A cross-disciplinary approach to learning medical physiology and behavioral skills involving drama students performing as simulated patients.

The early years of physiology education in medical curricula provide unique challenges. As well as inculcating concepts that are seen as difficult, modern curricula require that students learn in context in case-based learning courses. Additionally, regulating bodies stress that the soft skills of compassion, communication, and empathy are embedded throughout curricula. This has driven work in our organization involving drama and final-year medicine students during which they collaborate in realistic simulations of doctor/patient interactions. We adapted this transdisciplinary approach to second-year physiology tutorials. This emphasized the holistic importance of physiology to patient care, while also embedding "human factors" skills from the very earliest stages of the curriculum. After preparing by attending acting classes based on aspects of Konstantin Stanislavski's "System," the authors supervised tutorials in which drama students participated in a "physiology of hypofertility" session for second-year medical students, playing a 34-year-old woman with premature menopause (or their partner). Opinion (from all students) was evaluated by Likert questionnaires (which included open questions). A focus group of drama students was also interviewed, and the conversation was recorded for thematic analysis. Positive Likert scores were recorded for the authenticity of the tutorials, skills development, fostering empathy, and motivating students to improve. All participants evaluated the tutorial as highly enjoyable. These scores are reflected in positive open commentary on the questionnaires and in the focus group interviews. The results suggest that even basic science tutorials give opportunities for interdisciplinary study and enhancement of behavioral skills while gaining enthusiastic student acceptance.NEW & NOTEWORTHY This work details how physiology tutorials for early years medical students are transformed by taking the clinical case off the two-dimensional page and instead having the case scenario acted by drama students. This adds context and authenticity. The benefits are twofold: emphasizing the importance of physiology to the budding clinician and embedding empathy and compassion from the earliest points in a clinician's career.

"Should I Say Something?": A Simulation Curriculum on Addressing Lapses in Professionalism to Improve Patient Safety.

Introduction: Medical students may witness lapses in professionalism but lack tools to effectively address such episodes. Current professionalism curricula lack opportunities to practice communication skills in addressing professionalism lapses. Methods: We designed a simulation curriculum to introduce professionalism expectations, provide communication tools using elements of the Agency for Healthcare Research and Quality TeamSTEPPS program, and address observed professionalism lapses involving patient safety in hierarchical patient care teams. Students were surveyed on knowledge, skills, and attitude regarding professionalism before, immediately after, and 6 months after participation. Results: Of 253 students, 70 (28%) completed baseline and immediate postsurveys, and 39 (15%) completed all surveys. In immediate postsurveys, knowledge of communication tools (82% to 94%, p = .003) and empowerment to address residents (19% to 44%, p = .001) and attendings (15% to 39%, p < .001) increased. At 6 months, 96% of students reported witnessing a professionalism lapse. Discussion: The curriculum was successful in reported gains in knowledge of communication tools and empowerment to address professionalism lapses, but few students reported using the techniques to address witnessed lapses in real life.

Movies and matters of the mind- portrayal of psychiatric illnesses in Bollywood over last two decades: A content analysis.

AIM: to analyze Bollywood movies depicting psychiatric illnesses, released in last two decades, on content and scientific accuracy. METHODOLOGY: Google search was done to compile a list of Bollywood movies portraying psychiatric illnesses. Each movie was screened for character details, symptoms, diagnosis, and accuracy of depiction. RESULTS: Twenty-eight movies were analyzed. Most characters were middle-aged, unmarried, employed, and affluent. Most common symptom was aggression and diagnosis was Schizophrenia. Treatment-seeking was low and common outcome was deterioration. CONCLUSION: Bollywood's depiction of psychiatric illnesses differs from research evidence in many aspects. Greater alignment between cinematic portrayal and research evidence is needed.

Educating Nursing Students About Female Genital Cutting/Mutilation Using a Standardized Patient in a Virtual Dramatization Simulation.

