Oxytocin predicts positive affect gains in a role-play interaction.

Introduction: Role-play, a key creative process in theatre, is used in therapeutic interventions to improve social skills, emotion regulation, and memory. Although role-play is widely used as a psychotherapeutic technique, its mechanisms of action are not fully understood. Methods: Our study introduces a standardized controlled procedure for promoting role-play in the laboratory based on the portrayal of a fictional persona and examines its effects on anxiety, affect, prosocial attitudes, and salivary oxytocin dynamics in 38 participants. Results: In our experiment, role-play significantly increased positive affect and prosocial attitudes and decreased anxiety compared to a control condition. Basal salivary oxytocin levels predicted higher gains in positive affect following role-play, suggesting a specific moderating effect of oxytocin. The fictional persona used in the procedure was rated as very happy by subjects, creating a positive social context for the role-play social interaction. Discussions: We propose that the observed moderation effect of oxytocin in our study is specific to the role-play condition due to the capacity of role-play to generate an affective regulatory context based on congruency toward the emotional state of the fictional persona. Our findings indicate that basal oxytocin levels could predict specific outcomes of role-play in therapeutical setting. We discuss several psychological and biological mechanisms that could account for the observed effects of role-play and how oxytocin could act as a substrate for them.

Culture, sex and social context influence brain-to-brain synchrony: an fNIRS hyperscanning study.

BACKGROUND: Unique interpersonal synchrony occurs during every social interaction, and is shaped by characteristics of participating individuals in these social contexts. Additionally, depending on context demands, interpersonal synchrony is also altered. The study therefore aims to investigate culture, sex, and social context effects simultaneously in a novel role-play paradigm. Additionally, the effect of personality traits on synchrony was investigated across cultures, and a further exploratory analysis on the effects of these variables on pre- and post-session empathy changes was conducted. METHODS: 83 dyads were recruited in two waves from Singapore and Italy and took part in a within-subjects session where they interacted with each other as themselves (Naturalistic Conversation) and as others (Role-Play and Role Reversal). Big Five Inventory (administered pre-session) and Interpersonal Reactivity Index (administered pre- and post-session) were used as measures of personality and empathy respectively, while synchrony was measured using hyperscanning functional near-infrared spectroscopy in the prefrontal cortex. After data-preprocessing and preliminary analyses, a mixture of multiple linear regression and exploratory forward stepwise regression models were used to address the above study aims. RESULTS: Results revealed significant main and interaction effects of culture, sex and social context on brain-to-brain synchrony, particularly in the medial left cluster of the prefrontal cortex, and a unique contribution of extraversion and openness to experience to synchrony in the Italian cohort only. Finally, culture-driven differences in empathy changes were identified, where significant increases in empathy across sessions were generally only observed within the Singaporean cohort. CONCLUSIONS: Main findings indicate lowered brain-to-brain synchrony during role-playing activities that is moderated by the dyad's sex make-up and culture, implying differential processing of social interactions that is also influenced by individuals' background factors. Findings align with current literature that role-playing is a cognitively demanding activity requiring greater levels of self-regulation and suppression of self-related cognition as opposed to interpersonal co-regulation characterized by synchrony. However, the current pattern of results would be better supported by future studies investigating multimodal synchronies and corroboration.

Curiosities take the stage - role-play in parasitology teaching.

Careful observation of parasites, masters of camouflage, reveals an ingenious and fascinating world. However, students often perceive parasitology as impenetrable. What if a flamboyant flea circus director passionately introduced the multidimensional contexts of this discipline? Will role-play capture the imagination of students and guide them in their future learning?

The use of role-play in the learning of medical terminology for online and face-to-face courses.

Student engagement while learning a new, unfamiliar vocabulary is challenging in health science courses. A group role-play activity was created to teach students medical terminology and learn why its correct usage is important. This activity brought engagement and relevance to a topic traditionally taught through lecture and rote memorization and led to the development of an undergraduate and a stand-alone introductory course to teach students medical terminology. The undergraduate course was designed to be a fully online medical terminology course for health science students and a face-to-face course for first-year dental students founded in active learning and group work. The course's centerpiece learning activity focused on using published case studies with role-play. In this group activity, students are challenged to interpret a published patient case study as one of the members of a healthcare team. This course models the group work inherent in modern health care to practice building community and practicing professional skills. This approach gives students the capacity to work asynchronously in a team-based approach using our learning management system's wiki tool and requires students to take responsibility for their learning and group dynamics. Students practice identification, writing, analyzing, and speaking medical terms while rotating through the roles. Students in both classes self-reported a 92% to 99% strong or somewhat agreement using a five-point Likert scale that the course pedagogy was valued and helpful in their learning of medical terminology. Overall, this method has proven to be an engaging way for students to learn medical terminology.NEW & NOTEWORTHY Role-play can engage students and encourage learning in identification, pronouncing, writing, and understanding medical terminology in multiple course formats.

