New ways actors can benefit your doctors-in-training
Thursday, August 02, 2018
You're no doubt familiar with "standardized patients" — professional actors who role-play with medical students and residents to simulate real-life patient interactions. Often, these interactive experiences teach doctors-in-training how to handle basic communication situations, such as how to prescribe medication or explain a diagnosis.
New research initiatives, however, are greatly expanding the knowledge medical students and residents can glean from working with actors, leading to more emotional insight when they work with real patients, as well as better effectiveness at sharing medical information with those real patients.
Your own doctors-in-training can benefit from the following research models covering:
A study from the University of Pennsylvania School of Medicine found that actors who play patients who have been the victims of medical errors or their family members can help doctors-in-training effectively approach a very difficult patient encounter (in which the doctor-in-training admits to or explains the medical mistake).
In addition, the more convincing each actor is in conveying a patient's feelings of anger, distress or forgiveness during a discussion of medical error, the better a doctor-in-training can learn to process feelings of guilt, ineptitude and fear of consequences.
An innovative program at NYU Langone Medical Center/NYU School of Medicine utilizes transgender actors to teach newly minted doctors the respectful way to treat patient with different gender identities than the ones they were assigned at birth.
The program's excellent results show that its residents learned how to use preferred pronouns when working with transgender patients, as well as how to discuss care issues unique to this patient population without any preconceived bias or inaccurate assumptions, leading to kind and appropriate treatment.
Breaking bad news.
Here's how it works: an actor and medical student/resident role play a discussion in which the student/resident must explain a difficult diagnosis. A second student/resident stands behind the actor's chair and watches the interaction, voicing out loud the emotions that the patient must be feeling, from fear to sorrow to anger.
Giving voice in this way to a patient's innermost thoughts helps both students/residents in the exercise understand the power of such underlying feelings, and allows them to be humane in terms of their words as they continue talking about what the patient essentially needs to know in the medical sense.
The University of Rochester Medical Center conducted a study in which its doctors agreed to two unannounced visits from actors posing as patients; the actors would covertly record their interactions with each doctor.
Each actor expressed to each doctor a worry they had about chest pain; to respond properly, the doctors would have to compassionately address the emotional concerns the actor brought up. During this same time period, patients in the doctors' waiting room were surveyed as to how compassionate they felt the doctor working with the actor was, based on their own experiences.
The researchers then evaluated both the actor's recording and the patients' real-life impressions, and found that the most effective and appreciated doctors in the study were the ones who clearly and strongly expressed empathy before they even knew what a patient's potential diagnosis could be (not simply at the time they had bad news to deliver).
By watching such recorded interactions and reading patient comments, doctors-in-training can clearly see their strengths and weaknesses in terms of their emotional responses, and learn how to improve even further. Consider implementing similar teaching strategies — your students and residents will have an immediate, clear-cut understanding of these important concepts.
Give and take.
Any time your doctors-in-training improvise with an actor, their ability to listen to any prospective patients' feelings, questions or impressions is automatically strengthened. Use skilled actors whenever possible to help doctors take in this kind of information, and in turn, address it with clear, concise and humane communication.
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