INTRODUCTION: Female genital cutting/mutilation (FGC/M) is a ritual to remove any or all of the external female genitalia. Educational strategies regarding the teaching of FGC/M for nursing students are scarce. The focus of this article is to describe the development, implementation, and evaluation of a virtual, FGC/M-related dramatization simulation with a standardized patient (SP). METHODS: This educational intervention used an East African immigrant woman as the SP with 35 undergraduate nursing students in two nursing schools in the Midwest United States. RESULTS: Participants appraised the simulation as an effective way to teach and learn about FGC/M. Debriefing was a key part of the simulation. DISCUSSION: Students felt the simulation was novel and engaging for a highly sensitive topic. The SP thought the virtual setting made it more comfortable for her to reveal sensitive facts. The researchers confirmed that the simulation required extensive time commitment to develop, critique, and implement.

"Patient's Family Wants an Update": A Curriculum for Senior Medical Students to Deliver Telephone Updates for Hospitalized Patients.

Introduction: Residents have the important task of updating family members of hospitalized patients, often by telephone. There are limited curricula dedicated to preparing medical students for this task, which will become their responsibility as residents. Methods: We created a virtual workshop, including four patient cases, to facilitate teaching senior medical students enrolled in an internal medicine residency preparation course. Students alternated role-playing either physician or family member. We assessed performance using a self-assessment rubric before (preworkshop) and after (postworkshop) a didactic session. We compared pre- and postworkshop scores using t tests. We also used a retrospective pre-post survey with a 5-point Likert scale to assess each participant's comfort level, knowledge, and perceived ability. Results: Thirty-nine students completed the pre- and postworkshop evaluation (response rate: 70%). The mean score on the preworkshop self-assessment was 83% (SD = 9%) and on the postworkshop self-assessment was 94% (SD = 8%; p < .01), with a large effect size of 1.22. Among the 31 students (62%) who completed the survey, there was improvement in comfort level (2.9 vs. 3.7, p < .001), knowledge (2.7 vs. 3.8, p < .001), and perceived ability (2.9 vs. 3.7, p < .001). Discussion: Our workshop was effective in teaching medical students a structured format for providing telephone updates and was well received. The workshop was also effective when delivered virtually (with videos off) to mimic the non-face-to-face communication that occurs when delivering family updates by telephone. The curriculum could be expanded to other learner groups.

Nursing students' knowledge gained about female genital cutting/mutilation through dramatization simulation with a standardized patient: A quasi-experimental study.

BACKGROUND: Female genital cutting is a culture bound ritual involving excision of the female genitalia. Little is known about nursing students' knowledge and perceptions of female genital cutting and no studies using simulation to teach this topic exist. OBJECTIVE: The aim of this study was to examine the impact of a dramatization simulation on nursing students' knowledge about and perceptions of female genital cutting. DESIGN: A quasi-experimental pretest posttest study with a convenience sample. SETTING: Two Bachelor of Nursing schools in Northeast Ohio, United States. PARTICIPANTS: 35 third year undergraduate students. METHODS: Students were divided into an intervention group (n = 14) and a wait list control group (n = 21). The intervention group took a pre-test, did a reading assignment and then attended a virtual, dramatization simulation session with a standardized patient; a Muslim woman with a personal history of female genital cutting. They took the posttest within the next week. The control group took the pretest, did the reading assignment, and then took the posttest, followed by the simulation. The survey instrument used for pretest and posttest was the Knowledge, Perceptions, and Practice Questionnaire on Female Genital Cutting for Healthcare Professionals in the United States. Debriefing was a critical part of the simulation. RESULTS: The knowledge of female genital cutting of the nursing students in the intervention group increased more than that of the students in the control group (change score 3.57 and 2.05 respectively). Students' perceptions of female genital cutting were not significantly changed by intervention type. CONCLUSION: This study was the first of its kind to measure nursing students' knowledge and perceptions about female genital cutting before and after a dramatization simulation. A standardized patient dramatization simulation including focused debriefing may be an effective education strategy to teach nursing students about female genital cutting.

Psychotropic Medication Informed Consent: A Cross-Specialty Role-Playing Skill Builder.

