Media Training for Residents in
Obstetrics and Gynaecology:
Improving Communication Skills and
Advocacy for Women’s Health
Julie L.Tessier, MD, FRCSC1 Abstract
Philip M. Hahn, MSc2 Objective: To measure the effectiveness of a media training program on confidence and com-
Robert L Reid, MD, FRCSC3 munication skills in an interview situation dealing with menopause and perimenopause issues.
Subjects: Eighty-two residents in obstetrics and gynaecology from the 16 Canadian training
Division of Reproductive Endocrinology1-3 programs.
Department of Obstetrics and Gynaecology Main outcome measurements: A pre-workshop quiz assessed residents’ media experience,
Queen’s University attitudes and beliefs, knowledge, and confidence in dealing with the media. Knowledge and
Kingston ON confidence levels were reassessed with a post-workshop quiz. Pre-and post-workshop
videotaped interviews with the residents by a professional media training team (NBA
Communications, Ottawa, Ontario) were assessed for eight separate communication skills
by a media consultant blinded to the order (scoring: poor = 0, fair = 1, good = 2, excel-
lent = 3; maximum composite score = 24).
Results: Fifty-eight residents (71%) had no media experience whatsoever. While 76 percent
felt they had a responsibility to actively participate in public education programs, only nine
percent felt they could convey a message with impact. After the workshop, 89 percent of
the residents felt they were better able to convey a message to the media and 87 percent
felt they could better respond to difficult questions. An improvement in communication
skills was demonstrated by 69 percent of the residents and the composite interview score
increased by an average of 2.8 points (95% confidence interval = 1.5-4.2).
Conclusions: This focused, one-day workshop was an effective means to build residents’ con-
fidence as public educators and to improve their communication skills.
Objectif : Mesurer l’effet d’un programme de formation médiatique sur la capacité de faire
preuve d’assurance et d’aptitudes communicatives pour mener des interviews portant sur
des questions liées à la ménopause et à la périménopause.
Sujets : Quatre-vingt-deux résidents en obstétrique et gynécologie tirés des 16 programmes
de formation canadiens.
Mesure des principaux résultats : Un questionnaire donné avant l’atelier a évalué l’expé-
rience des résidents avec les médias, ainsi que leurs attitudes, leurs opinions, leurs con-
naissances et leur degré de confiance par rapport aux médias. Leurs connaissances et leur
degré de confiance ont été évalués de nouveau au moyen d’un questionnaire rempli après
l’atelier. Une équipe de formation médiatique professionnelle (NBA Communications,
Key Words Ottawa, Ontario) a enregistré, sur bande magnétoscopique, les entrevues menées par les
Mass media, communication, public résidents avant et après l’atelier et un expert-conseil en médias, inconscient de l’ordre, les
education, menopause a évalués suivant huit aptitudes de communication différentes (scores : faible = 0, pas-
sable = 1, bien = 2, ou excellent = 3 ; score composite maximum = 24).
Supported by an unrestricted Résultats : Cinquante-huit résidents (71 %) n’avaient aucune expérience des médias. Alors
educational grant to the SOGC from que 76 pour cent croyaient que c’était leur responsabilité de participer activement à des
Wyeth-Ayerst. programmes d’éducation publique, seulement neuf pour cent se croyaient capables de
transmettre un message de façon efficace. Après l’atelier, 89 pour cent des résidents
Competing interests: none declared croyaient être mieux préparés à communiquer un message par les médias et 87 pour cent
se sentaient mieux préparés à répondre à des questions difficiles. Soixante-neuf pour cent
Received on January 24th, 2001. des résidents ont fait preuve d’une amélioration en aptitude à communiquer et le score
Revised and accepted on March 9th, 2001. composite à l’interview s’est amélioré, en moyenne, de 2,8 points (IC de 95 % = 1,5 à 4,2).
JOURNAL SOGC 1 JUNE 2001
Conclusion : Cet atelier d’une journée, portant sur un point précis, s’est avéré un moyen
efficace d’améliorer la confiance des résidents dans leur rôle d’éducateurs de public et
leurs aptitudes de communication.
J Soc Obstet Gynaecol Can 2001;23(6):495-500
INTRODUCTION experience, beliefs and attitudes about the media and public edu-
cation, and their level of confidence in dealing with the media.
