The role of role-play: Managing activity ambiguities in simulated doctor consultation in medical education

Thomassen, Gøril

doi:10.1558/cam.v6i1.83

Cited by 9 publications

(7 citation statements)

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“…They too described the use of “real” patients as a very helpful and intense experience for the students. However, this idea was questioned in a study by Thomassen [31], who found significant misalignments between the expectations of patients and doctors-to-be and therefore questioned the “realism” of real patient encounters.…”

Section: Discussionmentioning

confidence: 99%

From board to bedside – training the communication competences of medical students with role plays

et al. 2014

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BackgroundRole plays and standardized patients are often used in medical education and have proven to be effective tools for enhancing the communication skills of medical students. Most course concepts need additional time and teaching staff, and there are only a few studies about role plays in the preclinical segment.MethodsWe developed a highly consolidated concept for the curricular course of 2nd-year medical students, including ten role plays about five subjects: anamnesis, shared decision making, prevention, breaking bad news, and so-called “difficult interactions”. Before the course, all students were asked about their expectations and attitudes toward the course. After the course, all students rated the course, their individual learning progress, whether their expectations had been fulfilled, and re-evaluated their attitudes. Questionnaires were self-report measures and had a quantitative and a short qualitative section and were analyzed with descriptive statistics. Group differences (sex, age, role played) were evaluated with t tests at a Bonferonni-corrected significance level of p = .03 and the non-parametric U-tests.ResultsImplementing this practical course concept is possible without incurring additional costs. This paper not only shows how that can be done but also provides 5 examples of role scripts for different training subjects. The course concept was highly appreciated by the students. More than 75% felt that they had learned important communication techniques and would be better able to handle difficult situations. Playing the doctor’s role was felt to be more useful than playing the patient’s role. Women admitted a higher degree of shyness in the beginning and gave higher ratings to their learning progress than men. Students’ most frequent wish in the qualitative analysis was to be able to play the doctor’s role at least once. The students’ answers showed a differentiated pattern, thus suggesting that the influence of social desirability was minimal.ConclusionsPractical skills can be taught successfully in the preclinical stage of medical education even without an increase in resources. The course concept described in this article provides an effective means by which to do so.

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Section: Discussionmentioning

confidence: 99%

From board to bedside – training the communication competences of medical students with role plays

et al. 2014

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“…Using the paperwork as a tool is an institutionally relevant and artful way of managing this work. Unlike the medical students in Thomassen's [24] study of role plays, Lisa (see Excerpt 3) displays willingness to negotiate multilayered frames in an explicit manner. She aligns with the patient by asking the nurse preceptor for assistance with the documentation.…”

Section: Concluding Discussionmentioning

confidence: 99%

“…As the close scrutiny of the elaborated turns demonstrated, the patient and the student build through embodied stance (gaze direction, facial expression, bodily movement, and manipulation of the artifact) a public field for mutual orientation to the acts of reading and writing. For instance, in Excerpt 3, we have seen in the multiparty exchange generated by Lisa's attention to the paper document (lines [23][24][25][26][27][28], how the student and the patient mutually orient to the nurse preceptor and use the paper document as a method for talking about the activity as an exercise. It is within this course of action that the artifact gains a specific relevance.…”

Section: Concluding Discussionmentioning

confidence: 99%

“…One of the few studies in the literature that pay attention to the dynamics of interaction is Thomassen's [23,24] investigation of videotaped student-patient interviews in both nurse and medical students' clinical practice studies at a university in Norway. Whereas the nurse students have a detailed checklist, the trainee doctors have an illusive abstract set of guidelines.…”

Section: Earlier Research On Student Nurse-patient Interactionmentioning

confidence: 99%

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The Multifaceted Use of a Written Artifact in Student Supervision

Jansson

2011

Education Research International

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This article explores the use of a written artifact, an assessment form encompassing a checklist with health care terms, in supervised nurse student-patient interactions during assessment interviews in a Swedish hospital ward. The students were doing their clinical practice and were in their first year of a three-year nursing degree. Even though the students are not in charge of the situation, they are expected to perform a professional task for which they lack adequate skills. As demonstrated, the use of the assessment form provided a useful way for the participants to manage specific tasks in an apprenticeship context, such as regulating affect display, demonstrating uptake of the patient's concerns and staging the interview as an exercise. For this article, three excerpts have been selected from history-taking sequences, when the patient's previous illness history is created. The analysis illustrates the affordances provided by the assessment form to handle perspective shifts, when the patient departs from a general pattern of unelaborated answers and offers a window into his/her concerns. Importantly, however, the students' feedback talk with the nurse preceptor offers evidence that the artifact also constrains their forms of action in the practice of gathering assessment data. The article argues for ward-level practices that socialize students into reflective ways of using the artifact.

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“…This approach pays particular attention to the micro level of interactions and to how decisions and actions can be considered interactional achievements based on negotiations by the team members [22, 23]. In the healthcare context, discourse analysis is used to investigate the structure and interactions between patients and clinicians in general medical practices, in genetic counselling and consultations in the emergency department [24–26]. It is also used to analyse shift handoffs and to identify communication patterns that are linked to collaboration during preoperative team briefings [27, 28].…”

Section: Introductionmentioning

confidence: 99%

Team talk and team activity in simulated medical emergencies: a discourse analytical approach

Gundrosen

Andenæs

Aadahl

et al. 2016

Scand J Trauma Resusc Emerg Med

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BackgroundCommunication errors can reduce patient safety, especially in emergency situations that require rapid responses by experts in a number of medical specialties. Talking to each other is crucial for utilizing the collective expertise of the team. Here we explored the functions of “team talk” (talking between team members) with an emphasis on the talk-work relationship in interdisciplinary emergency teams.MethodsFive interdisciplinary medical emergency teams were observed and videotaped during in situ simulations at an emergency department at a university hospital in Norway. Team talk and simultaneous actions were transcribed and analysed. We used qualitative discourse analysis to perform structural mapping of the team talk and to analyse the function of online commentaries (real-time observations and assessments of observations based on relevant cues in the clinical situation).ResultsStructural mapping revealed recurring and diverse patterns. Team expansion stood out as a critical phase in the teamwork. Online commentaries that occurred during the critical phase served several functions and demonstrated the inextricable interconnections between team talk and actions.DiscussionDiscourse analysis allowed us to capture the dynamics and complexity of team talk during a simulated emergency situation. Even though the team talk did not follow a predefined structure, the team members managed to manoeuvre safely within the complex situation. Our results support that online commentaries contributes to shared team situation awareness.ConclusionsDiscourse analysis reveals naturally occurring communication strategies that trigger actions relevant for safe practice and thus provides supplemental insights into what comprises “good” team communication in medical emergencies.

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The role of role-play: Managing activity ambiguities in simulated doctor consultation in medical education

Cited by 9 publications

References 0 publications

From board to bedside – training the communication competences of medical students with role plays

From board to bedside – training the communication competences of medical students with role plays

The Multifaceted Use of a Written Artifact in Student Supervision

Team talk and team activity in simulated medical emergencies: a discourse analytical approach

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