Becoming 'international': Transgressing national identity as a ritual for class identification.

Asking how being 'international' relates to privilege, I analyse a role-play game, the Students' League of Nations, where pupils and teachers from select international schools simulate the UN General Assembly in Geneva. I document distinctive practices of selection and visions of excellence as talent, using Bourdieu's notion of 'institutional rite'. I combine insider ethnography and quantitative analyses of the host school with a historical account of its' elitism to bridge the gap between macro- and micro-analyses of 'everyday nationalism'. I show how this game draws a symbolic boundary between 'international' and 'local' high schools by separating students who are considered worthy of transgressing their national identity from all others.

Should physician-assisted suicide (PAS) be legalised in the UK? An innovative workshop exploring medical students' perspectives.

This workshop aimed to investigate students' perspectives on physician-assisted suicide (PAS) and its potential legalisation. A two-pronged strategy was used - a goldfish bowl roleplay simulation and a facilitated group discussion. The roleplay enabled students to engage with practical and emotional challenges related to responding to a PAS request, while the discussion encouraged open dialogue on the ethical complexities of legalising PAS. Students showed nuanced changes in perspectives on PAS by actively participating in roleplay and discussions, demonstrating the potential for these approaches to promote deeper understanding.

Attitudes and Confidence in Communication Skills of Fourth-Year Medical Students After Online Small Group Discussion and Peer Role-Play: A Survey Study.

OBJECTIVE: This study investigated the impact of online small group discussions and peer role-play on medical students' attitudes toward and confidence in communication skills. METHODS: The study involved a 3-hour instructional design that integrated small group discussions and role-plays to enhance the communication abilities of fourth-year medical students. The data were obtained from students through a post-activity online survey. Likert scale responses were quantified as percentages. Students' narrative feedback on their learning achievements was subjected to content analysis. Codes and categories were agreed upon by investigators and reviewed by an external auditor. RESULTS: A total of 151 medical students responded to the survey, representing a 47.94% response rate. The majority strongly agreed that good communication skills help physicians obtain reliable information (94.00%) and that practicing questioning skills is essential (92.1%). Content analysis revealed that nearly half (48.34%) considered that the learning activities fostered positive attitudes toward communication. These attitudinal improvements included increased empathy and emotional care (37.75%), recognition of communication as a trainable skill (10.57%), and recognition of the necessity of communication skills for physicians (8.61%). Additionally, most students (75.5%) reported increased confidence in their communication skills. CONCLUSIONS: In alignment with transformative learning theory, online small group discussions combined with peer role-play may potentially enhance the attitudes and confidence of medical students in relation to communication skills.

Impact of Multimodal Intervention on Empathy Levels in Medical Students: A Questionnaire-Based Study.

Background Empathy is essential for effective doctor-patient communication. It enables doctors to understand patients' emotions and concerns, facilitating personalized care and support. Empathy can be cultivated through various methods and training programs. Objective The study aims to assess the effectiveness of a multimodal intervention involving interactive lectures, peer role-play, and guided reflection in enhancing empathy levels among second-year medical undergraduate students in India. Methods This study utilized a questionnaire-based, pre- and post-test interventional design. Seventy-nine second-year medical students were included after obtaining their informed consent. The students received the intervention through an interactive lecture on communication skills, role-play on selected case studies, and guided reflection. The empathy levels were assessed using the Toronto Empathy Questionnaire (TEQ) before and after the intervention. The Mann-Whitney U test was utilized to compare pre-test and post-test TEQ scores. A univariate analysis of variance was conducted to explore the relationship between demographic variables and post-test TEQ scores. Statistical significance was considered at p ≤ 0.05. Results The TEQ score improved significantly (p=0.009) after the intervention. The univariate analysis indicated that gender, style of education, and place of residence did not have a statistically significant impact on post-test scores. Conclusion The study demonstrates that a multimodal intervention significantly enhances the empathy level of medical students, highlighting the potential of focused interventions to reduce gender disparities in empathy levels. There were no significant differences in empathy scores based on gender, place of residence, or schooling, suggesting the intervention's benefits may apply to all medical students.