A 1994 Gallup survey identified that most women between This was followed by a simulated, videotaped interview about
the ages of 45 and 60 received information about menopause controversial menopause- or perimenopause-related issues.
from the media, even though this source may not always be Participants were then exposed to a two hour interactive
accurate and unbiased. An analysis of the lay literature on English and French language media training session that
menopause found that most articles blended opinion with fact, highlighted pitfalls of not being prepared, and developed strate-
and many of the authors of these articles did not have any stat- gies for acing an interview by getting the “corporate message”
ed qualifications in midlife women’s health.1 Physicians have across, no matter what the line of questioning. Video clips of
the opportunity to provide the information women need to disastrous interviews alerted participants to the dangers of
make educated choices about health and well-being, but they underestimating the potential of a reporter determined to cor-
have little training in media skills.2,3 rupt a simple message. Residents were shown how to prepare
The CanMEDS 2000 project4 is a Royal College of Physi- for an interview by obtaining information on the topic and
cians and Surgeons of Canada initiative to broaden the reporter’s angle, as well as names of others being interviewed
scope of medical training programs, and to ensure that post- for the same story. When a newspaper or research finding was
graduate training programs are fully responsible to societal to be discussed, they learned not to comment on it until see-
needs.3 Today’s physicians are expected to be effective com- ing a copy of the publication and then discussing it with other
municators and health advocates, in addition to their tradi-
tional roles of medical expert and decision-maker. When
psychiatry residents at the University of Toronto responded FIGURE 1
to a 1997 survey about the new roles outlined by CanMEDS FLOW DIAGRAM OF
2000, 22 percent felt they were not fully prepared to convey WORKSHOP COMPONENTS
information to patients and family, and 72 percent felt they
were not fully prepared to recognize and respond to situations
when advocacy is needed.5
Implementation of these new roles will require novel edu-
cational strategies and workshops in communication skills. It
follows that evaluation strategies are critical in the development
of any educational initiative. The Association of Professors of
Obstetrics and Gynaecology (APOG) and the Society of 1st videotaped interview *
Obstetricians and Gynaecologists of Canada (SOGC) have
responded with knowledge building and media training work-
shops for residents. The objective of this study was to measure Interactive media training session
the effectiveness of these new educational programs on confi-
dence and communication skills in dealing with the media.
METHODS (menopause 1999/perimenopause 2000)
On June 12, 1999, 41 residents from all 16 Canadian acade-
mic medical centres gathered in Toronto to take part in a 2nd videotaped interview *
menopause knowledge building and media training workshop.
The program was conducted with 41 more residents on
November 4, 2000 with a focus on perimenopause. A flow dia- Post-workshop quiz
gram of the workshop components is shown in Figure 1.
Detailed evaluations of each resident’s opinions, experience, * Blinded assessment by media consultant
and performance were obtained. Residents filled out a pre- (1999 program only)
workshop quiz designed to assess the extent of their media
JOURNAL SOGC 2 JUNE 2001
knowledgeable colleagues. They observed techniques for reach- to the media. Overall, residents learned that what may appear
ing out to the public and media through proper dress, posture, to be a simple, effective presentation to the media is often the
eye contact, use of lay terms, and a calm, honest demeanour result of careful planning, preparation, and practice.6,7
even in the face of a hostile reporter. Bridging techniques were Media training was followed in the afternoon by knowl-
emphasized to allow a return to the key message, no matter edge building sessions provided by two obstetrician/gynaecol-
where the reporter’s questions were headed. Timeliness of ogists (Robert Reid in English and Michel Fortier in French).
response and respect for the pressures on the reporter were The 1999 workshop focused on learning more about
among several measures taught to improve future interac- menopause as a public health issue, covering medical and social
tions with those responsible for conveying medical information aspects including heart disease, osteoporosis, lifestyle, hormone
replacement therapy, and the controversy over breast cancer.
The 2000 workshop covered perimenopausal issues including
abnormal uterine bleeding, premenstrual syndrome, concep-
tion, and counselling about menopause. Residents received a
PRE-WORKSHOP QUIZ: BASELINE comprehensive visual presentation package on “The
EXPERIENCE, ATTITUDES AND BELIEFS,
Menopause” and “The Perimenopause” respectively for use in
KNOWLEDGE, AND CONFIDENCE LEVEL (n = 82)
future public forums. At the conclusion of the training session
Media experience Response each resident had a second, simulated, videotaped interview
None 71% and then completed a post-workshop quiz to reassess confi-
Newspaper 12% dence levels and understanding of the media; after which the
Radio 10% group gathered for a plenary wrap-up session.
