-
BMJ Open Aug 2019With the growing prevalence of overweight and obesity, medical students should be prepared to engage in weight management and obesity-related communications in order to...
OBJECTIVE
With the growing prevalence of overweight and obesity, medical students should be prepared to engage in weight management and obesity-related communications in order to prevent patients from having stigmatising experiences. In addition, medical students should have training to reduce anti-fat prejudices.
DESIGN
Cross-sectional proof of concept study.
SETTING
University Hospital Tuebingen, Germany.
PARTICIPANTS
246 participants (207 second-year medical students, 13 standardised patients (SPs) and 22 teachers) took part in the study.
PRIMARY AND SECONDARY OUTCOME MEASURES
The primary outcome was the assessment of degree of reality of the encounter with the SP wearing an obesity simulation suit (OSS). The secondary outcome was the evaluation of students' awareness and prejudice against patients with obesity in a simulated role play. Additionally, a description of the advantages and disadvantages when using such a teaching tool is delivered.
RESULTS
The OSS contributed to a realistic perception of the patient group depicted in a role play according to students, teachers and SPs. OSS body mass index estimation by students, teachers and SPs correctly was over 30 kg/m-thus in the range of obesity. In a selected subscale of the Anti-Fat Attitudes Test, students showed significantly stronger anti-fat stigmatisation compared with teachers and SPs.
CONCLUSIONS
An OSS worn by an SP is a valuable teaching tool to raise awareness about patients with obesity. It gives a realistic picture of the encounter. Stigmatisation was low in general but was especially present in the students. Further research should include intervention studies to address this issue.
Topics: Adolescent; Adult; Attitude of Health Personnel; Cross-Sectional Studies; Female; Germany; Humans; Male; Middle Aged; Obesity; Prejudice; Proof of Concept Study; Role Playing; Simulation Training; Stereotyping; Students, Medical; Young Adult
PubMed: 31383708
DOI: 10.1136/bmjopen-2019-029738 -
PloS One 2019This paper reports the development and baseline data of a vignettes-based measure of gender equality.
UNLABELLED
This paper reports the development and baseline data of a vignettes-based measure of gender equality.
METHODS
Vignettes were developed through 3-day long focus groups. After piloting in 13 sites and repiloting a revised version in 6 countries, responses were categorized by the construct tapped and a scoring system developed. Finalized vignettes were then tested in DR Congo, Ecuador and China.
RESULTS
Young adolescents can successfully respond to vignettes; and can differentiate self from hypothetical protagonists of same and opposite sex. Response differences by sex of respondent and protagonist were statistically significant across a range of scenarios and settings.
CONCLUSION
This is the first vignettes-based measure for young adolescents assessing young adolescent perceptions of relationships differentiated by sex of the protagonist.
Topics: Adolescent; Adolescent Behavior; Child; China; Civil Rights; Cross-Cultural Comparison; Democratic Republic of the Congo; Ecuador; Female; Focus Groups; Human Rights; Humans; Interpersonal Relations; Male; Psychology, Adolescent; Role Playing
PubMed: 31247045
DOI: 10.1371/journal.pone.0218863 -
BMC Medical Education Jun 2019We believe junior doctors are in a unique position in relation to reporting of incidents and safety culture. They are still in training and are also 'fresh eyes' on the...
The co-design, implementation and evaluation of a serious board game 'PlayDecide patient safety' to educate junior doctors about patient safety and the importance of reporting safety concerns.
BACKGROUND
We believe junior doctors are in a unique position in relation to reporting of incidents and safety culture. They are still in training and are also 'fresh eyes' on the system providing valuable insights into what they perceive as safe and unsafe behaviour. The aim of this study was to co-design and implement an embedded learning intervention - a serious board game - to educate junior doctors about patient safety and the importance of reporting safety concerns, while at the same time shaping a culture of responsiveness from senior medical staff.