Introduction: Obtaining informed consent (IC) is an essential medical practice. Utilization of IC role-playing training with medication study cards and self-peer-supervisor review should improve student fund of knowledge and strengthen IC skills for clerkship-level medical students. Methods: Between 2017 and 2020, approximately 555 clerkship medical students used our formative role-playing exercise tools. Students independently prepared psychotropic medication study cards and role-played IC during group didactics. Peer and supervisor reviews were not recorded but were discussed as a group. Students completed routine anonymous postclerkship surveys regarding the IC exercise. An enhanced IC curriculum was deployed in 2020, adding a training video and peer/supervisor feedback form. Student feedback and specialty shelf exam scores were reviewed to assess the exercise's effectiveness. Results: Surveys indicated satisfaction with the exercise and increased confidence in obtaining IC. Interestingly, the student group that received enhanced IC training had fewer shelf exam failures than those without, perhaps indicating improved fund of psychotropic medication knowledge. Discussion: Peer role-playing IC training is well accepted by students, allows practice of essential elements of IC and shared decision-making, and provides an engaging way to improve medication fund of knowledge. Our clerkship has initiated development of an IC objective structured clinical examination station and is adapting the exercise across specialties for longitudinal learning in response to the positive feedback and ease of use. Structured review of psychotropics and peer IC role-playing can be tailored for other specialties, medications, and procedures and further developed for use in pre- and postclerkship education.

O uso da dramatização na avaliação do processo de ensino-aprendizagem / The use of role play on the assessment of the teaching-learning process / El uso de la dramatización en la evaluación del proceso de enseñanza-aprendizaje

O relato objetiva descrever a aplicação da dramatização na avaliação do processo ensino-aprendizagem no contexto acadêmico a partir da pedagogia psicodramática. A dramatização utilizada na avaliação acadêmica se mostrou um método que alia aprendizagem, conhecimento adquirido e congrega outros saberes; vivifica e reflete os conteúdos; promove a integração da turma no ambiente acadêmico; instiga o aqui e agora; desenvolve a espontaneidade, criatividade e telessensibilidade; impulsiona o comprometimento e a participação de todos; e dá um clima leve à avaliação.

The report aims to describe the application of dramatization in the assessment of the teaching-learning process in the academic context from psychodramatic pedagogy. The dramatization used in the academic evaluation showed itself to be a method that combines learning, acquired knowledge and congregates other knowledge; vivifies and reflects the contents; promotes the integration of the class in the academic environment; instigates the here and now; develops spontaneity, creativity and telesensitivity; promotes the commitment and participation of all; and gives a light climate to the evaluation.

El relato tiene por objetivo describir la experiencia en aplicar la dramatización en la evaluación del proceso de enseñanza-aprendizaje en el contexto académico a partir de la pedagogía psicodramática. La dramatización utilizada en la evaluación académica mostró una técnica que combina aprendizaje y conocimiento adquirido, congrega otros saberes; vivifica y refleja los contenidos; promueve la integración de la clase en el ambiente académico; instiga el aquí y ahora; desarrollo de la espontaneidad, creatividad y telesensibilidad; impulsa el compromiso y la participación de todos; y da un clima ameno a la evaluación.

A teatralização do poder: a questão da redução da maioridade penal / Dramatization of power: the question of the reduction of the age of majority / La teatralización del poder: la cuestión de la reducción de la mayoría penal

Em tempos de perplexidades e de algumas transformações sociais (com mais retrocessos do que avanços), podem-se perceber inovações, também, em formas distintas de governamentalidade. O texto insere-se nessa tentativa de diagnosticar o presente, na perspectiva de análise da atual conjuntura política nacional, em que várias formas de governamento insistem, quase que desesperadamente, em dar conta de uma agenda advinda de uma nova modalidade de teatralização do cenário político. Para tanto, utilizaremos os conceitos foucaultianos de governamentalidade e da teatralização do poder. O caloroso debate sobre a questão da Redução da Maioridade Penal será apresentado como uma das formas desse teatro político onde os argumentos e a razoabilidade ficam de lado e entram em cena, os discursos descontextualizados que fazem parte de uma dinâmica mais ligada a espetacularização desse cenário, num jogo de faz de conta, contrapondo-se aos dados amplamente divulgados, no Brasil e no exterior