Empowering students to create their dramatizations increases understanding of physiology.

Complex subjects such as physiology can be challenging for students to learn. These challenges are not uncommon in implementing the learning process in physiology and affect learning outcomes. Dramatization is an interactive and effective method to improve learning outcomes. In a project designed by senior medical students, junior medical students were guided in creating dramatizations related to three topics. Senior students were trained and assisted to prepare scenarios and make videos. The dramatizations were then carried out with junior medical students to help them better understand physiology and pathophysiology topics. A group of junior students receiving the same topics in a lecture format served as a control group. Pretest and posttest questionnaires were used to measure the improvement of learning outcomes. Assessment results showed an increase in performance in both groups. This study shows that dramatizations provide an effective alternative to lectures for instructing junior medical students.NEW & NOTEWORTHY The preparation of dramatizations involved students. The ideas, analogies, and dramatizations were originally from students. Dramatization is an alternative form of understanding learning objectives of medical physiology in an interesting way to increase motivation.

Mock court: a valuable tool to teach legal procedures to undergraduate medical students.

BACKGROUND: Teaching through role-plays is a preferred modality when certain behaviours or skills need to be taught. They provide a risk-free environment that simulates a real-life scenario. For a clinician, appearance in a Court of Law as an expert witness is a part of his/her legal obligation. OBJECTIVE: To explore the utility of Mock Court as an additional teaching tool for undergraduate medical students, in understanding and familiarizing with legal procedures, specifically the courtroom procedures. METHODOLOGY: We conducted Mock Court sessions with the students playing various roles, following which feedback was collected from the students, teachers and guest assessors. The data was statistically analysed by comparison of frequencies and paired t-test (pre- and post-session comparison). RESULTS: The study revealed a positive effect of the Mock Court sessions on the students, based on their increased confidence, motivation and a better grasp of legal procedures. There was a statistically significant (p < 0.001) improvement in the understanding of specific aspects of courtroom procedures after the session. CONCLUSION: The authors recommend the active implementation of Mock Court as a teaching aid for undergraduate medical students, and the use of PDSA (Deming) cycle as a tool for quality-checks and self-improvement in subsequent sessions.

The Usefulness of Dramatics for Teaching Cutaneous Tuberculosis: An Edutainment Approach for Postgraduate Medical Students.

About 1.5% of tuberculosis manifestations is cutaneous and accounts for 0.1-0.9% of total OPD patients in India. Forty first-year postgraduate medical students were taught cutaneous TB though conventional PPT, 'Carousel Role Play' and 'Theatre of the Oppressed' technique. The statistically significant effectiveness of theatrical workshops was noted.

The design and evaluation of gamified online role-play as a telehealth training strategy in dental education: an explanatory sequential mixed-methods study.

To evaluate user perceptions and educational impact of gamified online role-play in teledentistry as well as to construct a conceptual framework highlighting how to design this interactive learning strategy, this research employed an explanatory sequential mixed-methods design. Participants were requested to complete self-perceived assessments toward confidence and awareness in teledentistry before and after participating in a gamified online role-play. They were also asked to complete a satisfaction questionnaire and participate in an in-depth interview to investigate their learning experience. The data were analyzed using descriptive statistics, paired sample t-test, one-way analysis of variance, and framework analysis. There were 18 participants who completed self-perceived assessments and satisfaction questionnaire, in which 12 of them participated in a semi-structured interview. There were statistically significant increases in self-perceived confidence and awareness after participating in the gamified online role-play (P < 0.001). In addition, the participants were likely to be satisfied with this learning strategy, where usefulness was perceived as the most positive aspect with a score of 4.44 out of 5, followed by ease of use (4.40) and enjoyment (4.03). The conceptual framework constructed from the qualitative findings has revealed five key elements in designing a gamified online role-play, including learner profile, learning settings, pedagogical components, interactive functions, and educational impact. The gamified online role-play has demonstrated its potential in improving self-perceived confidence and awareness in teledentistry. The conceptual framework developed in this research could be considered to design and implement a gamified online role-play in dental education. This research provides valuable evidence on the educational impact of gamified online role-play in teledentistry and how it could be designed and implemented in dental education. This information would be supportive for dental instructors or educators who are considering to implement teledentistry training in their practice.

Simulation-based teaching of psychiatric interviewing to residents: A comparison of peer-to-peer and teacher role-play on confidence in clinical skills.

