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Background: This paper responds to previously published debate in this journal around the use of sociolinguistic methods in communication skills training (CST), which has raised the significant question of how far consultations with simulated patients reflect real clinical encounters. This debate concluded with a suggestion that sociolinguistic methods offer an alternative analytic lens for evaluating CST. We demonstrate here that the utility of sociolinguistic methods in CST is not limited to critique, but also presents an important tool for development and delivery., Methods: Following a scoping review of the use of role play and simulated interaction in CST for healthcare professionals, we consider the use of the specific sociolinguistic approach of conversation analysis (CA), which has been applied to the study of health communication in a wide range of settings, as well as to the development of training., Discussion: Role play and simulated interaction have been criticised by both clinicians and sociolinguists for a lack of authenticity as compared to real life interactions. However they contain a number of aspects which healthcare professionals report finding particularly useful: the need to think on one's feet in real time, as in actual interaction with patients; the ability to receive feedback on the simulation; and the ability to watch and reflect on how others approach the same simulation task in real time. Since sociolinguistic approaches can help to identify inauthenticity in role play and simulation, they can also be used to improve authenticity. Analysis of real-life interactions using sociolinguistic methods, and CA in particular, can identify actual interactional practices that are used by particular patient groups. These practices can then be used to inform the training of actors simulating patients. In addition, the emphasis of CA on talk as joint activity means that proper account can be taken of the way in which simulated interaction is co-constructed between simulator and trainee. We suggest that as well as identifying potential weaknesses in current role play and simulation practice, conversation analysis offers the potential to enhance and develop the authenticity of these training methods.

Debate and role play for learning critical thinking and communication skills are being increasingly used in various undergraduate medical schools worldwide. We aim to compare students' views about effectiveness of two teaching strategies; debate and role play to exercise critical thinking and communication skills during problem-based learning (PBL). This is a comparative, cross-sectional, and questionnaire-based study. Our subjects were second year undergraduate female medical students enrolled in Imam Abdulrahman Bin Faisal University (IAU), College of Medicine from September 2014-2016, divided into 10 small PBL groups (10-13 students/group/year). Students rated role play and debate as equally effective in improving communication skills. Debate was rated superior to role play in "opening new avenues of thinking" (p-value is 0.01), whereas in "integration of knowledge of basic medical sciences with clinical skills" and "reflection of real life experience" students rated role play being superior to debate (p-value 0.01 and 0.00, respectively). Both role play and debate are well accepted by the students in PBL curriculum as an effective teaching methodology. Both are perceived equally good in improving students' communication skills. Few aspects of critical thinking are improved more by role plays compared to debate and vice versa. © 2018 by The International Union of Biochemistry and Molecular Biology, 46:336-342, 2018., (© 2018 The International Union of Biochemistry and Molecular Biology.)

Background: The English language has been recognised as an international language, enabling the globalisation of education and work opportunities. An institute in Taiwan has committed to strengthening English teaching by implementing a student-centred teaching and learning activity using role play. In addition, the involvement of a visiting teacher from Australia has been established., Method: Data collection consisted of a questionnaire that collected qualitative and quantitative data that revealed student perceptions and attitudes towards learning English including nursing terminology, teamwork and communication., Results: Fifty five of sixty students participating in the activity completed the questionnaire. Students regarded this as a positive experience for learning English, collegiality and teamwork., Conclusion: This project revealed that students who are not generally exposed to English-speaking people enjoyed this experience. They gained confidence in their ability to learn English in a collegial atmosphere where teamwork and supportive relationships were developed, despite the perception that learning English was difficult.

