PHILADELPHIA-Researchers at the University of Pennsylvania have created a new training tool for medical students, a CD-ROM that examines how television medical dramas present ideas about doctors that may affect how patients interact with real physicians.

Approximately 20,000 first-year medical students will get the CD-ROM as part of the traditional ceremony in which they're presented white lab coats welcoming them into medical school.

The 20-minute disk "Prime Time Doctors: Why Should You Care?" contains TV clips from popular prime-time medical series such as "ER," "Gideon's Crossing" and "Ben Casey."

Joseph Turow, a professor in Penn's Annenberg School for Communication, who studies the relationship between television and the medical community, produced the CD-ROM through a grant from The Robert Wood Johnson Foundation.

According to Turow, the take-away message from the CD-ROM is that real doctors should be aware of the images presented about them in popular culture.  They should talk to patients to try to understand if and how media images of health care affect them.

The CD-ROM will provide U.S. medical students a forum for dialogue via a password-enabled Web site and bulletin board on which they can post opinions about TV medicine as they face the actual medical world.

Turow said that he hopes his CD-ROM will assist physicians-to-be  to communicate effectively with patients.

Turow wrote the script and led a team of graduate students in assembling TV clips and other materials for the disk.  The multi-media essay places contemporary prime-time doctors into historical perspective.  

It presents a clip from a 1940 "Dr. Kildare" movie that shows an operation by a surgeon that was accepted as heroic back then but today would be considered malpractice.  It contrasts a 1963 speech from "Ben Casey" about the social-service role doctors should take to eliminate child abuse with a 2000 "City of Angels" clip in which doctors' ability to even define child abuse is unclear.  

These and other vignettes raise ethical questions about issues like end-of-life-decisions, doctors' rights and malpractice.  Overall, they show that, compared to programs before 1980, today's TV programs depict physicians as far less in control over individual patients and society health policies.  Instead, an impersonal system guides doctors and patients alike.

Turow argues that TV images influence the way patients think about physicians and the places where they work.  

"Doctor shows bring viewers behind the scenes to portray how health-care providers behave when they and their patients are in crisis," Turow said.  "A lot of those images are not always comforting ones.  A study we conducted for the Kaiser Family Foundation in 2000 found that just about every medical series had at least one major malpractice story line.  The doctors were often at fault.  The focus was almost always on scary physician missteps.  TV's continual message is that doctors are quite fallible.  That may well frighten many patients."

At the same time, Turow pointed out that prime-time TV presents a powerful message for real-life physicians that, despite personal and professional troubles and bureaucratic roadblocks, doctors consistently care about their patients and have their best interests at heart.