In times of perplexities and some social transformations (with more setbacks than advances), it can be seen innovations in distinct forms of work. The text is inserted in that attempt to diagnose the present, in the light of the current national political climate analysis, in which various forms of governance insist, almost desperately, on accounting for a schedule from a new type of dramatization of the political scenario. To do so, we will use Michel Foucault's concepts of work and histrionics. The hearty debate on the issue of reducing Criminal Majority will be presented as one of the ways of that political theater in which arguments and reasonableness stand aside, while the uncommitted speeches that are part of a dynamic linked the spectacularization in this scenario of a make-believe game come into play, opposed to the data widely disseminated, in Brazil and abroad

En tiempos de perplejidades y de algunas transformaciones sociales (con más retrocesos que avances), se pueden percibir innovaciones, también, en formas distintas de gubernamentalidad. El texto se inserta en ese intento de diagnosticar el presente, en la perspectiva de análisis de la actual coyuntura política nacional, en que varias formas de gobierno insisten, casi desesperadamente, en dar cuenta de una agenda proveniente de una nueva modalidad de teatralización del escenario político. Para ello, utilizaremos los conceptos foucaultianos de gubernamentalidad y de la teatralización del poder. El caluroso debate sobre la cuestión de la Reducción de la Mayoridad Penal será presentado como una de las formas de ese teatro político donde los argumentos y la razonabilidad quedan de lado. Entra en escena, los discursos descontextualizados que forman parte de una dinámica más ligada a la espectacularización de ese escenario, en un juego de hace de cuenta, contraponiéndose a los datos ampliamente divulgados, en Brasil y en el exterior

O Jornal Vivo como aquecimento no role-playing do papel de educador / The use of Living Newspaper as a warm-up for the educator role / El Periódico en Vivo como caldeamento del rol de educador

Este trabalho apresenta a utilização do Jornal Vivo como parte de um projeto maior de desenvolvimento do papel de educador em um grupo de professores do ensino público. Relata-se a experiência psicodramática do Jornal Vivo, seus desdobramentos e suas repercussões no grupo, discutindo-se suas possibilidades como técnica ou recurso dramático em uma sessão de Sociodrama. Como resultado da sessão relatada, observou-se profundo impacto sobre os participantes, despertando reflexões sobre seu papel, o papel do aluno e o contexto.

This paper presents the use of the Living Newspaper as part of a major project aiming to develop the role of educator in a group of public school teachers. It describes the psychodramatic experience of the Living Newspaper and its impact and repercussions on the group, also reflecting on its possibilities as a dramatic technique or resource within a Sociodrama session. The session described in this paper had a profound effect on the participants, leading on reflections about their own role, the student's role, and the context.

Este artículo presenta el uso del Periódico en Vivo como parte de un proyecto importante para desarrollar el papel del educador en un grupo de profesores de una escuela pública. Se relata una experiencia psicodramática del Periódico en Vivo, sus consecuencias y su impacto en el grupo, discutiendo sus posibilidades como técnica o recurso dramático en una sesión de sociodrama. Como resultado de la sesión relatada, se observó un profundo impacto sobre los participantes, conduciendo a reflexiones sobre su propio papel, el rol del alumno y su contexto.

Cenas familiares e consulta terapêutica de adolescentes / Familiar scenes and therapeutic consultations with adolescents

A consulta terapêutica pais-filhos permite abordar os períodos sintomáticos da adolescência, favorecendo uma figuração dramatizada que descondensa a provocação agida da criança dirigida aos pais e sobredeterminada por aquilo que ela percebe sobre as dificuldades edípicas não elaboradas dos pais. A criança consegue, assim, liberar-se disso para a retomada do seu desenvolvimento. O exemplo de uma série de consultas terapêuticas ilustra essa dinâmica(AU)

Parents-child therapeutic consultation enables the approach to adolescence's symptomatic periods, favoring a dramatized figuration which decondenses the acted provocation of the child, aimed at the parents, and overdetermined by what he/she perceives of the parents's not-worked-through edipic difficulties. The child can, therefore, be freed to resume its development. The example of many therapeutic consultations illustrates this dynamics(AU)

La consulta terapéutica padres-hijos permite tratar los periodos sintomáticos de la adolescencia, favoreciendo una figuración dramatizada que descondensa la provocación actuada del niño dirigida a los padres y sobredeterminada por aquello que ella percibe sobre las dificultades edípicas no elaboradas de los padres. El niño logra, así, liberarse de eso para la retomada de su desarrollo. El ejemplo de una serie de consultas terapéuticas ilustra esa dinámica(AU)

