End-of-life discussions can be stressful and can elicit strong emotions in the provider as well as the patient and family. In palliative care, understanding and effectively addressing emotions is a key skill that can enhance professional competency and patient/family satisfaction with care. We illustrate how in coursework for a Master's degree in palliative medicine we used dramatic ''action methods'' derived from sociodrama and psychodrama in the portrayal of two challenging cases to train providers in the emotional aspects of caring for patients with advanced cancer. We describe the specific techniques of constructing and enacting case scenarios using warm-ups, role-creation, doubling and role-reversal. In particular, we illustrate how these techniques and others were used to reveal and address the ''hidden'' emotions, attitudes, and values that were central to the communication dilemma. Finally, we present an evaluation completed by the 26 participants who attended the course.
We introduce the technique of sociodrama, describe its key components, and illustrate how this simulation method was applied in a workshop format to address the challenge of discussing transition to palliative care. We describe how warm-up exercises prepared 15 learners who provide direct clinical care to patients with cancer for a dramatic portrayal of this dilemma. We then show how small-group brainstorming led to the creation of a challenging scenario wherein highly optimistic family members of a 20-year-old young man with terminal acute lymphocytic leukemia responded to information about the lack of further anticancer treatment with anger and blame toward the staff. We illustrate how the facilitators, using sociodramatic techniques of doubling and role reversal, helped learners to understand and articulate the hidden feelings of fear and loss behind the family's emotional reactions. By modeling effective communication skills, the facilitators demonstrated how key communication skills, such as empathic responses to anger and blame and using "wish" statements, could transform the conversation from one of conflict to one of problem solving with the family. We also describe how we set up practice dyads to give the learners an opportunity to try out new skills with each other. An evaluation of the workshop and similar workshops we conducted is presented.
The authors describe how sociodramatic methods were applied to teaching communication skills to professionals in a comprehensive cancer center. The article briefly reviews the importance of communication skills in oncology and the challenges in teaching key skills such as empathy and addressing emotions. It indicates how action methods can be applied to enact case scenarios generated by groups attending communication-skills workshops. It describes the advantages of action methods over other techniques for teaching communication skills in the medical setting. It suggests how these methods might be more widely disseminated among teachers of medical communication skills.
Histology is a core preclinical program at UBC Medical and Dental School. In conjunction with lectures and laboratories, a significant portion of student learning is through online resources such as weekly practice quizzes. We aimed to create new quizzes in Term Two of the first year Histology curriculum.In order to makequizzes more representative of questions encountered in summative assessments and in clinical situations, we animated virtual slides to simulate microscopic viewing. The movable virtual slides were created by compiling snapshots of tissue sections at increasing magnifications into a "gif" file using Adobe Photoshop. To producean online version of the quiz, questions were formatted using Respondus® software and uploaded to WebCT.WebCT allows easy access to online quizzes and instant feedback for students. In May 2009, we will survey the Medical/Dental Class of 2011 and compare student satisfaction with quizzes from Term One and Term Two. This project was supported by Summer Studentships from the Department of Cellular and Physiological Sciences at UBC.Grant Funding SourceAAA
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