Development of an Actor Rehearsal Guide for Communication Skills Courses

BACKGROUND

Established models of serious illness communication training frequently include role play with simulated patient actors. Yet preparing for communication courses can feel challenging, as most faculty have minimal experience directing actors, and no literature exists to guide faculty in how to lead course rehearsals.

METHODS

A team of palliative care educators partnered with a seasoned acting teacher to design and implement a faculty guide for directing actors during communication course rehearsals. Their approach involved a series of brainstorming sessions, creation and piloting of a draft rehearsal guide and revisions based on actor and faculty feedback.

RESULTS

The actor rehearsal guide offers a stepwise approach to beginning a rehearsal, rehearsing a patient case, giving feedback to the actor and ensuring the actor responds appropriately to learners of varied skill levels. From early 2021 to late 2022, the team used the guide to prepare for 36 courses, which trained 446 clinicians. Faculty and actors noted that the guide fostered predictable and efficient rehearsals.

CONCLUSIONS

A novel actor rehearsal guide can support preparation for communication courses at a single institution. Next steps include disseminating the guide to other institutions and evaluating the guide's impact on faculty and actors' experience of rehearsals and learners' experience of training.

An international comparison of student nurse practitioner diagnostic reasoning skills

BACKGROUND

Nurse practitioners (NPs) play a pivotal role in health care provision. Diagnostic reasoning is an important core skill of advanced practice.

PURPOSE

The purpose of this study was to compare diagnostic reasoning skills of NP students. It also identified the variability in clinical teaching components of a sample of international NP curricula.

METHODS

An international group of NP students completed an online survey using a validated diagnostic reasoning scale during the first year of their NP program. Program faculty surveyed provided data on core curricula.

RESULTS

The NP students' ( n = 152) mean diagnostic thinking inventory (DTI) score was 142, flexibility in thinking subscale score mean of 73 with a knowledge structure in memory of 69. The programs surveyed required bioscience courses. Most programs provided opportunities for students to practice diagnostic thinking using individual precepted clinical hours (range 500-950) and objective structured clinical examinations.

CONCLUSION

The lower scores of this group of NP students were similar to other NP students and first-year medical residents. Higher mean scores in the DTI reflect expertise and are developed over time. Courses providing a foundation of biomedical knowledge were identified in each program, with opportunities for the NP students to practice diagnostic thinking using objective structured clinical examinations and clinical practice hours.

IMPLICATIONS

The use of the diagnostic reasoning inventory is a useful tool for evaluating student NP's diagnostic reasoning during their NP program. Nurse practitioner programs should consider the provision of dedicated clinical hours, including supervised clinical practice experiences and objective structured clinical examinations to improve diagnostic reasoning.

Advocacy, Collaboration, and Conflict Management: Teaching Core Skill Sets in Mental Health Nursing

Caring for individuals with mental illness requires a core set of skills: knowledge of various disorders; therapeutic communication; collaboration with the multidisciplinary team; proficiency as an advocate whether for individuals, families, groups, or populations; and conflict management. In the current study, students completed toolkits with standardized patient experiences (SPEs) to practice core skill sets. Growth occurred in students' therapeutic communication and their ability to care for standardized or simulated patients with complex mental health issues. Proficiency in interprofessional collaboration, advocacy, and conflict management was also noted. Providing students with opportunities to apply leadership skills to care for individuals with complex mental illness may not always be possible in "real world" settings. Use of SPEs and toolkit activities can bridge the gap between classroom/clinical and real world settings and were highly effective in helping students meet core skill sets in mental health settings. [Journal of Psychosocial Nursing and Mental Health Services, 59(9), 26-29.].

Lights, Camera, Action: Lessons Learned From a Nursing and Theater Collaboration

BACKGROUND

Because nursing students do not always have opportunities to interact with individuals with mental illness due to various factors such as limited clinical sites, an innovative teaching strategy was developed.

METHOD

A plan was developed to collaborate with the theater department to offer undergraduate theater students an opportunity to practice acting skills while taking an independent study. These theater students, trained as standardized patients (SPs), engaged with senior nursing students enrolled in a psychiatric mental health nursing clinical course in a baccalaureate program.

RESULTS

This process has been successfully implemented for the past 2 years. With 10 theater students completing the independent study and 180 nursing students engaging in interactions with SPs, improvements in communication skills for nursing students have been seen.

