Simulated patient and role play methodologies for communication skills and empathy training of undergraduate medical students

Abstract

Background Verbal and non-verbal communication, as well as empathy are central to patient-doctor interactions and have been associated with patients’ satisfaction. Non-verbal communication tends to override verbal messages. The aim of this study was to analyze how medical students use verbal and non-verbal communication using two different educational approaches, student role play (SRP) and actor simulated patient (ASP), and whether the non-verbal behaviour is different in the two different poses. Methods Three raters evaluated 20 students playing the doctor role, 10 in the SRP group and 10 in the ASP group. The videos were analyzed with the Calgary-Cambridge Referenced Observation Guide (CCG) and, for a more accurate evaluation of non-verbal communication, we also evaluated signs of nervousness, and posture. Empathy was rated with the CARE questionnaire. Independent Mann Whitney U tests and Qhi square tests were performed for statistical analysis. Results From the 6 main tasks of the CCG score, we obtained higher scores in the ASP group for the task ‘Gathering information’ (p = 0.0008). Concerning the 17 descriptors of the CCG, the ASP group obtained significantly better scores for ‘Exploration of the patients’ problems to discover the biomedical perspective’ (p = 0.007), ‘Exploration of the patients’ problems to discover background information and context’ (p = 0.0004) and for ‘Closing the session – Forward planning’ (p = 0.02). With respect to non-verbal behaviour items, nervousness was significantly higher in the ASP group compared to the SRP group (p < 0.0001). Concerning empathy, no differences were found between the SRP and ASP groups. Conclusions Medical students displayed differentiated verbal and non-verbal communication behaviour during the two communication skills training methodologies. These results show that both methodologies have certain advantages and that more explicit non-verbal communication training might be necessary in order to raise students’ awareness for this type of communication and increase doctor-patient interaction effectiveness.

Relationship between emotional intelligence and job well-being in Chinese clinical nurses: multiple mediating effects of empathy and communication satisfaction

“…They should also train nurses to send, receive, and interpret communication content to improve their communication skills. In addition, role-playing exercises [46] may have value in this respect, in which nurses play the roles of patients when discussing medical history and physical examination results. Nurses could thereby express their role-play medical history and clinical problems, simulate specific clinical symptoms, and feel the patient's physical condition and emotional experience, which could improve nurses' emotional intelligence and empathy.…”

Undergraduate psychiatric education: current situation and way forward

“…Techniques such as student role-play and simulated patients have been found to improve the communication skills and empathy of undergraduate medical students and seem to be very well accepted. 12 These techniques are used to teach history taking and formulating a management plan and can depict challenging clinical situations (e.g. acutely agitated patients) or rare syndromes, which would otherwise be neglected during training.…”

Use of Alternative Methodologies in Veterinary Medicine Learning and Acceptance of Students

“…The use of gamification and educational videos have been one of the methodological alternatives that have been used for this purpose [25,26]. Within the use of games as a tool for interactive learning, one of the most used methodologies has been role-play, mainly in areas where the communication skills and empathy are more relevant for professional development [8,9,27]. On the other hand, the recent COVID-19 pandemic has caused higher education institutions to modify most of their activities, since face-to-face activities were suspended.…”

“…However, this is the first study where a role-play game has been applied to teaching in veterinary medicine. Role-play games are common practice in other disciplines such as physiotherapy [11,27], human medicine [9,32,33], and nursing [12,13], among others. Given the curricular similarities between these disciplines [34], acquiring this type of alternative teaching practices would be interesting for veterinary medicine students, from the point of view of active teaching and improving learning.…”

“…Strategies for the use of gamification in higher education are varied, including some more traditional ones such as role-playing games [7]. Several studies have demonstrated the benefits of role-play as a learning method to improve empathy, clinical skills, communication skills, and active listening [8][9][10][11][12][13]. However, as far as we Educ.…”