Background: The concerns of patients suffering from life-threatening disease and end-of-life care aspects have gained increasing attention in public perception. The increasing focus on palliative medicine questions can be considered to be paradigmatic for this development. Palliative medicine became a compulsory subject of the undergraduate curriculum in Germany to be implemented until 2013. The preexisting conditions and qualifications at the medical faculties vary, though. We describe the conceptual process, didactic background, and first experiences with the new interdisciplinary course "Delivering bad news" as a compulsory part of the palliative medicine curriculum., Methods: Since autumn 2009, this course has been taught at the University Medical Center Göttingen, consisting of two double lessons in the final year of medical education. Considering the curriculum-based learning goals in Göttingen, the focus of this course is to impart knowledge, attitudes and communication skills relating to "bad news"., Results: Although the seminar requires adequate staff and is time-consuming, students have accepted it and gave high marks in evaluations. In particular, the teachers' performance and commitment was evaluated positively., Discussion and Conclusions: We describe the first experiences with a new course. Didactic structure, theoretical contents, role-plays and usage of media (film, novel) are well- suited to communicate topics such as "bad news". Additional experiences and evaluations are necessary. According to the progressive nature of learning, it might be worthwhile to repeat communication- centered questions several times during medical studies.

Background: Accurate and reliable assessment of clinician integrity in the delivery of empirically supported treatments is critical to effective research and training interventions. Assessment of clinician integrity can be performed through recording simulated (SI) or real-life (RL) consultations, yet research examining the equivalence of these data is in its infancy. To explore the strength of integrity assessment between SI and RL samples in Motivational Interviewing (MI) consultations, this article examines whether Motivational Interviewing Treatment Integrity (MITI) assessments differ between SI and RL consultations and reviews the predictive validity of SI and RL MI skills categorisations for RL client response language. Methods: This study first compared MITI coding obtained in SI and RL consultations for 36 veterinary clinicians. Multilevel models of 10 MITI behaviour counts and four MITI global scores were run using MLwiN 3.02 to assess if a significant difference existed between SI and RL MITI data, with consultation within clinician within cohort (A and B) as nested random effects. Second, we investigated the effect of SI and RL MI skills groupings on rate of RL client response talk using three multivariable regression models. Two Poisson regression models, with random intercepts for farm and veterinarian and offset for number of minutes of the recordings, were estimated in the statistical software R using the package glmmTMB for the two response variables Change Talk and Sustain Talk. A logistic regression model, with the same random intercepts, with the response variable Proportion Change Talk was also estimated using the same package. Results: Veterinary clinicians were less MI consistent in RL consultations, evidenced through significantly lower global MITI Cultivating Change Talk (p < 0.001), Partnership (p < 0.001) and Empathy (p = 0.003) measures. Despite lower objective MI skills groupings in RL consultations, ranking order of veterinary clinicians by MI skills was similar between contexts. The predictive validity of SI and RL MI skills groupings for RL client Change Talk was therefore similar, with significantly more RL client Change Talk associated with veterinarians categorised in the highest grouping ('moderate') in both SI (p = 0.01) and RL (p = 0.02) compared to untrained veterinarians in each respective context. Conclusions: Findings suggest SI and RL data may not be interchangeable. Whilst both data offer useful insights for specific research and training purposes, differing contextual MI skills thresholds may offer a more equitable assessment of clinician RL client-facing MI integrity. Further research is needed to explore the applicability of these findings across health contexts. [ABSTRACT FROM AUTHOR]

