{"id":2083,"date":"2021-10-26T17:04:31","date_gmt":"2021-10-26T16:04:31","guid":{"rendered":"https:\/\/blogs.manchester.ac.uk\/itl\/?p=2083"},"modified":"2021-10-29T15:30:07","modified_gmt":"2021-10-29T14:30:07","slug":"i-am-your-patient-today-part-2-of-2-drama-in-medical-education","status":"publish","type":"post","link":"https:\/\/blogs.manchester.ac.uk\/itl\/2021\/10\/26\/i-am-your-patient-today-part-2-of-2-drama-in-medical-education\/","title":{"rendered":"I am your patient today! Part 2 of 2: Drama in Medical Education"},"content":{"rendered":"

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\"EleniProf<\/span>essor<\/span>\u00a0Raj\u00a0<\/span>Ariyaratnam<\/span>\u00a0<\/span>(<\/span>SFHEA<\/span>,\u00a0<\/span>NTF)<\/span>\u00a0is<\/span>\u00a0Chair in Dental Education and Global Oral Health<\/span>\u00a0<\/span><\/span>and\u00a0<\/span>Dr\u00a0<\/span>Eleni Deligianni is a Clinical Lecturer in Oral Medicine in the\u00a0<\/span>Division of Dentistry,\u00a0<\/span>School of Medical Sciences.<\/span>\u00a0In\u00a0<\/span>the second instalment<\/span>\u00a0of this 2<\/span>–<\/span>part post,\u00a0<\/span>they\u00a0<\/span>discuss<\/span>\u00a0<\/span>d<\/span>rama<\/span>tic enactment<\/span>\u00a0<\/span>as a teaching tool\u00a0<\/span>in the<\/span>\u00a0“I am your patient today<\/span>!<\/span>“<\/span>\u00a0clinical education programme.<\/span><\/span><\/strong><\/p>\n

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Drama in education is not a new idea. It\u00a0has been\u00a0explored\u00a0in the UK since the beginning of the 20th\u00a0century.\u00a0The major promoters of drama in education were Dorothy Heathcote and Gavin Bolton who evolved their theories later, in the 60\u2019s and 70\u2019s (Kolovou\u00a0and Kim 2020). According to them, \u201ceducational drama is being anything which involves people in active role-taking situations in which attitudes, not characters, are the chief concern\u201d\u00a0<\/i>and\u00a0\u201cdrama as an art form establishes a connection to knowing, without defining what that knowing entails\u201d\u00a0<\/i>(Allern\u00a02008).\u00a0Moreover, Heathcote illustrated interventions such as \u201cdramatic role-play<\/i>\u201d and \u201cteacher in role<\/i>\u201d and her methods\u00a0were\u00a0used\u00a0to create \u201cDrama in Education\u201d (Kolovou\u00a0and Kim 2020).\u00a0\u00a0<\/p>\n

In the medical sciences Drama in Higher Education was introduced as early as the 1960\u2019s, when Howard Barrows established the \u2018Standardized Patients\u2019 that would later evolve to \u2018Standardized Patient Educators\u2019 and turn into \u201cone of the most prominent evolving methodologies in medical education<\/i>\u201d, adopted in Medical Schools throughout the world. Moreover, this method influenced\u00a0greatly the\u00a0development of the OSCE as an examination form (Ryan\u00a0et al\u00a0<\/i>2010).\u00a0\u00a0<\/p>\n

Following the above innovations, programmes in the US have utilised for many years \u201cPatient instructor<\/i>\u201d techniques \u2013 mostly in Medical but also Dental Schools \u2013 where non-medically trained people act as patients and offer feedback,\u00a0in order to\u00a0simulate a clinical environment for training purposes. The results are promising,\u00a0indicating\u00a0that students\u00a0attain\u00a0and enhance the desired skills (Broder\u00a0et al\u00a0<\/i>2015).\u00a0\u00a0<\/p>\n

It\u00a0has been shown\u00a0that students in health-related subjects have found that part of their training through drama and role-play has been\u00a0helpful and\u00a0gave them a better understanding of how to approach a patient whilst enhancing their diligence (Ryan\u00a0et al\u00a0<\/i>2010). Little,\u00a0though,\u00a0is known\u00a0for the use of drama,\u00a0role-play\u00a0and its\u00a0possible benefits\u00a0in dental schools and traditional subjects such as\u00a0Oral Medicine. Most of the time the application of drama in education in schools providing training in Medicine, Dentistry and Health Sciences\u00a0is performed\u00a0by professionals with a drama rather than a dental background,\u00a0and trained individuals are being used systematically to \u2018represent\u2019 patients in SPEs and OSCEs (Ryan\u00a0et al\u00a0<\/i>2010).\u00a0\u00a0<\/p>\n

In our\u00a0case\u00a0we have implemented role-play guided by the tutor, acting as a patient\u00a0(See\u00a0Part 1:\u00a0I am your patient today! Taking clinical education online<\/a>).\u00a0Our aim was to engage the students and\u00a0provide\u00a0an experience as similar as possible to the one in the clinic. Our groups consisted by a maximum of four to five students at a time, thus enabling better engagement as all the students had the chance to\u00a0participate\u00a0in the given time of the session which was two hours. Based on the feedback we got, the attempt was overall a success.\u00a0Feedback\u00a0from\u00a0the two tutors was also positive,\u00a0and it\u00a0was mentioned\u00a0that after the\u00a0initial\u00a0\u2018breaking of the ice\u2019 the students appeared to\u00a0participate\u00a0collectively and successfully in interviewing the tutor-patient and\u00a0acted as if they were in clinic. Moreover, this teaching method\u00a0was found\u00a0to be\u00a0more engaging and quite enjoyable from the tutor\u2019s side as well.\u00a0<\/p>\n