METHODS
A serious game based on the PlayDecide framework was co-designed and implemented in two large urban acute teaching hospitals. To evaluate the educational value of the game voting on the position statements was recorded at the end of each game by a facilitator who also took notes after the game of key themes that emerged from the discussion. A sample of players were invited on a voluntary basis to take part in semi-structured interviews after playing the game using Flanagan's Critical Incident Technique. A paper-based questionnaire on 'Safety Concerns' was developed and administered to assess pre-and post-playing the game reporting behaviour. Dissemination workshops were held with senior clinicians to promote more inclusive leadership behaviours and responsiveness to junior doctors raising of safety concerns from senior clinicians.
RESULTS
The game proved to be a valuable patient safety educational tool and proved effective in encouraging deep discussion on patient safety. There was a significant change in the reporting behaviour of junior doctors in one of the hospitals following the intervention.
CONCLUSION
In healthcare, limited exposure to patient safety training and narrow understanding of safety compromise patients lives. The existing healthcare system needs to value the role that junior doctors and others could play in shaping a positive safety culture where reporting of all safety concerns is encouraged. Greater efforts need to be made at hospital level to develop a more pro-active safe and just culture that supports and encourages junior doctors and ultimately all doctors to understand and speak up about safety concerns.
Topics: Games, Experimental; Hospitals, Teaching; Humans; Ireland; Medical Staff, Hospital; Patient Safety; Role Playing; Safety Management; Surveys and Questionnaires
PubMed: 31238936
DOI: 10.1186/s12909-019-1655-2 -
BMC Medical Education Jun 2019An important barrier to smoking-cessation counseling for physicians is a lack of education at the undergraduate level. Interactive methods such as peer role-play (RP) or... (Comparative Study)
Comparative Study Randomized Controlled Trial
BACKGROUND
An important barrier to smoking-cessation counseling for physicians is a lack of education at the undergraduate level. Interactive methods such as peer role-play (RP) or modules utilizing standardized patients (SPs) may be effective for medical students to enhance their performance on tobacco cessation counseling. This study compared the effectiveness of a module using SPs to that of a RP module for undergraduate medical students on tobacco cessation counseling.
METHODS
This study was conducted over a single week of the family medicine clerkship. One hundred and thirteen fourth-year medical students were randomized into either the SP group or the RP group. A RP module involved a ten-minute encounter between the student doctor and the student patient followed by five minutes of feedback from the observer student using a group developed checklist. In a SP module, each student was asked to interview a SP portraying a smoker with willingness to quit. After the encounter, the SP provided five minutes of direct oral feedback to the student. In both modules, the total intervention lasted three-and-half hours and was supervised by faculty staff. Students' objective structured clinical examination (OSCE) scores were evaluated to determine their tobacco cessation counseling skills. Four evaluation periods were conducted at baseline, postintervention, post-clerkship, and before receiving the Korean medical licensing examination (KMLE). Students' smoking knowledge test scores and counseling self-confidence levels at pre- and post-intervention were also compared.
RESULTS
In both groups, post-intervention OSCE scores increased significantly compared to baseline (Cohen's d 0.87, p < 0.001 in SP group; d 0.77, p < 0.001 in RP group). However, there were no differences between the two groups. Students achieved the highest OSCE score for smoking-cessation counseling before the KMLE. After training, student self-confidence and smoking-knowledge test scores increased significantly, regardless of the type of module. Self-confidence was higher in the SP group compared with the RP group (d 0.37, p = 0.01).
CONCLUSIONS
Peer role-play may be equivalent to the SP method with regard to knowledge and skills reported during smoking-cessation counseling and SP method may be better in self-confidence. Cost and student self-confidence may be important factors when choosing among the teaching methods for smoking-cessation counseling.
