Objective |
To evaluate student perceptions when undergoing a simulated gynecological exam and potential behavioral changes. |
To encourage the students to talk about their role as students and their admission in medical school |
To rehearse ways of acting during the medical interview that favor the development of communication skills |
To review the abilities of communication and listening during the doctor-patient relationship, when addressing issues related to diseases (leukemia, HIV/AIDS, amputations, fetal loss) |
To allow the tutor to experience the role of student in the tutoring activity and, thus, not only increasing their awareness but also expanding their perceptions of the teaching process, their strengths and weaknesses |
Participants |
60 students (of the Gynecology and Obstetrics unit of the internship program) |
10 students of the 2nd and 4th year |
20 students and teacher of Medical Psychology 2nd year |
40 students of the 3rd semester of the discipline of Social and Health Sciences |
32 teachers from the 1st–4th semester of the medical and nursing schools |
Institution |
Centro Universitário de Volta Redonda, Rio de Janeiro – University Centre of Volta Redonda, Rio de Janeiro |
Universidade de São Paulo – University of São Paulo |
Unifesp, São Paulo – Federal University of São Paulo, São Paulo |
Universidade Estadual do Ceará (UECE) – State University of Ceará |
Faculdade de Medicina de Marília (FAMEMA) – Medicine College of Marília |
Initial Phase Warm-up |
Brief exposure about drama and the protagonists roles |
Choices of roles and think of scenes and characters based on their everyday routine |
Open dialogue about the importance of communication in medical task |
Exposition about role-playing, the activity and the roles of actors and observers |
Tutoring sessions whose problem case refers to the structure of Problem-Based Learning |
Main Phase Role-Playing |
Enactment of a gynecological examination - Teacher: - guided participants regarding potential pathologies - Corrected the technique during the exam, simulating an actual exam on an outpatient |
Dramatization of - Entrance in medical school, - Entrance in medical school, - First year students life, - Relationship with veteran students, school, family and community |
Staging - Organization of a waiting room - Cases of early consultation - Recording the scenes |
Staging in groups of three - Role reversal (physician, patient, observer) |
Several tutors acted as students, while others played the tutor’s role. |
Final Phase (sharing) |
Group discussion on: - Experience of each student - The statements of the students were recorded, transcribed and reviewed |
Reflection: - Each student commented on how he felt when put in the role of the other |
Brief Summary - Most important issues, - Feedback based on analysis of the recorded scenes |
Sharing with the large group - Experience, emotions and difficulties with the method |
At the end of the activities, they answered - Issues for analysis of their discourses in relation to the activity performed |
Advantages |
- The dynamics was fully incorporated and played by the participants - Showing that solutions for topics addressed can be found inside each student who goes through a situation of role reversal with their patients |
- share the difficulties of medical training - Integration of students from different years - Favors positive ties - Greater critical reflection on the development of the professional role |
-teachers begin staging bogeymen to minimize student resistance - Role-playing and filming facilitated training in communication techniques and interviews |
- participants developed active listening, trying to understand how the patients feel and interpret their disease - They showed difficulty in giving bad news, at the same time, they value the doctor-patient construction |
- A facilitator of the learning process, as the tutor was put in the student’s role, favoring new perspectives and perceptions, and raising their awareness to the tutoring process |
Limitations |
Not reported in the article |
- small size sample due to low volunteers adhesion |
- stress and resistance of students in relation to recordings and feedback |
- anxiety among participants - Inhibition because of the use of body expression |
- Low adherence - Difficulty in understanding the activity - Difficulty in role reversing |