Lived Experience Performance to Reduce Stigma, Enhance Understanding of Gambling Harm and Change Attitudes and Behaviours of Professionals and Community Members

Gamblers and their family members or friends (affected others) can experience stigma and shame due to gambling which can result in a reluctance to seek timely support. However, gamblers and affected others access intersecting health services and talk to friends or family, thereby providing opportunities for early intervention. Three sides of the coin is a group of storytellers with lived experience of gambling harm who use dramatic performance to share personal stories to enhance the understanding of gambling-related harm in allied professions and the broader community. They do this to encourage attitude and behaviour change so that gamblers and affected others receive empathy and support during encounters with these groups. A mixed-methods study was used to explore whether these performances were successful in increasing understanding and changing attitudes and behaviour of allied professionals and the community in the short and longer-term. Data collected immediately post-performance revealed that performances increased understanding of gambling, and improved attitudes and behavioural intent of audience members in relation to gamblers and affected others. Professionals also reported an increased willingness and confidence to discuss gambling harm with clients. Follow-up data demonstrated potential longer-term impact, with respondents continuing to report more positive attitudes towards those affected by gambling harm and professionals being confident to explore gambling issues in their clients and provide appropriate referrals. These finding demonstrate that performance based on lived experience can be a powerful education tool, encouraging deep connection to the issue, resulting in a nuanced understanding and sustained attitudinal and behavioural change.

The ERC PuppetPlays project : contribution for a non-linear history of the European theatre

This article is a presentation of the ERC Advanced Grant project  PuppetPlays - Reappraising Western European Repertoires for Puppet and Marionette Theatre (GA 835193). After a short overview of the project itself, it begins with a definition of puppetry, based on the phenomenon of double vision. Then it explains the choice of the corpus limitations, describes the variety of the available resources, and underlines the great discrepancy in the amount of material available in the different countries. The article continues with a brief overview of the role played by puppetry in the wider frame of performing arts: how much can we consider that puppeteers developed specific repertoires? What kind of differences can be observed between puppet or marionette theatre and actors' theatre? The answers to these questions differ in a considerable way according to the cultural and sociological contexts: sometimes puppet and marionette theatre were the only forms of performance allowed, and they acted as substitutes for actors theatre; but sometimes also - and this is increasingly the case since the end of the 19th century -  these instruments were chosen for their specific expressive qualities. In a last movement, I emphasize that collecting and analyzing puppet and marionette repertoires brings us to reconsider the general historiography of theatre: firstly, because we bring into the light theatrical genres that have been neglected by the historians; and secondly, because the plays written by the puppeteers, when we look closely at them, reveal a stratification of different layers that can be considered as a kind of heterochrony ; an alternative construction to social time. The forgotten patrimony of puppet and marionette dramaturgy conceals therefore many possibilities for research in humanities and social sciences.

The effect of drama-supported, patient role-play experience on empathy and altruism levels in nursing students: A randomized controlled study

AIM

This study aims to determine the effect of drama-supported, patient role-play experiences on the empathy and altruism levels of nursing students.

BACKGROUND

Empathy, one of the most important skills of the nursing profession, has an important place in the patient-nurse relationship. To be empathetic, which is acknowledged as the most basic motivation of altruistic behavior, requires recognizing emotional states and understanding the needs of others.

DESIGN

The format of this study was a pre-test-post-test, regular parallel-group, randomized, controlled experiment.

METHODS

The study data were collected between October 2021 and February 2022. The research was carried out with second-year students at Necmettin Erbakan University, Faculty of Nursing, who did not have any history of hospitalization or any chronic diseases. All subjects agreed to participate in the study (n = 52, intervention group=26, control group 26). Data were collected using a Descriptive Characteristics Form, the Altruism Scale and the Jefferson Scale of Empathy for Nursing Students (JSENS). After a three-hour drama workshop, participants in the intervention group acted out the role of a bed-bound patient in the laboratory environment and no intervention was applied to the control group. A series of Mixed ANOVAs were conducted for the analysis of the data.

RESULTS

The mean age of participants was 19.94 years (SD = ± 1.31) and 83.7 % of the participants were women. The intervention group showed a significant increase in altruism compared with the control group, as evidenced by higher scores in the Altruism Scale Total Score and a significant group*time interaction effect. However, in the JSENS Total Score, including the perspective taking and standing in patient's shoes sub-dimensions, no differences were observed based on group, time and group * time interactions.