Topics: Clinical Clerkship; Clinical Competence; Counseling; Education, Medical, Undergraduate; Family Practice; Humans; Patient Simulation; Republic of Korea; Role Playing; Smoking Cessation; Students, Medical
PubMed: 31238920
DOI: 10.1186/s12909-019-1668-x -
Early Intervention in Psychiatry Apr 2020Few interventions address social cognition or functioning in individuals at clinical risk (CR) for psychosis. Theatre Improvisation Training to Promote Social Cognition...
AIM
Few interventions address social cognition or functioning in individuals at clinical risk (CR) for psychosis. Theatre Improvisation Training to Promote Social Cognition (TIPS) is a manualized intervention based on drama therapy. We aim to describe TIPS, evaluate feasibility and acceptability, and present a preliminary investigation of outcomes in a quasi-experimental design.
METHODS
Thirty-six CR participants (15-25 years) were ascertained from the Philadelphia Neurodevelopmental Cohort. Twenty-six completed the TIPS protocol: 18 weekly 2-hour group sessions led by a theatre director and actor-assistant. Participants engaged in collaborative acting and improvisation exercises. Baseline and follow-up assessments included the Clinical Assessment Interview for Negative Symptoms (CAINS), Structured Interview for Prodromal Syndromes, Global Assessment of Functioning (GAF) and Penn Computerized Neurocognitive Battery (CNB), which includes social cognitive tests. Acceptability was assessed using focus groups. Preliminary outcomes were compared to CR controls who were not enrolled in the study but completed follow-up assessments using the same methods.
RESULTS
There were no significant differences in baseline demographics, psychosis symptoms, or cognition between those who did and did not complete the protocol. Overall, TIPS was considered feasible and acceptable among CR. Preliminary outcomes suggest that TIPS may be effective in improving positive and negative psychosis-spectrum symptoms and GAF, but not performance on facial emotion processing.
CONCLUSIONS
TIPS is a promising and acceptable intervention that may improve symptoms and functioning in CR while providing a framework for participants to develop more empowered and confident ways of relating to others. Larger randomized controlled trials investigating TIPS efficacy are warranted.
Topics: Adolescent; Adult; Cohort Studies; Female; Humans; Male; Prodromal Symptoms; Psychodrama; Psychotherapy, Group; Psychotic Disorders; Social Cognition; Young Adult
PubMed: 31177635
DOI: 10.1111/eip.12834 -
MedEdPORTAL : the Journal of Teaching... Jan 2019Knowledge and skill development related to communication must incorporate both affective and behavioral components, which are often difficult to deliver in a learning...
INTRODUCTION
Knowledge and skill development related to communication must incorporate both affective and behavioral components, which are often difficult to deliver in a learning activity. Using theater techniques and principles can provide medical educators with tools to teach communication concepts.
METHODS
This 75-minute faculty development workshop presents a variety of techniques from theater and adapts them for use in medical education. Using examples related to diversity and inclusion, this session addresses general educational and theater principles, role-play, sociodrama, applied improvisation, and practical aspects of involving theater partners. The session materials include a PowerPoint presentation with facilitator notes, interactive activities to demonstrate each modality, and an evaluation. The sessions can be extended to longer formats as needed.
RESULTS
Forty-five participants at Learn Serve Lead 2016: The AAMC Annual Meeting attended the 75-minute session. We emailed 32 participants 5 months after the conference, and eight responded. Participants reported that their confidence level in using theater techniques as a tool for medical education increased from low-to-medium confidence presession to high confidence postsession. All survey respondents who were actively teaching said they had made changes to their teaching based on the workshop. All commented that they appreciated the active learning in the session. Many indicated they would appreciate video or other follow-up resources.
DISCUSSION
Principles and techniques from theater are effective tools to convey difficult-to-teach concepts related to communication. This workshop presents tools to implement activities in teaching these difficult concepts.
