ACTup: advanced communication training simulation enhanced by actors trained in the Stanislavski system.

Strong communication, empathy and interpersonal skills are crucial to good clinical practice. Actors trained in interpretations of the Stanislavski system draw on their own life experience to develop the character. We hypothesised that simulation enhanced by trained actors would be an ideal way for our senior trainees to develop advanced communication skills. We developed a communication training course based on challenging situations which occur in paediatrics like child death and safeguarding. Actors were briefed and invited to develop characters that would behave and respond as a parent/carer might do in complex and stressful clinical scenario. Paediatric trainees then participated in simulations, with a focus on communication skills. Feedback and debrief were provided by a multidisciplinary faculty. The impact of the course was evaluated by analysis of data collected in focus groups held after the simulation. Trainees noted the actor's ability to respond in vivo to emotive situations and felt it was much more effective than their previous experience of simulation with simulated patients without formal training. Actors were able to offer feedback on aspects of body language, tone and use of language from a non-medical perspective. Actors enhanced the realism of the simulations by changing their language and emotional performance in response to the trainee's performance, improving trainee engagement.