Communication skills for medical/dental students at the University of Pretoria: Lessons learnt from a two-year study using a forum theatre method

Dental students' perception about using videos in teaching professionalism: A Saudi Arabian experience

OBJECTIVE

To describe the development and evaluation of using videos (watched and student-generated) for teaching stronger interpersonal communication skills to dental students.

METHODOLOGY

We used the Experiential Learning Theory to develop a professionalism course for third-year dental students. Videos were used as the core method of teaching communication skills. Students were guided to produce videos that addressed an array of communication scenarios. Quantitative data was collected using a Likert-scale questionnaire to assess students' perceptions about watching and generating videos. The questionnaire was divided into 3 parts: the first part assessed students' perceptions and skills gained when producing videos. The second part assessed students' perceptions about watching videos to gain knowledge. The last part assessed their perceptions about their overall learning experience.

RESULTS

A total of 110 students, 50 males and 60 females, were enrolled in the course. Developing team skills and a better understanding of professional communication with patients were acknowledged by 85% and 80% of students respectively during video production. Improved problem-solving skills were reported by 77% students while involved in video production. While watching motivational interviewing strategies and interpersonal skills videos, 86% stated that watching the videos improved their understanding of professional behavior with colleagues. Only 33% felt that they had enough time to prepare videos and only 38% were willing to prepare videos in the future.

CONCLUSION

Using videos in teaching communication skills was found effective. Producing videos had more benefits than simply watching videos. Caution should be given when allocating time for such activities.

Medical Education Empowered by Theater (MEET)

The medical education community acknowledges the importance of including the humanities in general, and the liberal arts in particular, in the education of health professionals. Among the liberal arts, theater is especially helpful for educators wanting to bring experiences that are both real and challenging to the learning encounter in an interactive, engaging, and reflective way. In this Perspective, the authors share what they have learned after working together with a company of actors for 8 years (2012-2019) in different obligatory and elective curricular activities. Influenced by Freire's Pedagogy of the Oppressed and the ideas of Boal's Theatre of the Oppressed, Medical Education Empowered by Theater (MEET) embraces social accountability and applies the concept of sensible cognition to empower medical students as the protagonists of their learning and professional development to become agents of change-both in patients' lives and in health care systems. The MEET theoretical framework builds on the concepts of liberation, emancipatory education, critical pedagogy, and participatory theater to offer medical students and teachers an opportunity to problematize, criticize, and hopefully reform the hierarchical and often oppressive structures of medical education and practice. MEET sessions include activating previous knowledge and experiences, warm-up exercises, different improvisational exercises, debriefing, and synthesis. Vital to the praxis of MEET is applying theater-teaching traditions to develop capacities important in medicine: presence, empathy, improvisation, communication (verbal and nonverbal), and scenic intelligence (i.e., the capacity to self-assess one's performance while performing). The authors believe that theater offers a venue to integrate both the personal and professional development of students into a process of reflection and action, targeting the transformation of the medical culture toward social justice.

Enhancing the Empathic Connection: Using Action Methods to Understand Conflicts in End-of-Life Care

Empathy is a core feature of patient-centered care. It enables practitioners to better understand the patient and family concerns that are key to patient and family satisfaction, prevention of anxiety and depression, and provider empowerment. Current methods of teaching communication skills do not specifically focus on enhancing the ability to "stand in the patient's shoes" as a way of connecting with the patient and/or family experience and understanding feelings that may be a source of conflict with providers. In this paper, we present a model for deepening empathic understanding based upon action methods (role-reversal and doubling) derived from psychodrama and sociodrama. We describe these techniques and illustrate how they can be used to identify hidden emotions and attitudes and reveal that which the patient and family member may be thinking or feeling but be afraid to say. Finally, we present data showing that these methods were valuable to participants in enhancing their professional experience and skills.

Applying sociodramatic methods in teaching transition to palliative care

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.

Using sociodrama and psychodrama to teach communication in end-of-life care

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.

Communications skills in dental education: a systematic research review

Communication is an essential element of the relationship between patient and dentist. Dental schools are required to ensure that undergraduates are adequately trained in communication skills yet little evidence exists to suggest what constitutes appropriate training and how competency can be assessed. This review aimed to explore the scope and quality of evidence relating to communication skills training for dental students. Eleven papers fitted the inclusion criteria. The review found extensive use amongst studies of didactic learning and clinical role-play using simulated patients. Reported assessment methods focus mainly on observer evaluation of student interactions at consultation. Patient involvement in training appears to be minimal. This review recommends that several areas of methodology be addressed in future studies, the scope of research extended to include intra-operative communication, and that the role of real patients in the development of communication skills be active rather than passive.