Advertisement

Journal of Cancer Education

, Volume 29, Issue 4, pp 704–708 | Cite as

Use of Interactive Theater and Role Play to Develop Medical Students’ Skills in Breaking Bad News

  • Eric P. Skye
  • Heather Wagenschutz
  • Jeffrey A. Steiger
  • Arno K. Kumagai
Article

Abstract

Creative arts have been increasingly implemented in medical education. This study investigated the use of interactive theater and role play with professional actors in teaching breaking bad news to medical students. The objectives were to explore the contexts, approaches, experiences, and reactions in giving and receiving bad news. Second-year medical students participated in a required educational session that utilized interactive theater which helps students learn about the issues of breaking bad news to a patient with cancer. Following the interactive theater piece, professional actors provided students role play experiences in small groups with breaking bad news. Anonymous evaluation surveys were given out to all second-year medical students at the conclusion of the breaking bad news session. Surveys contained quantitative and qualitative responses. Three years of evaluations were analyzed. A total of 451 (88 %) students completed the evaluations. Comments were thematically analyzed. Ninety-four percent agreed that the theater piece prompted reflection on patient-provider communications, and 89 % agreed that it stimulated discussion on complex issues with breaking bad news. The two most common themes in student comments concerned the importance of realism in the theater piece, and the value of experiencing multiple perspectives. Use of professional actors during the role play exercises enhances the realism and pushed the students out of their own “comfort zones” in ways that may more closely approximate real life clinical situations. Interactive theater can be a potentially powerful tool to teach breaking bad news during medical school.

Keywords

Death and dying Communication skills Instructional design Small group learning Ethics/attitudes Interactive theater 

References

  1. 1.
    Shapiro J, Hunt L (2003) All the world's a stage: the use of theatrical performance in medical education. Med Educ 37(10):922–927CrossRefPubMedGoogle Scholar
  2. 2.
    Lorenz KA, Steckart JM, Rosenfeld KE (2004) End-of-life education using the dramatic arts: the Wit educational initiative. Acad Med 79(5):481–486CrossRefPubMedGoogle Scholar
  3. 3.
    Rosenbaum ME, Kreiter C (2002) Teaching delivery of bad news using experiential sessions with standardized patients. Teach Learn Med 14(3):144–149CrossRefPubMedGoogle Scholar
  4. 4.
    Kohn M (2011) Performing medicine: the role of theatre in medical education. Med Human 37(1):3–4CrossRefGoogle Scholar
  5. 5.
    Kumagai AK, White CB, Ross PT, Purkiss JA, O'Neal CM, Steiger JA (2007) Use of interactive theater for faculty development in multicultural education. Med Teach 29:335–340CrossRefPubMedGoogle Scholar
  6. 6.
    Tang TS, Skye EP, Steiger JA (2009) Increasing patient acceptance of medical student participation: using interactive theatre for faculty development. Teach Learn Med 21(3):195–200CrossRefPubMedGoogle Scholar
  7. 7.
    Gray RE, Fitch MI, Labrecque M, Greenberg M (2003) Reactions of health professionals to a research-based theater production. J Cancer Educ 18(4):223–229CrossRefPubMedGoogle Scholar
  8. 8.
    Johnson L, Ousley A, Swarz J, Bingham RJ, Erickson JB, Ellis S, Moody T (2011) The art and science of cancer education and evaluation: toward facilitating improved patient outcomes. J Cancer Educ 26(1):27–35CrossRefPubMedGoogle Scholar
  9. 9.
    Back T (2013) Breaking bad news. Retreived from Ethics in Medicine, University of Washington School of Medcine http://depts.washington.edu/bioethx/topics/badnws.html
  10. 10.
    Boal A (1985) Theatre of the oppressed. Teatro del oprimido y otras po√©ticas pol√ ≠ ticas.English, vol. xiv, 197 p. Theatre Communications Group, New YorkGoogle Scholar
  11. 11.
    Kumagai AK (2010) Invited commentary: Forks in the road: disruption and transformation in professional development. Acad Med 85:1819–1820CrossRefPubMedGoogle Scholar
  12. 12.
    Piaget J (1985) The equilibration of cognitive structures: the central problem of intellectual development. In: Terrance B, Thampy KJ (eds) Equilibration des structures cognitives. English. University of Chicago Press, ChicagoGoogle Scholar
  13. 13.
    Dewey J (1910) How we think. Barnes & Noble, New YorkCrossRefGoogle Scholar
  14. 14.
    Mezirow J (1991) Transformative dimensions of adult learning. The Jossey-Bass higher and adult education series. Jossey-Bass, San FranciscoGoogle Scholar
  15. 15.
    Belling C (2006) The "bad news scene" as clinical drama part I: writing scenes. Fam Med 38(6):390–392PubMedGoogle Scholar
  16. 16.
    Kumagai AK (2012) Perspective: acts of interpretation: a philosophical approach to using creative arts in medical education. Acad Med 87(8):1138–1144CrossRefPubMedGoogle Scholar
  17. 17.
    Salmon P, Young B (2011) Creativity in clinical communication: from communication skills to skilled communication. Med Educ 45(3):217–226CrossRefPubMedGoogle Scholar
  18. 18.
    Levy J (1997) Theatre and Moral Education. J Aesthetic Educ 31(3):65–75CrossRefGoogle Scholar
  19. 19.
    Aristotle (2009) The Nicomachean ethics. Trans. W. D. Ross, and Lesley Brown, xliiith edn. Oxford University Press, New York, 277 pGoogle Scholar
  20. 20.
    Montgomery K (2006) How doctors think: clinical judgment and the practice of medicine. Oxford University Press, New YorkGoogle Scholar
  21. 21.
    Pellegrino ED, Thomasma DC (1993) The virtues in medical practice. Oxford University Press, New YorkGoogle Scholar
  22. 22.
    Fuks A, Brawer J, Boudreau JD (2012) The foundation of physicianship. Persp Biol Med 55:114–126CrossRefGoogle Scholar
  23. 23.
    Kumagai AK (2013) From competencies to human interests: ways of knowing and understanding in medical education. Acad MedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Eric P. Skye
    • 1
  • Heather Wagenschutz
    • 2
  • Jeffrey A. Steiger
    • 3
  • Arno K. Kumagai
    • 1
  1. 1.Department of Family MedicineUniversity of Michigan Medical SchoolAnn ArborUSA
  2. 2.Office of Medical Student EducationUniversity of Michigan Medical SchoolAnn ArborUSA
  3. 3.George Washington University Medical SchoolThe George Washington UniversityWashingtonUSA

Personalised recommendations