Television 7% A professional media training team assembled by NBA
Newspaper, radio, and television 6% Communications of Ottawa, Ontario designed the question-
Attitudes and beliefs about the media naires and accumulated the results.8,9 In the 1999 program, a
media consultant blinded to the order assessed the pre- and
Necessary tool to reach the public 90%
post-workshop videotaped interviews. Eight media skills and
Create controversies 73%
abilities (composure under pressure, overall demeanour, level
Distort what people say 50%
Do a fair job of reporting overall 39%
of language, ability to make people relate to topic, remem-
bering the corporate message, ability to stay on topic, ability
Knowledge to offer sound bite, ability to direct or redirect interview) were
How to convey a message with impact 9% scored from 0 to 3 (0 = poor, 1 = fair, 2 = good, 3 = excel-
How to prepare for an interview 6% lent), giving a 24 point maximum for the composite score.
What is needed to “ace” an interview 5% These ordinal scores were analyzed using the Wilcoxon signed
What to expect from the media 5% ranks test, which considers the ranks of the paired differences
Confidence level (after-before). Bonferroni corrections were applied to control
for multiple significance testing. The composite interview
Perceived favourably by peers when participating scores were treated as continuous data and analyzed using a
in public education program 43%
paired t-test. Statistical tests were generated using SPSS for
Fearful of an attack by an aggressive member
Windows, Release 10, SPSS Inc.
of a special interest group 39%
Confident in ability to convey an understandable
message to lay people 35%
Comfortable presenting information to a large
audience 33% PRE-WORKSHOP QUIZ:
Able to “handle” questions 23% CONCERNS ABOUT MEDIA INTERVIEWS (n = 82)
Feelings about public education programs Concerns about doing media interviews Mean
and the media Nervousness 3.9
Felt responsible for actively participating 75% Inability to convey message 3.7
Felt favourably perceived by peers when Forgetting 3.6
educating the public 43% Having one’s words taken out of context 3.5
Felt that self-promotion may lead to Not being in control of the interview 3.4
unrealistic public expectations about new
(often experimental) procedures 21% (scale: 1 = very small; 5 = very big)
JOURNAL SOGC 3 JUNE 2001
RESULTS believed the media are a necessary tool to reach the public. The
residents’ biggest concern about participating in media inter-
PRE- AND POST-WORKSHOP QUIZ views was nervousness. Only five residents knew how to pre-
The results of the pre-workshop quiz are given in Tables 1 and 2. pare for an interview, and overall their confidence in dealing
Seventy-one percent of the 82 residents said they had no media with the media was low.
experience whatsoever. Seventy-three percent of residents The results of the post-workshop quiz are given in Table 3.
believed that the media create controversies, but 90 percent After media training, 89 percent of residents felt they had a
better understanding of how to convey a message to the media,
and 81 percent felt more confident about doing a real media
POST-WORKSHOP QUIZ: SELF-EVALUATION (n = 82)
Media training Response SIMULATED, VIDEOTAPED INTERVIEWS
Thirty-five of the 41 residents (85%) from the first year had
Better understand the media/reporters 94%
complete records for analysis. Defective tapes (n = 2), inaudi-
Better understand how to avoid common
pitfalls and media traps 93% ble sound (n = 2), and missing data (n = 2) accounted for the
Better understand how to convey a message remainder. The pre- and post-workshop interview scores of the
to the media 89% eight communication skills are given in Table 4. A significant
More confident in dealing with difficult or improvement was observed in two areas: remembering the
hostile questions from the media 87% “corporate message” that all women deserve information on
Better understand how to prepare an their options at menopause to allow them to make informed
interview 86% decisions (p = 0.008), and the ability to stay focused on the
More confident about doing a real media topic or issue (p = 0.024). Sixty-nine percent of residents were
interview 81% better able to remember and reiterate the “corporate message,”
Menopause or perimenopause and 54 percent were better able to stay focused on the topic or
knowledge-building issue. Significant improvements in interview scores were not
found for the other six communication skills (Table 4). Less
Recognize the importance of participating
in public information forums 93% than half of the residents showed improvement for composure
More confident about doing a presentation under pressure (43%), overall demeanour (31%), ability to
on menopause or perimenopause 89% direct or redirect interview (37%), offering a sound bite (31%),
More confident in dealing with difficult or making people relate to the topic by using anecdotes (29%),
hostile questions from the media 81% and using lay terms (20%).