Background Accurate and reliable assessment of clinician integrity in the delivery of empirically supported treatments is critical to effective research and training interventions. Assessment of clinician integrity can be performed through recording simulated (SI) or real-life (RL) consultations, yet research examining the equivalence of these data is in its infancy. To explore the strength of integrity assessment between SI and RL samples in Motivational Interviewing (MI) consultations, this article examines whether Motivational Interviewing Treatment Integrity (MITI) assessments differ between SI and RL consultations and reviews the predictive validity of SI and RL MI skills categorisations for RL client response language. Methods This study first compared MITI coding obtained in SI and RL consultations for 36 veterinary clinicians. Multilevel models of 10 MITI behaviour counts and four MITI global scores were run using MLwiN 3.02 to assess if a significant difference existed between SI and RL MITI data, with consultation within clinician within cohort (A and B) as nested random effects. Second, we investigated the effect of SI and RL MI skills groupings on rate of RL client response talk using three multivariable regression models. Two Poisson regression models, with random intercepts for farm and veterinarian and offset for number of minutes of the recordings, were estimated in the statistical software R using the package glmmTMB for the two response variables Change Talk and Sustain Talk. A logistic regression model, with the same random intercepts, with the response variable Proportion Change Talk was also estimated using the same package. Results Veterinary clinicians were less MI consistent in RL consultations, evidenced through significantly lower global MITI Cultivating Change Talk (p < 0.001), Partnership (p < 0.001) and Empathy (p = 0.003) measures. Despite lower objective MI skills groupings in RL consultations, ranking order of veterinary clinicians by MI skills was similar between contexts. The predictive validity of SI and RL MI skills groupings for RL client Change Talk was therefore similar, with significantly more RL client Change Talk associated with veterinarians categorised in the highest grouping (‘moderate’) in both SI (p = 0.01) and RL (p = 0.02) compared to untrained veterinarians in each respective context. Conclusions Findings suggest SI and RL data may not be interchangeable. Whilst both data offer useful insights for specific research and training purposes, differing contextual MI skills thresholds may offer a more equitable assessment of clinician RL client-facing MI integrity. Further research is needed to explore the applicability of these findings across health contexts.

Abstract Background Verbal and non-verbal communication, as well as empathy are central to patient-doctor interactions and have been associated with patients’ satisfaction. Non-verbal communication tends to override verbal messages. The aim of this study was to analyze how medical students use verbal and non-verbal communication using two different educational approaches, student role play (SRP) and actor simulated patient (ASP), and whether the non-verbal behaviour is different in the two different poses. Methods Three raters evaluated 20 students playing the doctor role, 10 in the SRP group and 10 in the ASP group. The videos were analyzed with the Calgary-Cambridge Referenced Observation Guide (CCG) and, for a more accurate evaluation of non-verbal communication, we also evaluated signs of nervousness, and posture. Empathy was rated with the CARE questionnaire. Independent Mann Whitney U tests and Qhi square tests were performed for statistical analysis. Results From the 6 main tasks of the CCG score, we obtained higher scores in the ASP group for the task ‘Gathering information’ (p = 0.0008). Concerning the 17 descriptors of the CCG, the ASP group obtained significantly better scores for ‘Exploration of the patients’ problems to discover the biomedical perspective’ (p = 0.007), ‘Exploration of the patients’ problems to discover background information and context’ (p = 0.0004) and for ‘Closing the session – Forward planning’ (p = 0.02). With respect to non-verbal behaviour items, nervousness was significantly higher in the ASP group compared to the SRP group (p

This paper tries to find out how the success of the language learners is attained through proper speaking skills. As of English language, it cannot be denied and neglected because it is accepted as the official among most of the countries. Most of the students miss their job opportunities due to the lack of proficiency in speaking but they are talented in their own field. Students do not have exposure to the spoken format of language because of old education system like memorizing the contents of textbook and writing exams so that they do not concentrate on practical knowledge. This research tries to identify the problems involved in developing speaking proficiency and it insists on the importance of language. This research provides certain approaches and techniques that can be initiated for the development of speaking proficiency. [ABSTRACT FROM AUTHOR]

Background: Verbal and non-verbal communication, as well as empathy are central to patient-doctor interactions and have been associated with patients' satisfaction. Non-verbal communication tends to override verbal messages. The aim of this study was to analyze how medical students use verbal and non-verbal communication using two different educational approaches, student role play (SRP) and actor simulated patient (ASP), and whether the non-verbal behaviour is different in the two different poses. Methods: Three raters evaluated 20 students playing the doctor role, 10 in the SRP group and 10 in the ASP group. The videos were analyzed with the Calgary-Cambridge Referenced Observation Guide (CCG) and, for a more accurate evaluation of non-verbal communication, we also evaluated signs of nervousness, and posture. Empathy was rated with the CARE questionnaire. Independent Mann Whitney U tests and Qhi square tests were performed for statistical analysis. Results: From the 6 main tasks of the CCG score, we obtained higher scores in the ASP group for the task 'Gathering information' (p = 0.0008). Concerning the 17 descriptors of the CCG, the ASP group obtained significantly better scores for 'Exploration of the patients' problems to discover the biomedical perspective' (p = 0.007), 'Exploration of the patients' problems to discover background information and context' (p = 0.0004) and for 'Closing the session – Forward planning' (p = 0.02). With respect to non-verbal behaviour items, nervousness was significantly higher in the ASP group compared to the SRP group (p < 0.0001). Concerning empathy, no differences were found between the SRP and ASP groups. Conclusions: Medical students displayed differentiated verbal and non-verbal communication behaviour during the two communication skills training methodologies. These results show that both methodologies have certain advantages and that more explicit non-verbal communication training might be necessary in order to raise students' awareness for this type of communication and increase doctor-patient interaction effectiveness. [ABSTRACT FROM AUTHOR]