OBJECTIVE: To compare the effects of two simulation-based teaching programs of psychiatric interviewing using two role-play modalities on first-year psychiatry residents' confidence in their psychiatric clinical skills. METHODS: The teaching program consisted of seven 2-hour sessions per month led by two psychiatrists and academic teachers. In the peer-to-peer role-play group, students played either the patient's or doctor's role, and case scenarios were proposed by the students; in the teacher role-play group, a teacher played the patient' role and case scenarios were written by teachers. Simulation debriefing was teacher-guided in both groups. Confidence was measured with the Confidence in Psychiatric Clinical Skills Questionnaire (CPCQ) before and after the teaching program. RESULTS: Both strategies induced a significant improvement in the CPCQ total score. However, the peer-to-peer role-play program induced a significantly larger improvement in the CPCQ total score. DISCUSSION: Compared to teacher role-play, peer-to-peer role-play may enable a better comprehension of the patient perspective, reduce performance anxiety during the simulated scenario, and provide a partly improvised scenario that is more transferable to real-life clinical experiences. CONCLUSION: Teaching psychiatric interviewing using the peer-to-peer role-play approach enables greater improvement in confidence in clinical skills than teacher role-play.

Teaching breaking bad news in a gyneco-oncological setting: a feasibility study implementing the SPIKES framework for undergraduate medical students.

BACKGROUND: It is a crucial task for physicians to deliver life threatening information to patients (breaking bad news; BBN). Many aspects influence these conversations on both sides, patients, and doctors. BBN affects the patient-physician relationship, patients' outcome, and physicians' health. Many physicians are still untrained for this multi-facetted task and feel unprepared and overburdened when facing situations of BBN. Therefore, any faculties should aim to integrate communication skills into their medical curricula as early as possible. The SPIKES protocol is an effective framework to deliver BBN. Aim of this study is to evaluate the feasibility and obstacles of a BBN seminar and its acceptance and learning curve among undergraduate medical students. METHODS: 158 2nd year undergraduate medical students attended a compulsory BBN seminar. The task was to deliver a cancer diagnosis to the patient within a patient - physician role-play in a gyneco-oncological setting before and after a presentation of the SPIKES protocol by the lecturer. The students evaluated important communication skills during these role-plays respectively. Self-assessment questionnaires were obtained at the beginning and end of the seminar. RESULTS: Most students indicated that their confidence in BBN improved after the seminar (p < 0.001). They like the topic BBN to be part of lectures (76%) and electives (90%). Communication skills improved. Lecturer and seminar were positively evaluated (4.57/5). CONCLUSION: The seminar significantly increased confidence and self-awareness in delivering life-threatening news to patients among undergraduate medical students. Important learning aspects of BBN and communication skills could be delivered successfully to the participants within a short time at low costs. The integration of communication skills should be implemented longitudinally into medical curricula starting before clinical education to increase the awareness of the importance of communication skills, to decrease anxiety, stress, and workload for future doctors and- most importantly- to the benefit of our patients.

Anti-racism bystander training: A critical need in medical schools.

Despite increasing acknowledgment of racism in both the curricular and clinical spaces, it continues to pervade the medical field, with clear detrimental impacts to the health of our patients. The introduction of anti-racism bystander training (ARBT) may provide a unique opportunity to reduce inequitable care and health disparities that occur secondary to racism in healthcare. ARBT, in its various forms, has been shown to be an effective method to increase participants' confidence and efficacy in intervening on observed racist encounters. This training can take numerous forms, and the authors provide one successful template used with medical students at their own institution. If medical centers, educators, and leaders in the field of medicine truly hope to mitigate the individual racist behaviors that remain in healthcare, ARBT must be employed to a much wider degree in medical education.

Educational interventions for promoting sexual and reproductive health in school counselors: a three-arm, randomized control trial comparing lecturing, buzz group and role-play.

BACKGROUND AND OBJECTIVE: School-based sexual and reproductive health (SRH) education is often reported as being inadequate and/or inconsistent. This study aimed to investigate the educational interventions for promoting SRH in school counselors and compare the results in three groups: lecturing, buzz group and role-play. MATERIALS AND METHODS: An intervention quasi-experimental design was employed to evaluate the usefulness of educating SRH topics by using interactive teaching methods for 120 school counselors. Changes in the participants' knowledge, attitudes and self-efficacy toward SRH education were evaluated by each group using a pretest and a posttest. RESULTS: The results of this study revealed that 75% of counselors deemed SRH training vital and felt that the best SRH educators are health care providers and the reason might be their lack of educational skills. They also stated that the most significant barriers to education in schools include concerns about parental feedback and lack of appropriate abilities. CONCLUSION: The present study showed that the use of all three methods (lecturing, buzz groups and role-play) in SRH training improves the level of knowledge, attitude and self-efficacy; although role-play could have been more effective than lecturing in improving counselors' knowledge.