CONCLUSION

The patient role-play experience increased the empathy and altruism levels of nursing students, but the effect was not evident at the three-month follow-up.

Effects of student-led drama on nursing students' attitudes to interprofessional working and nursing advocacy: A pre-test post-test educational intervention study

BACKGROUND

Nursing educators need to equip students to work in interprofessional teams and advocate for patients in increasingly integrated health and social care settings. Drama-based education has been used in nursing to help students understand complex concepts and practices, including communication, empathy, and patient safety. However, few studies have evaluated drama-based education to promote understanding of interprofessional care and advocacy, and none have involved student-led drama where students create dramatic performances to support learning.

OBJECTIVES

To examine the effects of student-led drama on student nurses' attitudes to interprofessional working and advocacy.

DESIGN

Pre-test post-test educational intervention study.

SETTINGS

Public university in Scotland.

PARTICIPANTS

400 undergraduate student nurses enrolled on a 15-week module focussed on health and social care integration and interprofessional working.

METHODS

Students completed paper questionnaires at the start (n = 274, response rate: 80.1 %) and end (n = 175, 63.9 %) of the module. Outcome measures were the validated Attitudes Towards Healthcare Teams Scale (ATHCTS) and Protective Nursing Advocacy Scale (PNAS). Change in mean ATHCTS and PNAS scores were assessed using paired samples t-tests, with Cohen's d to estimate effect size.

RESULTS

ATHCTS scores significantly increased from 3.87 to 4.19 (p < 0.001, d = 0.52). PNAS scores increased from 3.58 to 3.81 (p < 0.001, d = 0.79), with significant improvements in the 'acting as an advocate' (4.18 to 4.51, p < 0.001, d = 0.81) and 'environmental and educational influences' subscales (3.79 to 4.13, p < 0.001, d = 0.75). Statements focussed on promoting holistic, dignified care and enabling health professionals to be responsive to emotional and financial needs of patients, showed greatest change.

CONCLUSIONS

Education based on plays created and performed by student nurses led to significant improvements in student nurses' attitudes towards interprofessional working and nursing advocacy. Student-led drama should be embedded in nursing curricula to enable students to understand the realities and complexities of health and social care integration and interprofessional working.

Comparing the effect of social media-based drama, music and art therapies on reduction in post-traumatic symptoms among Nigerian refugees of Russia's invasion of Ukraine

PURPOSE

The objective of this study was to ascertain the effectiveness of social media-based music, art and drama therapies in treating PTSD symptoms among Nigerian evacuees from the Russia-Ukraine war.

DESIGN AND METHODS

This study was a quasi-experiment involving a sample of 330 participants that were randomly assigned to control and treatment groups. The treatment group was further classified into three groups according to the different contents of the therapies they received.

RESULTS

The study result showed that social media-based therapies effectively reduced PTSD symptoms for participants in the treatment group, unlike those who did not receive the intervention. Comparatively, drama therapy was more effective than art and music therapies. The reason drama therapy was more effective could be because it engaged the minds and body of the participants more than the other therapies.

CONCLUSION

Although art, music and drama therapies are effective treatment options for reducing symptoms of PTSD among victims of war, drama therapy is the most effective among them all.

PRACTICAL IMPLICATIONS

The result of this study has practical implications for health promotion from the perspective of nursing services by showing that social media-based therapies could serve as viable and cost-effectivealternativese to face-to-face group therapy.

Drama as a Powerful Tool to Enrich Socio-scientific Argumentation

Socio-scientific argumentation (SSA) is increasingly being recognized as a key aspect of scientific literacy. Much of the reason for this is that this skill is crucial for helping students to become active participants in twenty-first-century democratic societies in which the construction of informed and critical views of socio-scientific issues (e.g. climate change, COVID-19 vaccination, genetic testing) plays a fundamental role. The problem is that instructors rarely give students explicit and research-based opportunities to enrich their SSA skills. Therefore, the aim of this study was to provide evidence that drama can be used as a platform to enrich argumentation in genetic testing. The data were derived from the written responses and the audio recordings of seventy-six university students (37 females and 39 males, 16-29 years old) in Colombia during a complete drama-based teaching-learning sequence (TLS) supervised by the same instructor. The outcomes suggest that the sequence can be used to enrich argumentation in genetic testing as it effectively provided participants with explicit opportunities to produce both arguments and counterarguments about the controversy whether the use of genetic tests among people should be encouraged. This study contributes to the literature on SSA in science education by demonstrating that drama is a promising tool to enhance argumentation about science-based social issues.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10763-022-10320-3.

