Department of Pediatrics, University Hospital, 4 rue Larrey, 49000, Angers, France.
Department of Psychiatry, University Hospital, Angers, France.
BMC Med Educ. 2020 Feb 24;20(1):58. doi: 10.1186/s12909-020-1965-4.
Physician empathy has been associated with improved clinical outcomes and lower physician burnout. We evaluated whether forum theater (FT), a form of applied drama that allows participants to enter the performance and represent the actions associated with emotions, would foster empathy in medical students, and which underlying variables would be associated to empathy scores.
Three classes totaling 488 fourth-year medical students participated in the study. Forum theater was used to explore difficult encounters with patients and family members: announcement of cancer, fall at home of an elderly person requiring hospitalization, appointment with a patient suffering from depression, announcement of diabetes in an adolescent. The first scene was played by actors in front of a group of students, then audience members were asked to enter the performance and, by taking over the role of the "physician-actor," to explore alternative interactions. All the students followed two sessions as actors and observers in random order and were randomly assigned to FT sessions after 36 or 56 weeks of clinical rotations. They completed the Jefferson Scale of Physician Empathy (JFSE) anonymously.
Students were 22.1 ± 1.5 years old (43% males). Empathy scores increased after each session: 102.0 ± 9.8 before the sessions, 106.3 ± 9.8 after session 1 and 107.8 ± 11.5 after session 2 (p < 0.05). In regression models, gender (F vs. M, + 3.0 ± 1.0, p < 0.001) and position in the session (actor vs. observer, + 2.1 ± 1.0, p < 0.05) were significant determinants of JFSE scores, whereas age, session theme, and duration of clinical rotation were not.
Being an actor in forum theater was a valuable tool for enhancing empathy scores in medical students.
医生同理心与改善临床结果和降低医生倦怠有关。我们评估了论坛剧场（FT）是否可以促进医学生的同理心，以及哪些潜在变量与同理心分数相关。FT 是一种应用戏剧形式，允许参与者进入表演并代表与情绪相关的行为。
共有 3 个班的 488 名四年级医学生参加了这项研究。使用论坛剧场探讨与患者和家属的困难遭遇：癌症的宣布、老年人在家摔倒需要住院、抑郁患者的预约、青少年糖尿病的宣布。第一幕由演员在一群学生面前表演，然后要求观众进入表演，并通过扮演“医生演员”来探索替代互动。所有学生随机顺序地作为演员和观察者参加两个课程，并在临床轮转 36 或 56 周后随机分配到 FT 课程。他们匿名完成了医生同理心杰斐逊量表（JFSE）。
学生年龄为 22.1±1.5 岁（43%为男性）。每次课程后同理心分数都有所增加：课程前为 102.0±9.8，课程 1 后为 106.3±9.8，课程 2 后为 107.8±11.5（p<0.05）。在回归模型中，性别（F 与 M，+3.0±1.0，p<0.001）和课程中的角色（演员与观察者，+2.1±1.0，p<0.05）是 JFSE 分数的显著决定因素，而年龄、课程主题和临床轮转时间则不是。
在论坛剧场中扮演演员是提高医学生同理心分数的有效工具。
