What do children think about doctors' communication at the Teddy Bear Hospital?

Abstract

Aim: Excellent communication is essential for health professionals working with children. Teddy Bear Hospital (TBH) is an innovative method of developing paediatric communication skills in health-care students. By exploring the child's perspective of medical students' communication at the TBH, we sought to better understand the role TBH plays in the development of the communication skills in medical students. Methods: Semi-structured interviews were conducted with 31 children, aged 3-8 years old, who were attending a TBH run by third year medical students at the Royal Children's Hospital in Melbourne. These interviews were recorded and transcribed after which themes were generated by inductive content analysis using the programme NVivo 12. Results: Children used mostly positive language when describing interactions with teddy doctors. However, almost half of the children could not recall the medical students explaining why their teddy was sick or how their teddy would get better. Furthermore, many teddies returned from TBH with medical issues different to their initial presentation. Conclusions: The communication described at TBH was overwhelmingly positive with children describing little difference between medical students and actual doctors. However, the mismatch in teddy medical issues before and after a visit to TBH along with the lack of understanding on teddy health management plans, suggests the need for further evidence-based training in communication skills for medical students to improve their ability to communicate with very young children.

Researcher positionality in eliciting young children’s perspectives

“…Jazrawy et al (2021) in a scoping review that involved 11 studies of the Teddy Bear Hospital (TBH) and medical role plays involving the teddy bears, found that they were overwhelmingly positively received and that children's level of anxiety was lowered whilst their health knowledge improved. In a further review by Moore et al (2022) it was noted that while the Teddy Bear Hospital (TBH) contributed to better communication skills by medical professionals, further training on how to listen (rather than ask questions and/or impart information) was recommended. Beyers et al (2017Beyers et al ( , 2018 explored the use of teddy bears in the development of family therapy interventions with children and their parents.…”

“…Third, the presence of the object might encourage children to engage in research processes because they identify with the object more readily than they might do with adult researchers. Fourth, children are known to derive comfort and confidence from the presence of objects (such as puppets, teddy bears and dolls), which can lower anxiety and facilitate engagement in research (Epstein et al, 2008; Moore et al, 2022).…”

“…The technique adopted was loosely based on the Teddy Bear Hospital (TBH) and the ‘Teddy Bear Therapy’ approach which features in research literature. In work with ill children who need to attend and stay in hospital, the Teddy Bear Hospital (Jazrawy et al, 2021; Moore et al, 2022) involves the use of teddy bears which are ascribed various illnesses and/or in need of various treatments as a means of imparting information to children regarding their illnesses and planned medical interventions in a way that is accessible to them and that also aims to reduce children’s fear and anxiety regarding their situation. Jazrawy et al (2021) in a scoping review that involved 11 studies of the Teddy Bear Hospital (TBH) and medical role plays involving the teddy bears, found that they were overwhelmingly positively received and that children’s level of anxiety was lowered whilst their health knowledge improved.…”

Directed Medical Role Play for Children: Review of the Teddy Bear Hospital Implementations, Objectives, and Reported Experiences

“…It is evident that regardless of the different approaches and strategies used to implement the Teddy Bear Hospital, they all ultimately share the same intent: to raise health care awareness and alleviate young children's anxiety over medical treatment while focusing on the promotion of positive healthy lifestyle. Of the 11 included studies, 2 were quasi-experimental pre/post design [13], [16], 1 scoping systematic review [17], 2 were Analysis of variance ANOVA [7], [19], 1 control group trials [8] and the remainder were qualitative research studies [11], [12], [14], [15], [18].…”

“…All studies portray the teddy bear hospital as an intervention of medical roleplay. They took place place between the years 2008 to 2021, where two of the studies were in Canada (Ontario and London, ON) [14], [16], two in Malaysia [17], [18], two in Israel/ Palestine [8], [11], one in Norway [12], one in Germany [13], one in the Netherlands [7] and lastly, two in Australia [15], [19] as displayed in Figure 3, which predominantly involved either medical or veterinary students or researchers that dedicated their time and effort to improve on the effectiveness of medical roleplay through The Teddy Bear Hospital.…”