Topics: Clinical Competence; Communication; Curriculum; Education; Education, Medical; Faculty, Medical; Female; Humans; Knowledge; Male; Peer Review; Problem-Based Learning; Retrospective Studies; Role Playing; Self Concept; Students, Medical; Surveys and Questionnaires; Video Recording
PubMed: 31044155
DOI: 10.15766/mep_2374-8265.10801 -
Eye (London, England) Oct 2019To survey the members of the American Glaucoma Society (AGS) to determine which glaucoma procedures they would prefer to have performed on themselves.
BACKGROUND/OBJECTIVES
To survey the members of the American Glaucoma Society (AGS) to determine which glaucoma procedures they would prefer to have performed on themselves.
SUBJECTS/METHODS
We distributed an anonymous, electronic survey via the AGS listserv. The participants were asked to adopt the role of a patient with primary open angle glaucoma with progressive visual field loss in need of glaucoma surgery. Three preoperative intraocular pressure (IOP) levels were provided (>26 mmHg, 21-26 mmHg, and <21 mmHg), and the participants were asked to choose a glaucoma procedure they would prefer performed on themselves under each preoperative IOP levels from a list of fifteen procedures.
RESULTS
Out of 289 responses (representing 27.4% of active and provisional AGS members), the most preferred procedures were ab interno trabeculotomy (20.3%), Xen gel stent (18.6%), iStent with two devices (14.3%) and traditional trabeculectomy augmented with mitomycin C (14.1%). 17.6% and 6.9% of participants preferred a trabeculectomy performed or a glaucoma drainage device (GDD) implanted on themselves, which is a lower than what would be offered to a hypothetical patient. Significant proportions of participants prefer non-bleb forming or conjunctiva-sparing procedures, even with low preoperative IOP levels. Older participants were more likely to prefer traditional trabeculectomy and having a single procedure across all levels of preoperative IOP.
CONCLUSIONS
The majority of AGS participants in the survey would prefer micro-invasive glaucoma surgery over traditional trabeculectomy or a GDD performed on themselves as a primary glaucoma procedure, and most would prefer non-bleb forming and conjunctiva-sparing procedures.
Topics: Adult; Aged; Aged, 80 and over; Female; Glaucoma Drainage Implants; Glaucoma, Open-Angle; Health Care Surveys; Humans; Intraocular Pressure; Male; Middle Aged; Ophthalmologists; Ophthalmology; Practice Patterns, Physicians'; Role Playing; Societies, Medical; Trabeculectomy
PubMed: 31043689
DOI: 10.1038/s41433-019-0452-9 -
Currents in Pharmacy Teaching & Learning Apr 2019Pharmacists need to learn communication styles which adopt a more consultative model. The objectives of this paper are to describe the use of forum theatre facilitated...
BACKGROUND AND PURPOSE
Pharmacists need to learn communication styles which adopt a more consultative model. The objectives of this paper are to describe the use of forum theatre facilitated by actors to teach communication skills to pharmacy students and to highlight perceptions of the workshops.
EDUCATIONAL ACTIVITY AND SETTING
During the actor-led forum theatre, students redirected scenes depicting pharmacist-patient consultations. Students also learned about their own communication styles and role-played consultations and interview situations with actors. Pharmacy undergraduate students enrolled in years 2, 3, and 4 answered open-ended questions online at the end of workshops. All responses were coded to identify themes.
FINDINGS
Five themes emerged from 752 comments: (1) workshops were useful in facilitating communication skills development, (2) workshops encouraged reflection, (3) appreciation of feedback provided, (4) the live, interactive nature of the workshop enhanced learning, and (5) suggestions for improvement. There were requests for more varied scenarios involving different patient groups and more opportunities to participate in the role-plays. Students also requested smaller groups, which would encourage participation from those who were reticent and allow more personal feedback.
SUMMARY
The use of forum theatre employing role-play, small group coaching on consultation and interview skills, and emphasizing feedback was perceived as an effective and engaging method to teach communication skills.