Managing conflict situations nursing students encounter during their clinical practice, narrated and performed through Forum Play

AIM

To describe and illuminate conflict situations nursing students encounter during their clinical practice, narrated and performed through Forum Play.

BACKGROUND

Conflicts are common in healthcare settings and affect patient care and the wellbeing of nurses. To be able to manage complex practice situations, conflict management is an essential competence for nurses and should be highlighted during education. The aim of the study was to describe and illuminate conflict situations nursing students encounter during their clinical practice, narrated and performed through Forum Play.

DESIGN

The study was designed as a summative qualitative analysis of written group assignments related to nursing students' participation in a drama workshop.

METHOD

A summative qualitative content analysis of written group assignments related to nursing students' participation in a drama workshop, focusing on conflict management. During the workshop the students explored conflict situations they had encountered during clinical practice, through Forum Play. After the workshop, the students handed in a mandatory written group assignment where they described one of the conflict situations.

RESULTS

The findings are presented in three categories; Parties; Arenas; Situations, one main theme; "Who knows best" and two subthemes; Difficulties to adapt to the new and Difficulties reaching a mutual understanding.

CONCLUSION

Conflict situations that nursing students encounter during their clinical practice often stem from the health care staff's difficulties in adapting to the new and difficulty reaching a mutual understanding. Conflict management can be implemented as a powerful learning strategy in nursing education.

Using process drama to explore the causes of dental anxiety in primary-school children

Background

Drama and role play can be unlisted as methods to allow children to view problems from a range of different perspectives that may differ from their own experience. Application of drama technique to assess the cause of dental fear and anxiety in a school setting is novel.

Aim

The aim of this study was to engage primary school children in the core investigation via participatory arts methodologies, namely, process drama to gain understanding of the causes of dental anxiety.

Design

Sixty-three children, aged 7–10 years from three primary schools participated in this study. A 90-min drama workshop was carried in each school. The children were encouraged to identify the causes of dental anxiety using key concepts from process drama. The sessions were audio-recorded and transcribed.

Results

Four key concepts emerged: (1) fear of the unknown; (2) unpleasant sensory experience; (3) society’s perception and portrayal of the dentist; and (4) learnt negative associations with the dentist. Within each four key concepts, two sub-themes were identified.

Conclusions

Role-playing and use of drama are a novel application and can reveal a considerable amount of information from the child’s perspective on the cause of dental fear and anxiety.

Drama with a focus on professional communication - A phenomenographic study

The nursing program is intended to prepare students for future occupational life. One role for nurses in the nursing occupation includes being prepared to communicate well in various patient situations. The aim of this study was to describe variations in nursing students' conceptions of a drama workshop to practically illustrate communication in nurses' work. This qualitative study was conducted at a university in southern Sweden. Interviews with 15 nursing students were conducted and the data were analyzed using a phenomenographic approach. Four descriptive categories were identified through the analysis: 'Conceptions in relation to the development of empathy', 'Conceptions in relation to "my" learning', 'Conceptions in relation to personal development of professional identity' and 'Conceptions in relation to the understanding of applying pedagogy through drama as a method'. This study illustrates that the use of drama in nursing education can increase nursing students' understanding of professional communication relating to the care of patients. To use drama as an educational method provides opportunities to develop nurses' professional identity and professional role. Moreover, drama can act as a teaching strategy that increases the understanding of theory through practical exercises.

The educational benefits of drama in nursing education: A critical literature review

BACKGROUND

With the increasing use of technology in nursing, the importance of interpersonal skills can often be forgotten. Patient safety can also be compromised if these skills are not emphasised in nursing education.

OBJECTIVES

This review explores how drama in undergraduate and postgraduate nursing education can enhance the development of interpersonal skills such as empathy, emotional intelligence and communication.