"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.

Researcher-initiated role play, stimulated recall interview, storycrafting, painting and drawing as research methods to reach children's perspectives in health sciences.

AIM: To describe the application of selected creative and participatory research methods in nursing science. DESIGN: Research methodology paper. METHODS: Researcher-initiated role play, stimulated recall interviews, the Storycrafting method, painting and drawing. Altogether, 11 children (5-7 years old) and 12 parents participated in the research. RESULTS: Each small group (n = 3) acted differently during the data collection. Not every child wanted to play, draw or tell stories, but they all expressed their views through some method. Although the same themes emerged from children's narratives, they could not have been verified by just one method. CONCLUSIONS: Using creative and participatory methods and the principles of studies of child perspectives are applicable ways of conducting research in nursing science. Children must be treated as individuals during the research process, and they must have opportunities to use several communication methods to express their views. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE: Understanding different ways to interact with children and hear children's views will help nurses to encounter children. IMPACT: In this article, we present a valid way of conducting research with children. By following our protocol, nursing research from a child perspective can be implemented. REPORTING METHOD: Consolidated criteria for reporting qualitative research (COREQ). PATIENT CONTRIBUTION: The child participants were involved in choosing physical places for data collection and the usage and order of the selected methods. Both the children and the adult participants took part in interpreting the research data.

Practice Makes Perfect: MSW Students Reflect on Skill-Based Teaching Methods in Clinical Social Work Education.

In the current focus-group study, we consider student experiences with and perceptions of teaching methods that involve practice observation, demonstration, and performance assessment and feedback (i.e., skill-based teaching methods). Focus groups included masters of social work students (N = 40) from six universities in the United States. Students were, on average, 34 years of age (range 21 to 58) with 75% female, 20% male, and two non-binary students. Students identified as White (50%), Latinx/Latine (20%), Black (12.5%), and multi-racial (12.2%). A framework-guided content analysis was used, and revealed four broad themes: 1) classroom-based opportunities for practice observation and feedback, 2) field-based opportunities for practice observation and feedback, 3) other methods such as standardized patient simulations and computer simulations, and 4) attitudes about these methods. Experiences with these methods were quite diverse with classroom-based role plays being the most common. Attitudes were generally positive, though lack of authenticity and performance anxiety were perceived as drawbacks. Student reflections on their experiences yielded several teaching recommendations specific to preparation, the nature of the simulated client role, and feedback.

Training first-year medical residents to break bad news using healthcare role-play and trainees as simulated patients: Experience of the "ADIAMED" program from Lille University School of Medicine.

INTRODUCTION: Several studies suggest the relevance of healthcare simulation to prepare future doctors to deliver bad news. A such, we designed a role-play workshop to train first-year residents enrolled in Lille University School of Medicine to break bad news. The objective of this work is to report on our experience of this training and to assess its educational value through its capacity to satisfy residents' expectations, to induce a feeling of ease towards bad news disclosure, and to change trainees' preconceptions regarding these situations. METHODS: The training consisted of a 45-minute heuristic reflective activity, aimed at identifying residents' preconceptions regarding bad news disclosure, followed by 4 30-min role-plays in which they played the parts of the physician, the patient and/or their relatives. Trainees were asked to answer 2 questionnaires (pre- and post-training), exploring previous experiences, preconceived ideas regarding bad news disclosure and workshop satisfaction. RESULTS: Almost all residents felt very satisfied with the workshop, which they regarded as formative (91%) and not too stressful (89%). The majority felt "more capable" (53% vs. 83%) and "more comfortable" (27% vs. 62%) to deliver bad news, especially regarding "finding the right words" (12% vs. 22%). Trainees tended to overestimate their skills before the workshop and lowered their assessment of their performance after attending the training, especially when they played the role of a patient in the simulation. CONCLUSION: Healthcare role-play seems an interesting technique for training to breaking bad news. Placing residents in the role of patients or relatives is an active approach that encourages reflexivity.