Of course, our method was not without limitations and those\u00a0were acknowledged\u00a0from the beginning. It\u00a0was implemented\u00a0as an \u2018emergency\u2019 tool,\u00a0and planning was complicated due to the sudden changes in lockdown rules under the ongoing pandemic. None of the two tutors involved in this way of teaching had any background or training in drama or drama in education, so the teaching very much depended on the tutor\u2019s professional experience and performing ability.\u00a0\u00a0<\/p>\n

Results of other programmes in the UK implementing drama in dental education\u00a0have been published\u00a0and seem to agree with our own.\u00a0\u00a0\u201cPerforming Medicine<\/i>\u201d\u00a0was\u00a0shown\u00a0to \u201cincrease empathy<\/i>\u201d and \u201creduce performance anxiety<\/i>\u201d for\u00a0students (De la Croix\u00a0et al\u00a0<\/i>2011). A pilot programme run in the Dental Institute at King\u2019s College London,\u00a0with one\u00a0component\u00a0including role-play guided by a\u00a0drama qualified\u00a0individual,\u00a0was\u00a0also\u00a0a success. The pilot group achieved\u00a0higher scores in that year\u2019s\u00a0OSCEs (Objective Structured Clinical Exams)\u00a0<\/b>that followed by at least 4% when compared with their fellow peers (Zahra and\u00a0Dunton\u00a02017).\u00a0\u00a0<\/p>\n

\u2018Mask-Ed\u2019,\u00a0a novel method used in a nursing school in Australia, has\u00a0shown that training the tutor health care professional in drama, so that he or she can implement the role-play in their teaching,\u00a0benefits\u00a0the students more as the depth and breadth of the health care professional\u2019s knowledge is\u00a0facilitated\u00a0(Reid-Searl\u00a0et al\u00a0<\/i>2014).\u00a0\u00a0<\/p>\n

To our knowledge, this is the first time that a role-play teaching method based on the tutor\u2019s skills and his\/her clinical experience\u00a0has been\u00a0successfully explored\u00a0on a synchronous platform, and our\u00a0innovation won the Faculty of Biology, Medicine and Health (FBMH) Pandemic Pedagogy Teaching Award.\u00a0We are\u00a0more than happy to\u00a0share our experiences and\u00a0this model\u00a0with our colleagues\u00a0from other similar clinical T&L courses. As this turned out to be a successful\u00a0pedagogy, we plan to\u00a0continue\u00a0to use\u00a0this as\u00a0an\u00a0additional\u00a0synchronous\u00a0teaching and learning tool even after Covid-19.\u00a0<\/p>\n

\u00a0<\/h5>\n
References<\/b>\u00a0<\/h5>\n
    \n
  1. Rogers, H.,\u00a0Sollecito, T.P., Felix, D.H.,\u00a0Yepes, J.F., Williams, M., and\u00a0D\u2019Ambrosio, J.A., Hodgson, T.A., Prescott-Clements, L., Wray, D., Kerr, A.R. (2011)\u00a0An\u00a0international survey in\u00a0postgraduate\u00a0training in Oral Medicine. Oral Diseases 17 (Suppl. 1), pp95\u201398.\u00a0\u00a0<\/li>\n<\/ol>\n
      \n
    1. Kolovou, M. and Kim, N.J. (2020) Effects of implementing an integrative drama-inquiry learning model in a science classroom. The Journal of Educational Research, 113(3), pp 191-203.\u00a0\u00a0<\/li>\n<\/ol>\n
        \n
      1. Allern, T-H. (2008).\u00a0A comparative analysis of the relationship between dramaturgy and epistemology in the praxis of Gavin Bolton and Dorothy Heathcote<\/i>. Research in Drama Education, 13(3), pp 321-335.\u00a0\u00a0<\/li>\n<\/ol>\n
          \n
        1. Ryan, A.,\u00a0Walshe, N., Gaffney, R., Shanks, A., Burgoyne, L.,\u00a0Wiskin\u00a0C.M. (2010)\u00a0Using standardized patients to assess communication skills in medical and nursing Students<\/i>, BMC Medical Education, 10(24), pp1-8.\u00a0\u00a0<\/li>\n<\/ol>\n
            \n
          1. Broder, H.L.,\u00a0Janal, M.,\u00a0Mitnick, D.M., Rodriguez, J.Y.,\u00a0Sischo, L. (2015). Communication Skills in Dental Students: New Data Regarding Retention and Generalization of Training Effects. Journal of Dental Education, 79(8), pp940-948.\u00a0\u00a0<\/li>\n<\/ol>\n
              \n
            1. De la Croix, A., Rose, C.,\u00a0Wildig, E., and\u00a0Willson, S. (2011). Arts-based learning in medical education: the students\u2019 perspective. Medical Education, 45, pp 1090\u20131100.\u00a0\u00a0<\/li>\n<\/ol>\n
                \n
              1. Zahra, F. Smyth and\u00a0Dunton, K. (2017). Learning to look from different perspectives \u2013 what can dental undergraduates learn from an arts and humanities-based teaching\u00a0approach?\u00a0British Dental Journal, 222(3), pp147-150.\u00a0<\/li>\n<\/ol>\n
                  \n
                1. Reid-Searl,\u00a0K.,Levett-Jones, T., Cooper, S., and\u00a0Happell, B. (2014). The implementation of Mask-Ed: Reflections of academic participants. Nurse Education in Practice, 14, pp485-490.<\/li>\n<\/ol>\n

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