DESIGN

A critical review of qualitative literature.

DATA SOURCES

Seven databases (CINAHL, MEDLINE, Scopus, Eric, Psycinfo, and databases dedicated to the Arts, Modern Language Association (MLA) and JSTOR were searched.

REVIEW METHODS

Studies were screened against inclusion and exclusion criteria. Data from studies selected for the review were extracted using a summary table and a thematic analysis was conducted to identify major themes to answer the research question.

RESULTS

1275 studies were identified. Following a rigorous screening process, 29 studies met the inclusion criteria and were critically appraised using the CASP tool. Of the 29 studies, 17 were excluded due to their methodological quality. A final 12 studies were included in this review. Four themes demonstrated the value of drama in nursing education. These were an understanding of the patient experience, the development of professional identity, the enhancement of communication skills and increased self-reflection and critical thinking.

CONCLUSIONS

Interpersonal skills are at the core of nursing and educational interventions that use drama can enhance the development of these skills.

The "seeing place": Teaching nurse practitioners about cultural difference through dramatization

BACKGROUND

The use of dramatization in health professional education is one method to teach students about implicit bias and cultural difference, yet it has not been widely studied among graduate students of nursing.

OBJECTIVES

The purpose of this article is to present a qualitative analysis of data regarding doctoral nursing students' responses to a new dramatic exercise as part of a funded project to facilitate cultural learning in a diversity-enhanced nursing curriculum.

DESIGN

We employed a cross-sectional posttest design with qualitative data collection and hermeneutic analysis. Setting and.

PARTICIPANTS

Subjects were students from two cohorts in a Doctor of Nursing Practice program at a large metropolitan university in the Midwestern United States (n = 136).

METHODS

Following a dramatic exercise facilitated by a local theatre group, students debriefed and provided feedback via paper-based surveys collected by their instructor. The research team reviewed and analyzed student feedback with an eye toward new learning or insights around cultural difference.

RESULTS

Students rated the dramatic exercise highly. Their written feedback provided for a deeper exploration of how they internalized messages about cultural difference. These experiences were thematized in the following way: (a) Awareness is facilitated through integrating nonverbal (kinesthetic) and verbal encounters, (b) Hesitancy to participate in unfamiliar activities creates tension, and (c) Safety is a foundational aspect of learning sensitive issues.

CONCLUSION

Dramatization of culturally sensitive scenarios for advanced practice nurses can lead to new understanding. Educators who understand the need for thoughtful introduction of dramatization experiences can better prepare nurses for interaction in cross-cultural clinical environments.

Early Retirement, Social Class, and Family Relationships in Cloutier's Bonne retraite, Jocelyne (2018)

BACKGROUND AND OBJECTIVES

Aging women are continuously underrepresented in performing arts. An exception to this trend in Québec is Fabien Cloutier's latest play Bonne retraite, Jocelyne (2018), whose protagonist is a middle-aged woman who has decided to take early retirement. This article aims at examining the interplay between the protagonist's voluntary early retirement, gender, social class, and family relationships.

RESEARCH DESIGN AND METHODS

This article mobilizes the theoretical framework of aging studies, which is underdeveloped in the French academic sphere. This qualitative case study connects gender issues and performative strategies in order to study a complex phenomenon within its context.

RESULTS

We showed that Cloutier provides new representations of middle-aged women in his play, a corrective to the under-representation of such an age group of actors and actresses in Québec. Our results cast a new light on the combination of class privilege, gender, and ageism, as a most fruitful research orientation to be further developed in the future in order to pursue an in-depth analysis of early retirement.

DISCUSSION AND IMPLICATIONS

The play reveals that belonging to the upper-middle class is essential in order to be able, economically speaking, to retire early. Cloutier empowers Jocelyne both as an aging individual and as a woman by means of granting her the right to make her own decisions in life.

Playworlds and Executive Functions in Children: Theorising with the Cultural-Historical Analytical Lenses

This paper provides a theorisation of developmental conditions to support executive functions (working memory, inhibition and shifting) in children in playworlds settings, where children and teachers play together in collectively created imaginary situations. Vygotsky's general law of development of psychological functions constitutes the general frame for the analysis of the process of development of executive functions (EF) in playworlds, and the theoretical concepts of drama, social situation of development and perezhivanie are used as analytical tools to examine opportunities of playworlds to support children executive functions.

