Theme
2JJ Communication
INSTITUTION
Universidad de Chile - Facultad de Medicina - Sede Occidente - Santiago
The Medical Intheatreview Workshop (MIW) emerges during the course of Medical Semiology as a practical learning space for medical students to uncover, develop and optimize their communication skills and empathy, in order to improve their performance in clinics. Tools adapted from dramatic arts’ pedagogy are used: corporal and vocal training, role-playing with constant and personalized feedback.
MIW teaching was introduced in 2013 within the Medical Semiology program, aimed at fifth semester students from the West campus of the School of Medicine at Universidad de Chile. This model was applied only in this campus, in a group of 30 students out of 200 enrolled in the course. The rest of the students (170), maintained the traditional Semiology teaching format based on mentor-mentee work in Hospital and lectures in their respective campuses. It is important to remark that all of the students were from five different campuses (West, North, East, Central, South).
Each MIW session was organized under the following structure:
1. Physical-vocal exercises based on actors’ professional techniques.
2. Drama exercises to develop clinical interview skills.
3. Pooling, feedback and reflections on the work done and achievements.
The sessions were divided into three parts, each one with specific emphases:
- First part: Breathing, vocal expression and technique.
- Second part: Conscious use of the body and body language
- Third part: Integration of first and second parts.
In addition, we briefly trained aural memory by means of active listening and retention of information without any external aids.
Finally, we had regular instances of feedback and reflection between classmates and teachers throughout the workshop, in order to promote and strengthen empathy.
The questionnaire, composed by 5 questions, establishes MIW as a methodology for the generation of significant learning in effective communication, acquisition of confidence for clinical interview, promotion of empathy and leveraging the integral development of a future medical doctor.
In the statement "Having attended the Medical Intheatreview Workshop (MIW) I feel more confident when performing a Clinical Interview", 13 students declared to "strongly agree", 14 to "agree," and only 1 declared to be "indifferent ".
Given the statement "After participating in the MIW I manage more expressive tools to communicate effectively", 12 students marked "strongly agree", 12 marked "agree" and 4 marked "indifferent".
With the statement "The MIW was useful for me to develop my capacity for empathy with patients", 7 students expressed to "strongly agree", 16 to "agree", 4 were "indifferent" and 1 expressed to "disagree".
Regarding the statement "The MIW contributed to my overall development as a doctor", 16 students showed to "strongly agree," 10 students showed to "agree", and only 1 to "disagree".
Finally, in the statement "I consider it necessary to devote more hours to MIW", opinions were more divided: 8 "strongly agree", 7 "agree", 6 "indifferent", 5 "disagree" and 1 "strongly disagree ". Nonetheless, there is a slight tendency to show that students "agree".
In the focus group, students highlighted the importance of getting feedback from the teaching staff, and the value of continuous work where achievements were noticed over time, allowing them to potentiate their strengths and improve their deficiencies in interpersonal communication.
What students said:
“I remember the empathy issue improved considerably because it was quite practical, I mean, the fact that they didn’t tell you: "let's see the studies that talk about empathy," but you were told what you stood out at and you could reinforce it when you were with the patient.”
“what’s best about the workshop is the active feedback we had. And that was greatly supported by the human group, classmates and teachers, which was very good; then, no one had a problem with telling someone else what was wrong about them and reinforce what they did well ... I think that really helped everyone to develop their positive skills and improve their weaknesses.”
“What also helped us was having the confidence to criticize a classmate, positively or negatively, because we did not know each other. I find the MIW was very helpful for us to be more confident to say: "hey, I know you and know that you are shy in everyday life, but now you look super-confident" ... stuff like that makes you feel more confident when interviewing. It was very useful …”
“I enjoyed the course (Semiology), it has been the one that I’ve enjoyed the most in my college studies, it shows that teachers were very committed. There was affection from teachers towards students, they wanted students to learn. It was not just listening and nothing else. I could really say they were very committed (...) and also with actresses teachers who eventually pointed out different things, your weaknesses, strengths, and at the end of the term they told you the things you had improved, the things you needed to work on ... So, building a relationship was also super important.”
“Regarding the feedback from the teachers, I found that there was dedication to monitor each student, they knew well the things we had to improve ... and also, you could realize yourself what your weaknesses were... and that is done through practice. I don’t know if empathy improved much, but your own skills did, such as your voice tone, speaking more calmly, breathing, your posture towards the patient... these things I found super-valuable.”
“What seemed to me very good and enriching for the performance of everyone in the course of Semiology was that the hours devoted to MIW not only contributed to our communication skills development, but also helped us to relax, to know each other in a better way and ease up the atmosphere of study overload.”
Just like an actor, medical doctors must know themselves and handle their strengths, potentials and limitations, in order to masterly perform their role, and therefore obtain a healthy “Oscar”.
We wanted to know the perception of students about this methodology as it was implemented for the first time. For this reason, qualitative research was conducted, based on a questionnaire and a focus group.
To develop the research, a sample of 39 sixth semester students from the West Campus of the Universidad de Chile was selected.
Thus, the student sample was divided into two groups:
Group 1, those who had taken the course of Medical Semiology in 2013 in the West Campus (29 students), who had experienced the Medical Intheatreview Workshop (MIW).
Group 2, those who had taken Medical Semiology in 2013 in other campuses and those who had completed this course in 2012 in the West campus (10 students). These students had not experienced the Medical Intheatreview Workshop (MIW).
A survey was designed and a focus group was organized with the participation of both groups of students. A different survey was applied to each group depending on whether they had attended Medical Semiology in 2013 on West Campus or not. The same criterion was applied to the completion of the focus group, using a different question form for each group.
Both instruments were implemented within one morning.
MIW is perceived by students as a positive instance for the development of communication skills that improve their performance in clinical interviews, and also represents a practical space for personal development.
Within this perception, students appreciated the following:
- The practical nature of the workshop (beyond theory).
- The constant feedback from the teaching staff, and the creation of an instance for constant peer feedback.
- This allowed the students be conscious of their own strengths and weaknesses.
- They also praised the creation of an instance of continuous work where achievements were highlighted over time, which also allowed leverage of their strengths and improvement of their weaknesses in interpersonal communication.
-The type of methodology used (from theater pedagogy) allowed students to further develop their communication skills, to have a forum for sharing, to know each other better and ease the atmosphere of such academic overload.
This study is presented as the first compilation of experiences in the implementation of this kind of methodology, aimed to directly reinforce the students’ communication skills . An enhancement of MIW for future implementations was proposed relying on this compilation.
Dr. Sergio Bozzo, Head Professor, Medical Semiology, 2013
Dr. Gisella Alarcón, Medical School Director, 2011 - 2014
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