PRE- AND POST-WORKSHOP SCORES OF EIGHT
COMMUNICATION SKILLS FROM VIDEOTAPED INTERVIEWS
Communication Skills Mean Score
(n = 35)
Pre Post Difference p value *
1. Composure under pressure (stress management) 2.0 2.2 0.2 0.109
2. Overall demeanour (mannerisms, gestures) 1.7 1.7 0.0 0.800
3. Level of language (lay terms / too technical) 1.8 1.9 0.1 0.334
4. Able to make people relate to topic (anecdotes) 1.0 1.0 0.0 1.000
5. Remember corporate message (spokesperson) 0.5 1.9 1.4 0.001 †
6. Able to stay on topic (issue) 1.8 2.4 0.6 0.003 ‡
7. Able to offer sound bite 1.9 2.1 0.2 0.087
8. Able to direct/redirect interview 2.2 2.3 0.1 0.333
* Wilcoxon Signed Ranks Test (for paired ordinal data)
† p = 0.008;
‡ p = 0.024 (Bonferroni correction for eight comparisons)
JOURNAL SOGC 4 JUNE 2001
Post-workshop composite scores reflecting overall com- sports, but health news. Arizona Dental Association Director
munication skills during an interview were significantly high- of Public Relations Tina Strickler states:
er by an average of 2.8 points (p < 0.001, paired t-test, 95% One of the most valuable things about media training is that
confidence interval = 1.5-4.2, n = 35). The mean pre- and post- it helps dentists realize that their dental training and clinical
workshop composite scores (± SD) were 12.8 ± 3.0 and experience alone won’t see them through when they talk to
15.6 ± 3.9 respectively. Twenty-four residents (69%) demon- a reporter. If they’re going to represent dentistry in the pub-
strated improved post-workshop composite scores, and four lic spotlight, they have to know they can’t wing it. A suc-
showed higher scores by eight points or more. cessful interview depends on preparation and practice.6
The American Dental Association maintains a stable of official
DISCUSSION spokespeople as consumer advocates, who have undergone
media training and are poised to respond to critical situations.
The media training workshop was an effective means of broad- Most of the residents felt that the media tend to create con-
ening the residents’ knowledge base about important health issues troversy and distort the facts, yet are a necessary tool to reach
and improving their overall communication skills. The participants the public. This uneasy relationship between medical scientists
gained confidence as public educators and were better equipped and the media was spotlighted by the “pill scare” of October
to take on future roles as community health advocates. 1995.10,12,13 Many women taking third generation combined
The ability to remember and reiterate the “corporate mes- oral contraceptives experienced uncertainty, concern, and
sage” that all women deserve information on their options at panic. The consequences of over-reporting the adverse effects
menopause was the area where residents showed the greatest of oral contraceptives to the general public included pill
improvement, followed by their ability to stay on topic. discontinuation, a rise in abortion rates, and a doubling of the
Although residents did not improve their abilities to direct and average consultation time taken to discuss contraception. More
redirect the interview and to offer sound bites, their post-work- recently, the collaborative reanalysis of data from epidemiolog-
shop scores in these areas were high. The participants’ overall ical studies on hormone replacement therapy (HRT) and breast
demeanour and use of body language to support their state- cancer was leaked before official publication in The Lancet
ments did not improve, which was not surprising, as innate and misinterpreted by a reporter of the Sunday Times:14,15
mannerisms and gestures are resistant to change. a small increased relative risk of 1.023 for breast cancer among
The use of lay language is critical when spokespersons are HRT users was reported with a 100-fold error as 2.3. British
relating complex medical information to the public and women became alarmed by the bold newspaper headline,
media,6,10 and residents did not improve in this key area. As well, “HRT link to breast cancer proved.” The Medicines Control
average scores from the first round of interviews indicated that Agency responded to this mayhem with reassuring statements
the residents’ ability to make the audience relate to the topic was to physicians and the public explaining the increased risk in
only fair, with no improvement in the second round of inter- absolute terms, and The Lancet published an accompanying
views. Further development and strengthening of this ability is commentary putting the findings in perspective.16
key, particularly when addressing medical issues which can be The media will always report and even exaggerate “bad
complex and hard to translate into lay terms. The use of anec- news” since that is what sells.12,17-19 The present course was suc-
dotes and imagery could be expanded upon in future courses. cessful in providing residents with the necessary communication
Analysis of individual communication skills was restricted tools to respond to the media in an appropriate and measured
due to the small sample size and the four point ordinal scale fashion. The new physician roles mandated in CanMEDS 2000
(0 to 3) which limited subtle changes between pre- and post- require new educational opportunities, and APOG and the
workshop scores. Many participants had pre-workshop scores SOGC are responding to this challenge.