The Cultural Value of Older People's Experiences of Theater-making: A Review

Purpose of the Study

Although a number of existing reviews document the health and social benefits of arts participation by older people, there are none which focus specifically on theater and drama. This article presents the findings of a study conducted as part of the UK's Arts and Humanities Research Council "Cultural Value Project." The 2-year (2013-2015) "Cultural Value Project" sought to make a major contribution to how we think about the value of arts and culture to individuals and to society. It made 72 awards: 19 critical reviews of existing bodies of research, 46 research development awards to carry out new research, and 7 expert workshop awards to facilitate discussions among academics and practitioners. Together, these awards explored the components of cultural value and the ways in which cultural value is evidenced and evaluated.

Design and Methods

Following an extensive search of academic databases and E-mail requests via relevant organizations and networks, 77 publications formed the basis for our own critical review.

Results

Our findings highlight the benefits and value of older people's theater and drama participation on health and well-being, group relationships, learning and creativity, and draw attention to the importance of the esthetic value and quality of older people's drama.

Implications

Despite the recent surge of interest in this field (a third of the reviewed literature was published between 2010 and 2014), we suggest that there are multiple areas for further research.

Engaging adolescents in tuberculosis and clinical trial research through drama

Background

The South African Tuberculosis Vaccine Initiative is based in Worcester where tuberculosis (TB) is endemic, and incidence rates are amongst the highest nationally. In high TB burden settings after an early childhood peak, incidence rates start to rise again in adolescents, therefore they are an important target group for tuberculosis vaccine research. In 2012, learners from a local school developed a one-off theatrical production out of an educational comic book Carina’s Choice, developed by the South African Tuberculosis Vaccine Initiative in 2010. A Wellcome Trust International Engagement grant allowed for this one-off production to be further developed, with input from university students and staff, and rolled out to schools in the Worcester area as an engagement and education intervention.

Methods

Focus group feedback was used to identify key messages and to develop the play’s script. Qualitative methods were used to collect and analyse relevant data. Interviews were conducted with learner-actors, pre- and post-focus group feedback was obtained from a sample of school-going adolescents, and pre- and post-questionnaires were administered to adolescent audience members.

Results

From the pre-drama focus group discussions, topics such as TB symptoms, stigma and transmission were identified as areas that needed attention. After the performances, adolescents showed improved knowledge on the identified topics and they discussed TB prevention measures. They highlighted transmission of TB during pregnancy as a further topic to be addressed in future iterations of the drama. Although stigma is a difficult phenomenon to interpret, post-drama participants understood that TB transmission could occur in all individuals. Learner-actors agreed with focus group participants that the play could impact the wider community if it were rolled out. Feedback from the South African Tuberculosis Vaccine Initiative staff verified that recruitment for an upcoming trial was facilitated by the preparedness that the play provided in recruitment areas. The study showed that before and after evaluations provide data on the usefulness of the play as an education tool.

Conclusions

Theatre, presented and motivated by adolescent peers, can raise awareness of TB, and assist clinical trial preparedness and further engagement between trial staff and their trial community.

Representations of epilepsy on the stage: From the Greeks to the 20th century

Epilepsy is a disorder that has been used by dramatists in various ways over the ages and therefore highlights the views of the disorder as people saw it at the time the plays were written and performed. In the 6th century BC, links between tragedy and epilepsy were developed by Greek playwrights, especially Euripides, in Iphigenia among the Taureans and Heracles where epilepsy and madness associated with extreme violence occur together. Both Heracles and Orestes have episodes after a long period of physical exhaustion and nutritional deprivation. During the Renaissance, Shakespeare wrote plays featuring different neurological disorders, including epilepsy. Epilepsy plays a crucial part in the stories of Julius Caesar and Othello. Julius Caesar is a play about politics, and Caesar's epilepsy is used to illustrate his weakness and vulnerability which stigmatizes him and leads to his assassination. Othello is a play about jealousy, and Othello, an outsider, is stigmatized by his color, his weakness, and his 'seizures' as a form of demonic possession. In modern times, Night Mother portrays the hard life of Jessie, who lives with her mother. Jessie has no friends, her father has abandoned the family, and she has no privacy and is ashamed. Stigma and social pressures lead her to commit suicide. Henry James' novella, The Turn of the Screw, portrays a governess with dream-like states, déjà vu, and loss of temporal awareness who has been sent to the country to look after two small children and ends up killing one. This novella was turned into an opera by Benjamin Britten. Most recently, performance art has been portraying epilepsy as the reality of a personally provoked seizure. Both Allan Sutherland and Rita Marcalo have purposely provoked themselves to have a seizure in front of an audience. They do this to show that seizures are just one disability. Whether this provokes stigma in audiences is unknown. Whether the performance artists understand the potential for status epilepticus has not been discussed. This article is part of a Special Issue entitled "Epilepsy, Art, and Creativity".

