Video improved role play for teaching communication skills

Context and setting It is widely acknowledged that communication skills are central to effective clinical practice and must be taught. Role play can give students the opportunity to gain insight into a parent's perspective as well as experiencing how the doctor may feel dealing with difficult situations, and allows the practice and exploration of appropriate responses. We have developed and evaluated a new teaching aid in communication skills for second-year clinical medical students using edited video footage. This material provides a useful starting point for learning through role play and subsequent open discussion. Why the idea was necessary Although many medical students dislike role play, the experience can be enhanced if the students are able to develop some insight into the situations they are role playing by exposure to authentic discussion of parental circumstances beforehand. However, parents find repeated discussion of their experiences emotionally draining and time-consuming. Using recorded material overcomes this problem effectively, while preserving most of the impact of their account. What is being done Three mothers of ill children (diabetes, cerebral palsy and complex congenital heart disease) were videoed talking about their experiences. They discuss the impact the diagnosis had on siblings and family, how the news was initially broken, their feelings of guilt, blame and anger and their experience of the health-care system and its professionals. The edited testimony of one of the mothers (lasting 30 minutes) was shown to groups of 12 medical students during their paediatric attachment. The video was a prelude to role play lasting 5 minutes. Each group consisted of a ‘mother’, a ‘doctor’ and 1 or 2 observers, and explored 1 of 3 challenging situations faced by the mother. After the role play the students fed back to each other about their performance using the Calgary–Cambridge guide for the medical consultation within their groups for a further 5 minutes. Finally there was a facilitated discussion for the whole group for 20 minutes. Students completed questionnaires with 100 dot Likert scales (0 = not useful, 100 = useful) to evaluate the session. Evaluation of results and impact Attendance rate was 80% (n = 205) in a 6-month period. All students completed the questionnaires. Interim data suggest that this is an effective teaching approach. The following sections were felt to be useful; videos (median Likert score 84, 95% confidence intervals (CI), 20–100), role play (median score 68, 95% CI, 8–99) and discussion (median score 77, 95% CI, 7–99). Free text comments were generally constructive and encouraging, although 26 students felt that the role play was not useful. Overall, students rated the session positively (median 73, 95% CI, 23–99). Students reported that the video brought the mother's perspective to life and is an effective trigger from which to explore issues such as empathy, sensitivity and tact. Video-informed role play appears to be an effective teaching method for communication skills training in paediatrics.

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