Conceitos em ação: o uso de um jogo dramático como instrumento da pedagogia psicodramática aplicado em um grupo de alunos de formação em Psicodrama / Concepts in action: the use of a dramatic game as a tool from psychodramatic pedagogy applied to a group of psychodrama trainees / Conceptos en acción: el uso de un juego dramático como instrumento de la pedagogía psicodramática aplicado en un grupo de alumnos de formación en Psicodrama

Este artigo discute os efeitos do jogo dramático aplicado no grupo de alunos de Psicodrama na ótica da Pedagogia Psicodramática. Os resultados apontam o aprimoramento da compreensão e da relação entre os conceitos, semeados pelo estímulo do espírito crítico, da espontaneidade, da criatividade e de uma proposta de relação horizontal e democrática.

This article discusses the effects of dramatic games used with a group of psychodrama students, through the perspective of Psychodramatic Pedagogy. The results show an improvement in the understanding and inter-connecting of concepts, through the stimulation of critical thinking, spontaneity, creativity and a proposal for horizontal and democratic relationships.

Este artículo discute los efectos del juego dramático aplicado al grupo de alumnos de Psicodrama desde la perspectiva de la Pedagogía Psicodramática. Los resultados señalan la mejora de la comprensión y la relación entre los conceptos, sembrados por el estímulo del espíritu crítico, de la espontaneidad, la creatividad y por una propuesta de una relación horizontal y democrática.

Dramatização de histórias infantis e a compreensão de leitura por crianças institucionalizadas / Dramatization of children's stories and reading comprehension of institutionalized children

Para aferir qual o efeito da dramatização de histórias sobre o grau de compreensão delas foi feito um experimento envolvendo 12 crianças alfabetizadas, com idades entre 7 e 10 anos. Foram divididas em duplas e remanejadas segundo delineamento de grupo, em dois tipos de atividades: leitura de histórias e exposição às histórias dramatizadas. Para a avaliação da compreensão das histórias foram solicitados: reprodução oral, respostas a perguntas literais e inferenciais, desenho e exemplificação de palavras-chave. A quantidade de respostas desconexas foi maior na condição de leitura do que na de dramatização da história. É possível concluir que expor-se à história dramatizada favorece a melhor compreensão pelos participantes, em comparação com os seus desempenhos quando a história é somente lida.(AU)

To measure the effect of story dramatization on the level of story comprehension an experiment was carried out with 12 children varying in age between 7 and 10 years old. Subjects were split in couples and ordered in a group design, and engaged alternately in two types of activities: listening to and watching dramatized stories. The assessment was based on: oral reproduction of story, answering literal and inferential questions, drawings, and creation of story key-words. The number of disjointed answers was higher in the situation of listening to the story, in comparison to watching it. It is concluded that watching dramatized stories favors better story comprehension of children, in comparison with their performances when only listening to the story.(AU)

Dramatização de histórias infantis e a compreensão de leitura por crianças institucionalizadas / Dramatization of children's stories and reading comprehension of institutionalized children

Para aferir qual o efeito da dramatização de histórias sobre o grau de compreensão delas foi feito um experimento envolvendo 12 crianças alfabetizadas, com idades entre 7 e 10 anos. Foram divididas em duplas e remanejadas segundo delineamento de grupo, em dois tipos de atividades: leitura de histórias e exposição às histórias dramatizadas. Para a avaliação da compreensão das histórias foram solicitados: reprodução oral, respostas a perguntas literais e inferenciais, desenho e exemplificação de palavras-chave. A quantidade de respostas desconexas foi maior na condição de leitura do que na de dramatização da história. É possível concluir que expor-se à história dramatizada favorece a melhor compreensão pelos participantes, em comparação com os seus desempenhos quando a história é somente lida.

To measure the effect of story dramatization on the level of story comprehension an experiment was carried out with 12 children varying in age between 7 and 10 years old. Subjects were split in couples and ordered in a group design, and engaged alternately in two types of activities: listening to and watching dramatized stories. The assessment was based on: oral reproduction of story, answering literal and inferential questions, drawings, and creation of story key-words. The number of disjointed answers was higher in the situation of listening to the story, in comparison to watching it. It is concluded that watching dramatized stories favors better story comprehension of children, in comparison with their performances when only listening to the story.