The use and application of drama in nursing education--an integrative review of the literature

BACKGROUND

Caring is grounded on universal humanistic values such as kindness, empathy, concern and love for self and others. Nurses need to learn how to implement these values in the care for patients. Nursing students find it hard to assimilate theoretical knowledge in practice. Experiential learning in the form of drama has been used in several studies to enhance nursing students' learning.

AIM

The aim of this study was to review empirical and theoretical articles on the use and application of drama in nursing education.

DESIGN

An integrative review of the literature.

METHOD

The databases CINAHL, PubMed, ProQuest and Academic search elite were searched for articles.

RESULT

The search generated 64 articles, with 20 articles meeting the inclusive criteria. Three themes with their attendant subthemes emerged through the analysis. The themes are: The Framing, The Objectives and The Embodiment.

CONCLUSION

Drama is effective in entry level courses in nursing education to enhance student learning and can be flexible and adjusted to various contexts. Further research using drama to enroll nursing students as fictive patients and relatives and thereby explore different perspectives is suggested, and more research on the application of drama in nursing education at an advanced level is required.

"There's No Correspondence Between Me and My Age": Old Age in Theresia Walser's King Kong's Daughters

PURPOSE OF THE STUDY

Against the context of a rapidly aging population, the theme of senescence has been figuring increasingly prominently in contemporary German theater. This paper discusses the depiction of old age in one notable example, Theresia Walser's King Kong's Daughters, a hugely successful black comedy set in a nursing home.

DESIGN AND METHODS

This paper takes an interdisciplinary approach in its analysis of Walser's play, drawing not just on drama and theater studies, but also on performance, film, and cultural studies as well as the sociology and psychology of aging.

RESULTS

King Kong's Daughters might seem to be pervaded with negative ageist stereotypes. It is argued here, however, that Walser skillfully exploits the special formal qualities of theatrical performance--in particular, its liveness, corporeality, and communality--to illuminate both what it is like to be old and what it is like to care for the elderly in today's world.

IMPLICATIONS

Given demographic developments, senescence seems set to increasingly inform the themes, motifs, and characters of theater in Germany and beyond. Paying closer attention to how old age is invoked on the contemporary stage can generate insights that are not only of interest to theater scholars, but are also of value to gerontologists and age scholars more generally.

Who is that masked educator? Deconstructing the teaching and learning processes of an innovative humanistic simulation technique

Simulation learning in nursing has long made use of mannequins, standardized actors and role play to allow students opportunity to practice technical body-care skills and interventions. Even though numerous strategies have been developed to mimic or amplify clinical situations, a common problem that is difficult to overcome in even the most well-executed simulation experiences, is that students may realize the setting is artificial and fail to fully engage, remember or apply the learning. Another problem is that students may learn technical competence but remain uncertain about communicating with the person. Since communication capabilities are imperative in human service work, simulation learning that only achieves technical competence in students is not fully effective for the needs of nursing education. Furthermore, while simulation learning is a burgeoning space for innovative practices, it has been criticized for the absence of a basis in theory. It is within this context that an innovative simulation learning experience named "Mask-Ed (KRS simulation)", has been deconstructed and the active learning components examined. Establishing a theoretical basis for creative teaching and learning practices provides an understanding of how, why and when simulation learning has been effective and it may help to distinguish aspects of the experience that could be improved. Three conceptual theoretical fields help explain the power of this simulation technique: Vygotskian sociocultural learning theory, applied theatre and embodiment.