Medical drama: Playing sick to teach doctors

Medical students practise their communication skills on actors role-playing patients at Barts and the London School of Medicine and Dentistry.

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"Being given bad news means potentially crying 50 times a day, which can be tough," says Deborah Asante.

As an actor, Deborah is used to playing a distressed patient. It is one of the ways medical students can help to improve their communication skills.

"Role-play is becoming a growing trend in Britain and an accepted from of training," says Sarah O'Keefe, Director of Scenario, a company that provides actors to the NHS and private sector.

Medical role-play is widely used; from testing the language skills of overseas doctors, to training GP receptionists on how to deal with upset patients.

Realism

To achieve a realistic scenario, actors need a different set of abilities from TV.

Dr Anne Cushing is reader in clinical communication at Barts and the London School of Medicine and Dentistry, Queen Mary, University of London.

Actor Jacqui MacKenzie Gray

Actor Jacqui MacKenzie Gray: "I enjoy playing a patient with attitude"

As well as playing the role, they need to be aware of how they are feeling emotionally and to give constructive feedback, she says.

"It is also important they play at the same level, that they are consistent for each student.

"They need to act as real people and not show off or over perform.

"It is no good for medical students to know or watch a procedure - they need to try it out."

Professor Jim McKillop, chair of the undergraduate board for the General Medical Council (GMC), agrees: "Role-play is invaluable for a student's first steps. They can try out different approaches without having to worry about upsetting a real patient.

"They can practise asking difficult or private questions and overcome any embarrassment or reluctance.

"They can also play 'patient' and feel what it is like to be on the other side of the consultation desk."

Empathy

But he stresses: "While it is important to have role-play as a teaching technique, it does not take the place of real patient contact - this teaches professionalism and allows students to build up a 'typical database', allowing them to distinguish between normal patient variations."

In recent years, however, it has been more difficult for students to get on the wards, with patients spending less convalescence time in hospital and students requiring increased supervision due to concerns over patient safety and litigation.

As a result, the GMC called last year for more hands on experience in their Tomorrow's Doctors report.

Prof McKillop says: "In particular we would like to see more medical schools offering a 'preparation for practice' module between finals and starting work in August, where students would shadow a doctor."

With exams looming for second year medical student, Ziyaad Sultan, his feedback from role-play with actor Deborah, should help his confidence: "You showed some empathy and I felt your tone matched mine considering she was in a lot of pain."

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