Bell Sigall K, Pascucci Robert, Fancy Kristina, Coleman Kelliann, Zurakowski David, Meyer Elaine C
Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA; Institute for Professionalism and Ethical Practice, Boston Children's Hospital, Harvard Medical School, Boston, USA.
Critical Care Medicine and Perioperative Anesthesia, Departments of Critical Care Medicine and Anesthesia, Boston Children's Hospital, Harvard Medical School, Boston, USA.
Patient Educ Couns. 2014 Sep;96(3):381-8. doi: 10.1016/j.pec.2014.07.001. Epub 2014 Jul 14.
To assess the educational value of improvisational actors in difficult conversation simulations to teach communication and relational skills to interprofessional learners.
Surveys of 192 interprofessional health care professionals, and 33 teaching faculty, and semi-structured interviews of 10 actors. Descriptive statistics, Fisher's exact test and chi-square test were used for quantitative analyses, and the Crabtree and Miller approach was used for qualitative analyses.
191/192 (99.5%) interprofessional learners (L), and 31/33 (94%) teaching faculty (F) responded to surveys. All 10/10 actors completed interviews. Nearly all participants found the actors realistic (98%L, 96%F), and valuable to the learning (97%L, 100%F). Most felt that role-play with another clinician would not have been as valuable as learning with actors (80%L, 97%F). There were no statistically significant differences in perceived value between learners who participated in the simulations (47%) versus those who observed (53%), or between doctors, nurses, or psychosocial professionals. Qualitative assessment yielded five actor value themes: Realism, Actor Feedback, Layperson Perspective, Depth of Emotion, and Role of Improvisation in Education. Actors independently identified similar themes as goals of their work.
The value attributed to actors was nearly universal among interprofessional learners and faculty, and independent of enactment participation versus observation. Authenticity, feedback from actors, patient/family perspectives, emotion, and improvisation were key educational elements.
评估即兴演员在困难对话模拟中对跨专业学习者进行沟通和关系技能教学的教育价值。
对192名跨专业医疗保健专业人员和33名教师进行调查，并对10名演员进行半结构化访谈。定量分析采用描述性统计、费舍尔精确检验和卡方检验，定性分析采用克拉布特里和米勒方法。
192名跨专业学习者中有191名（99.5%），33名教师中有31名（94%）回复了调查问卷。10名演员全部完成了访谈。几乎所有参与者都认为演员很逼真（学习者98%，教师96%），且对学习有价值（学习者97%，教师100%）。大多数人认为与另一位临床医生进行角色扮演不如与演员一起学习有价值（学习者80%，教师97%）。参与模拟的学习者（47%）与观察模拟的学习者（53%）之间，以及医生、护士或心理社会专业人员之间，在感知价值上没有统计学显著差异。定性评估产生了五个演员价值主题：逼真性、演员反馈、外行视角、情感深度以及即兴表演在教育中的作用。演员们独立确定了类似的主题作为他们工作的目标。
跨专业学习者和教师几乎普遍认可演员的价值，且与参与表演还是观察无关。真实性、演员反馈、患者/家属视角、情感和即兴表演是关键的教育要素。