of 2 or 3, which left little or no room for improvement. For
example, 30 of the 35 residents had pre-workshop scores of ACKNOWLEDGEMENTS
2 or 3 (good or excellent) for composure under pressure. This
would be expected since medical residents, by the very nature • Program Director: Dr. Robert Reid, Past President, SOGC.
of their vocation, generally have good stress management and • Media Training Team, NBA Communications (1999-2000):
ability to face hostile questions and controversy. In contrast, Jocelyne Beaulieu (Director), Paul Howard, Shawn Murray,
remembering the “corporate message” is probably a concept Lucie Boileau, Kathleen Tourigny, Michel Rodrigue, Karen
not practised during residency training, and pre-workshop McCarthy, Christine Fish, Lisa Brazeau.
scores were lower in this area. • Media Training Team (2000): Nadia Bouchard, Edith
Physicians are the most trusted source of medical infor- Dauphinais, Mélanie Goulette, Rosemary Hnatiuk, Sandra
mation,11 and Gallup polls in the late 1980s have indicated Upeslacis, Mohamed Boudjenane, Helena Moncrieff,
that what people wanted most was not more weather and Neil Walker, Rainer Stadus.
JOURNAL SOGC 5 JUNE 2001
• Menopause/Perimenopause Training Team:
Dr. Robert Reid (English), Dr. Michel Fortier (French).
• Research Team: Dr. Julie Tessier (1999), Dr. Robert Reid,
Phil Hahn, André Nadeau, Jocelyne Beaulieu, Nadia
Bouchard, Karen Flanagan-McCarthy (1999).
• SOGC Observers: Dr. André Lalonde, Rosemary Killeen
(1999); Louise Tremblay (2000).
• APOG Observer: Dr. Salim Daya (2000).
• Special thanks to: Terry Davidson, Mike Hill, James Carver,
Ron Quinlan, and Luke Lukic of Wyeth-Ayerst for their support.
1. Carlson ES, Li S, Holm K.An analysis of menopause in the popular
press. Health Care Women Int 1997;18(6):557-64.
2. Hoffman-Goetz L, Dwiggins S.Teaching public health practitioners
about health communication: the MPH curriculum experience. J Com-
mun Health 1998;23(2):127-35.
3. Rich M, Miriam Bar-on. Child health in the information age: media edu-
cation of pediatricians. Pediatr 2001;107(1):156-62.
4. Societal Needs Working Group. CanMEDS 2000 project: skills for the
new millennium.Ann R Coll Physician Surg Can 1996;29(4):207-16.
5. Sinai J, Hodges B.An evaluation of the CanMEDS roles with psychiatry
residents: a pilot study.Annals; RCPSC 1999.32(7):398-402.
6. Curtis EK.Are you ready for your 15 minutes of fame? Contact Point
7. Kelly CC. Dealing with the news media: effective communication strate-
gies for medical examiners.Am J Forensic Med Pathol 1998;19(2):181-5.
8. NBA Communications. Results of SOGC-APOG resident training
workshop on menopause and the media. September 1999.
9. NBA Communications. Results of SOGC-APOG resident training
workshop on perimenopause/menopause and the media. November
10. Egarter C, Strohmer H, Lehner R, Foldy M, Leitich H, Berghammer P.
Contraceptive knowledge and attitudes of Australian adolescents after
mass media reports linking third-generation oral contraceptives with an
increased risk of venous thromboembolism. Contracept 1997;56:147-52.
11. Arnold DE, Holm RP.The quantity and quality of medical information
available to the public. S Dakota J Med 1996;49(2):69-74.
12. Martinez F. Responsibility of health providers and the media in response
to scientific information. Eur J Contracept Reprod Health Care
13. Wetherall MW.The “pill scare” of October 1995, the media, and the
public understanding of science. Br J Fam Plann 1996;347:1533-5.
14. Collaborative Group on Hormonal Factors in Breast Cancer. Breast can-
cer and hormone replacement therapy: collaborative reanalysis of data
from 51 epidemiological studies of 52,705 women with breast cancer
and 108,411 women without breast cancer. Lancet 1997;350:1047-59.
15. Horton R. ICRF: from mayhem to meltdown. Lancet 1997;350:1043-4.
16. LaCroix AZ, Burke W. Breast cancer and hormone replacement thera-
py. Lancet 1997;350:1042-3.
17. Chadwick P. Do media help or harm public health? Aust NZ J Publ
18. Smith ER. Medicine and the media. Can J Cardiol 2000;16(4):527-8.
JOURNAL SOGC 6 JUNE 2001