[New Forms of Hysteria: Globalization, Market and the Comeback of Hysteria]. / Nuevas formas de histeria: globalización del mercado y repunte de la histeria.

INTRODUCTION: Hysterical disorder has had different interpretations and therapeutic approaches according to the different cultural contexts. In the Middle Ages, hysteria was conceived as devilish possessions whose symptoms became a sort of veracity certificate for the era's cultural pillar: the Bible. During Renaissance, hysteria obeys a new master: Science, dramatizing the neurological degenerative injuries to give reputation to physicians of the time. There is a kind of consensus: hysteria is an ever less observable disorder in consultation. It has practically disappeared in the North American Diagnosis Manual, DSM-IV. We wonder, has hysteria as such disappeared? Has it gotten new expressions? METHODS: Psychoanalytic review of hysteria, followed by a qualitative, historical and hermeneutic study. DEVELOPMENT: In these days of globalization, science is not the master anymore; instead, science is at the service of computing and market. The market biggest sellers are: depressive and anxious disorders, bulimia, anorexia, fibromyalgia, sexual drawbacks, somatoform disorders and extreme exhaustion disorder. Hysteria, raising bewilderment in modern medicine, comes back, cut up into pieces, in the form of these multiple disorders. Not only hysteria has not disappeared, but it has increased in consultation, almost perfect simulation of the disorders most promoted by capitalistic markets, granting power to the new master. Subsequently, its powerlessness is denounced, nothing alleviates said disorders. As Freud stated, the problem lies in the fact that this word does not have a receiver to decipher it.

A dramatização como estratégia de aprendizagem da linguagem escrita para o deficiente auditivo / Dramatization as a strategy in learning written language for the deaf

O deficiente auditivo tem como conseqüência de sua privação auditiva um atraso de aquisição e desenvolvimento de fala e linguagem oral. A linguagem determina o desenvolvimento lingüístico-cognitivo do indivíduo e desempenha papel imprescindível na aprendizagem, ou seja, a aprendizagem é um produto da exposição sistemática da linguagem. A aprendizagem da linguagem escrita se dá através da linguagem oral, especificamente o deficiente auditivo, terá como conseqüência um atraso tanto da leitura como da escrita, pois são produções consideradas abstratas para ele. O presente estudo teve o objetivo de verificar a possibilidade da arte de dramatizar ser um instrumento terapêutico que facilite o desenvolvimento da interpretação e compreensão de textos pelos deficientes auditivos. O trabalho foi desenvolvido com quatro deficientes auditivos, com idades de 9 a 15 anos, pacientes da Clínica do Curso de Fonoaudiologia - UNIARA. Os indivíduos foram trabalhados em três etapas: leitura do texto e resolução de um questionário individualmente, dramatização e nova resolução do questionário individualmente. Os participantes melhoraram a compreensão do texto em 100 por cento, demonstrando ser capazes de compreender e expressar essa compreensão mesmo que com dificuldades gramaticais e sintáticas. A dramatização possibilitou ao deficiente auditivo experienciar de maneira concreta o texto, tornando-o capaz de compreender e interpretar o que não compreenderia apenas com a leitura.

As a consequence of hearing loss, the deaf present delayed speech and oral language development. Language determines an individual's linguistic and cognitive development and plays an essential role in learning, that is, learning is produced through systematic exposure to language. Learning of written language is tied to verbal language, so deafness will likely result in delayed reading as well as writing, since such productions will be seen as abstract. The aim of the present study was to verify the possibility of using dramatization as a therapeutic instrument for learning written language, so as to promote the development of interpretation and understanding of written texts for deaf students. The study was developed with four deaf students, aged between 9 and 15 years, patients of the Speech Pathology Course Clinic - UNIARA. The study had three stages: reading the text and individually filling out a questionnaire, dramatization, and repetition of the application of the questionnaire. The participants' understanding of the text improved 100 percent; they demonstrated that they were able to understand the text and express their comprehension, albeit with some grammatical and syntactic difficulties. The dramatization enabled the deaf students to experience the text concretely, which helped them to understand and interpret that which they hadn't understood while reading.