Use of Psychodrama in medicine in Brazil: a review of the literature

Liberali, Rafaela; Grosseman, Suely

doi:10.1590/1807-57622014.0524

Brazil

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Articles • Interface (Botucatu) 19 (54) • Jul-Sep 2015 • https://doi.org/10.1590/1807-57622014.0524 linkcopy

Use of Psychodrama in medicine in Brazil: a review of the literature

Uso de Psicodrama em medicina no Brasil: uma revisão de literatura

Uso del Psicodrama en la medicina en Brasil: una revisión de la literatura.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstracts

Objective To review the literature on experiences of the use of psychodrama in medical education in Brazil.

Methods Papers published between 2003 and 2013 were identified in the main databases.

Results Seven papers were identified. Role playing and sociodrama were the psychodrama techniques reported. They were used to address aspects of relationships such as emotions and behavior and to improve some communication and clinical skills. Psychodrama provided the students with opportunities for critical reflection, questioning of professional practices and sharing of experiences, and also decreased their anxiety and fear. Role playing was used among students and among teachers undergoing academic development, while sociodrama was only used among students.

Conclusions There are still few papers reporting on experiences from the use of psychodrama in Brazilian medical schools.

Psychodrama; Sociodrama; Medical education; Role playing

Year	Database	Journal	Teaching strategy	Study
2005	Scielo	Interface - Comunic., Saúde, Educ.	Sociodrama	Ramos-Cerqueira et al.²⁹
2009	Scielo	Revista Brasileira de Educação Médica	Role playing	Aragão et al.³⁹
2009	Scielo	Revista Brasileira de Educação Médica	Role playing	Colares and Andrade²
2009	Scielo	Revista Brasileira de Educação Médica	Sociodrama	Ramos-Cerqueira et al.²⁶
2010	Scielo	Revista Brasileira de Educação Médica	Role playing	Jucá et al.²⁴
2010	Scielo	Interface - Comunic., Saúde, Educ.	Role playing	De Marco et al.¹⁹
2011	Scielo	Interface - Comunic., Saúde, Educ.	Role playing	Francischetti et al.⁴⁰

Study	Aragão et al.³⁹	Colares and Andrade²	De Marco et al.¹⁹	Jucá et al.²⁴	Francischetti et al.⁴⁰
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

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