CONCLUSION

Because this is a pilot project, additional research should be conducted to further explore the effectiveness of learning for both nursing and theater students. [J Nurs Educ. 2019;58(6):369-371.].

An Observational Study of a Simulation-Based Cross-Discipline Learning Activity Between Theater Arts and Physical Therapy Students

INTRODUCTION

Professional actors are often used to portray simulated patients during healthcare professional training. This study aimed to create an activity where physical therapy (PT) and theater arts (TA) students could address discrete learning outcomes in a common setting with mutual benefit.

METHODS

Mixed methods observational study of 246 university students (201 PT, 45 TA) undertaking a scenario involving the provision of a clinical history. All students completed a 5-question qualitative survey relating to the activity, and each group scored themselves and each other using an observer rubric rating performance from 1 (do not agree) to 10 (agree).

RESULTS

For PT students, the range of means (SDs) across the five questions were significantly different (P < 0.001) with 6.2 (1.6) to 6.8 (1.4) for self-assessment and 8.2 (1.4) to 8.7 (1.1) for TA assessment of PT. For TA students, across all repetitions and all questions, the mean (SD) was 7.6 (1.5) for self-assessment and 7.9 (1.2) for PT assessment of TA, representing a significant difference (P < 0.001). After initial enactment, there was a significant improvement in TA self-assessment of performance (P = 0.002), but thereafter, there was no significant difference over time (P = 0.114).Qualitative data analysis revealed the following three themes common to both groups: worthiness, authenticity/realism, and anxiety/confidence. The PT students also identified history-taking skills and the importance of patient/PT relationships. The TA students identified learning around character portrayal, improvisation, and concentration.

CONCLUSIONS

This study describes a simulation-based learning activity undertaken within existing infrastructure with complementary learning objectives for both TA and PT students that was realistic and engaging.

The use of theatre in medical education in the emergency cases school: an appealing and widely accessible way of learning

INTRODUCTION

Theatre models in medical education have been used worldwide in order to train medical students and graduates in managing various situations. However, the literature reports little regarding its appeal to trainees. We conducted a medical seminar, entitled Emergency Cases School, which employed such techniques. Actors simulated the actions of doctors and patients involved in various emergency cases, in front of a large audience, in a specially modified theatre hall which resembled the emergency room environment.

METHODS

A total of 303 undergraduate medical students participated in the seminar. The audience evaluated the course with the DREEM questionnaire, along with two extra questions: Q1. 'Do you think that the course will prove itself beneficial to your clinical skills?' and Q2. 'Would you suggest the course to another student?', in a 0-4 scoring scale. Of the attendees, 281 (92.7%) answered the questionnaire.

RESULTS

The overall DREEM score was 140.32 (±23.39) out of 150, which is interpreted as 'More positive than negative'. The results of Q1 and Q2 were 3.07 (±0.78) and 3.65 (±0.61), respectively.

DISCUSSION

The Emergency Cases School received positive feedback as a theatre educational tool, targeted to a large audience. With the advantage of the realistic setting of an emergency room, along with its low-budget needs, this course model could function as a creative alternative of the more traditional lecturing teaching techniques.

A Novel Approach to Simulation-Based Education for Veterinary Medical Communication Training Over Eight Consecutive Pre-Clinical Quarters

Experiential learning through the use of standardized patients (SPs) is the primary way by which human medical schools teach clinical communication. The profession of veterinary medicine has followed suit in response to new graduates' and their employers' concerns that veterinary interpersonal skills are weak and unsatisfactory. As a result, standardized clients (SCs) are increasingly relied upon as invaluable teaching tools within veterinary curricula to advance relationship-centered care in the context of a clinical scenario. However, there is little to no uniformity in the approach that various colleges of veterinary medicine take when designing simulation-based education (SBE). A further complication is that programs with pre-conceived curricula must now make room for training in clinical communication. Curricular time constraints challenge veterinary colleges to individually decide how best to utilize SCs in what time is available. Because it is a new program, Midwestern University College of Veterinary Medicine (MWU CVM) has had the flexibility and the freedom to prioritize an innovative approach to SBE. The author discusses the SBE that is currently underway at MWU CVM, which incorporates 27 standardized client encounters over eight consecutive pre-clinical quarters. Prior to entering clinical rotations, MWU CVM students are exposed to a variety of simulation formats, species, clients, settings, presenting complaints, and communication tasks. These represent key learning opportunities for students to practice clinical communication, develop self-awareness, and strategize their approach to future clinical experiences.