Topics: Communication; Education, Pharmacy; Feedback; Humans; Learning; Psychodrama; Qualitative Research; Students, Pharmacy; United Kingdom
PubMed: 31040013
DOI: 10.1016/j.cptl.2019.01.015 -
Frontiers in Psychology 2019The embodied approach to cognition consists in a range of theoretical proposals sharing the idea that our concepts are constitutively shaped by the physical and social...
The embodied approach to cognition consists in a range of theoretical proposals sharing the idea that our concepts are constitutively shaped by the physical and social constraints of our body and environment. Still far from a mutually enriching interplay, in recent years embodied and psychoanalytic approaches are converging on similar constructs as the ones of intersubjectivity, bodily self, and affective quality of verbal communication. Some efforts to cope with the subject were already present in classical cognitivism: having expunged desires and conflicts from the , bodily emotions re-emerged but only as a noisy dynamic friction. In contrast, the new, neural, embodied cognitive science with its focus on bodily effects/affects has enabled a dialogue between neuro-cognitive perspectives and clinic-psychological ones, through shared conceptual frameworks. I will address crucial issues that should be faced on this reconciling path. With reference to two kinds of contemporary addictions - internet addiction disorder and eating disorders - I will introduce a possible therapeutic approach that is built upon the core role of the acting-sentient bodily self in a dynamic-social and affective environment. In Psychoanalytic Psychodrama, the spontaneous re-enactment of a past (socially and physically constrained) experience is actualized by means of the other, the Auxiliary Ego. This allows homeostatic and social-emotional affects, i.e., drives and instincts, to be re-experienced by the agent, the Protagonist, in a safe scenario. The director-psychoanalyst smoothly traces back this simulation to the motivated, and constrained, early proximal embodied interactions with significant others, and to the related instinctual conflicting aims. The psychoanalytic reframing of classical psychodrama does not merely exploit its original cathartic function, rather stands out for exploring the interpersonal constitution of the self, through an actual "re-somatization" of psychoanalytic therapy. Unspoken/unspeakable feelings pop up on stage: the strength of this treatment mainly rests on re-establishing the priority of the over the . By pointing out the possible conflicts between these two selves, this method can broaden the embodied cognition perspective. The psychodramatic approach will be briefly discussed in light of connectionist models, to finally address linguistic and methodological pivotal issues.
PubMed: 31024371
DOI: 10.3389/fpsyg.2019.00492 -
American Journal of Public Health Jun 2019To assess how instructional techniques affect officers' intent to communicate syringe legality during searches in Tijuana, Mexico, where pervasive syringe confiscation...
To assess how instructional techniques affect officers' intent to communicate syringe legality during searches in Tijuana, Mexico, where pervasive syringe confiscation potentiates risk of HIV and HCV among people who inject drugs (PWID) and of occupational needle-stick injury among police. Using the SHIELD (Safety and Health Integration in the Enforcement of Laws on Drugs) model, Tijuana police underwent training to encourage communication of syringe possession legality to PWID. Trainees received either passive video or interactive role-play exercise on safer search techniques. We used logistic regression to assess the training's impact on self-reported intent to communicate syringe legality by training type and gender. Officers (n = 1749) were mostly men (86%) assigned to patrol (84%). After the training, intent to communicate the law improved markedly: from 20% to 39% (video group) and 20% to 58% (interactive group). Gender and training type significantly predicted intent to communicate syringe legality. Male and female officers' adjusted odds ratios in the interactive group were 5.37 (95% confidence interval [CI] = 4.56, 6.33) and 9.16 (95% CI = 5.88, 14.28), respectively, after the training. To more effectively persuade police to endorse harm reduction and occupational safety practices, police trainings should include interactive elements.
Topics: Adult; Communication; Criminal Law; HIV Infections; Harm Reduction; Hepatitis C; Humans; Inservice Training; Law Enforcement; Mexico; Needle Sharing; Needlestick Injuries; Occupational Exposure; Police; Role Playing; Substance Abuse, Intravenous; Syringes; Video Recording
PubMed: 30998406
DOI: 10.2105/AJPH.2019.305030