIEWER: Dr. Kristina McAteer

References

1.     Kwallek, Nancy, and Carol M. Lewis. "Effects of environmental colour on males and females: A red or white or green office." Applied ergonomics 21.4 (1990): 275-278.

2.     Bennett, C. Peter, Alan Hague, and Christopher Perkins. "The use of Baker-Miller pink in police operational and university experimental situations in Britain." International Journal of Biosocial & Medical Research (1991).

3.     Fairweather, Leslie, and Sean McConville. Prison architecture. Routledge, 2013.

4.     Cooper, B., A. Mohide, and S. Gilbert. "Testing the use of color in a long-term care setting." Dimensions in health service 66.6 (1989): 22-24.

5.     Gulak, Morton B. "Architectural guidelines for state psychiatric hospitals." Psychiatric Services 42.7 (1991): 705-707.

6.     Hribar, Casey A., et al. "Association between patient perception of surgeons and color of scrub attire." JAMA surgery 158.4 (2023): 421-423.

7.     Caspari, Synnøve, Katie Eriksson, and Dagfinn Nåden. "The importance of aesthetic surroundings: A study interviewing experts within different aesthetic fields." Scandinavian journal of caring sciences 25.1 (2011): 134-142.

8.     Haans, Antal. "The natural preference in people's appraisal of light." Journal of Environmental Psychology 39 (2014): 51-61.

9.     Ulrich, Roger S. "View through a window may influence recovery from surgery." science 224.4647 (1984): 420-421.

10.  Adams, Corey, et al. "As loud as a construction site: Noise levels in the emergency department." Australasian Emergency Care 27.1 (2024): 26-29.

11.  Xie, Hui, Jian Kang, and Gary H. Mills. "Clinical review: The impact of noise on patients' sleep and the effectiveness of noise reduction strategies in intensive care units." Critical Care 13 (2009): 1-8.

12.  Folscher, Lindy-Lee, et al. "Emergency department noise: mental activation or mental stress?." Emergency Medicine Journal 32.6 (2015): 468-473.

13.  Getto, Leila P., et al. "The effect of noise distraction on emergency medicine resident performance during intubation of a patient simulator." The Journal of emergency medicine 50.3 (2016): e115-e119.

14.  Gatti, Maria Fernanda Zorzi, and Maria Júlia Paes da Silva. "Ambient music in the emergency services: the professionals' perception." Revista latino-americana de enfermagem 15 (2007): 377-383.

15.  Holm, Lydia, and Laura Fitzmaurice. "Emergency department waiting room stress: can music or aromatherapy improve anxiety scores?." Pediatric emergency care 24.12 (2008): 836-838.

16.  Golden, Blair P., et al. "Sitting at the bedside: Patient and internal medicine trainee perceptions." Journal of general internal medicine 37.12 (2022): 3038-3044.

17.  Tackett, Sean, et al. "Appraising the practice of etiquette-based medicine in the inpatient setting." Journal of general internal medicine 28 (2013): 908-913.

18.  Orloski, Clinton J., et al. "Grab a seat! Nudging providers to sit improves the patient experience in the emergency department." Journal of patient experience 6.2 (2019): 110-116.

19.  Kelly‐Blake, Karen, et al. "Rationales for expanding minority physician representation in the workforce: a scoping review." Medical Education 52.9 (2018): 925-935.