This article will explore the development of communication training within nurse training. Beginning by outlining current thinking around this practice, it then discusses Schön’s notion of reflective practice and its frequently cited relevance to nursing before pointing out some of its limitations. In particular, it looks at the limitations of the individual being able to critically reflect on their self within a broader social context. Drawing on the theories of Habermas and Bourdieu, it suggests that encouraging a greater awareness of one’s own social context, and hence of one’s own subject position, would develop a deeper awareness of other potential perspectives and a better ability to listen to patients. Finally, it argues for the use of role play in assisting nurses to gain such awareness, particularly in difficult clinical situations such as end-of-life care. [ABSTRACT FROM PUBLISHER]

Introduction: Effective patient education is a fundamental aspect of healthcare provision, which requires the use of effective clinical and communication skills. Simulation approaches using group discussion and feedback are effective for clinical and communication skills training in healthcare students. The purpose of this study was to investigate such an approach in improving physiotherapy students' patient education skills and self-efficacy in a clinical education setting. Methods: A simulated learning activity consisting of a case study and structured role play with feedback and discussion was developed for use during the first week of final-year musculoskeletal physiotherapy clinical placements. Student self-efficacy in relation to patient education was evaluated before and after, and compared using nonparametric statistical tests. Student performance of patient education was contrasted to that of previous cohorts. Student and clinical educator perception of the intervention was also evaluated with descriptive statistics and qualitative framework analysis. Results: Twenty-four students took part in the study. Student self-efficacy significantly improved following the intervention (p < 0.01). Although performance scores were not significantly higher than those of previous cohorts, all students within the current study passed the assessment of physiotherapy practice, which contrasts to previous cohorts. The intervention was well received by students, and themes relating to importance of patient education, improved quality and increased engagement in patient education were generated from clinical educator and student qualitative data. Conclusion: Within physiotherapy clinical placement settings, a small group learning intervention using case studies, simulation, facilitated feedback and discussion provides an effective and well-received approach to patient education skills training. [ABSTRACT FROM AUTHOR]

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The article offers the authors' insights regarding an innovative approach for the improvement of the consultation and communication skills of international medical graduates (IMGs). According to the authors, the method was applied in a sequence of three communication workshops for third year genera practice (GP) specialty trainees (ST3s). The author mentions that they used role players and two experienced simulators in each workshop.

WHAT IS ALREADY KNOWN IN THIS AREA Actors have been used for many years to contribute to the training and assessment of medical students, specialty trainees and established doctors. Their role to date, however, has largely been limited to playing patients in scenarios. WHAT THIS WORK ADDS The study presented here is a qualitative evaluation of a pilot scheme to trial a workshop method which used professional actors to play doctors in the role of an appraisee or registrar (GPST3). The main findings showed that this method allowed participants to: gain insight into the dynamics of interpersonal communication and interaction - reflect on the responsibilities of being an appraiser/GP trainer-test out different ways of handling difficult situations which may be encountered. It also allowed the session organisers to look more closely at the method in practice, in order to develop and fine-tune it for the future. SUGGESTIONS FOR FUTURE RESEARCH The findings from the present study would benefit from further evidence arising from wider testing and reporting of the workshop method. Consideration of the impact of playing the role of doctor from an actor's perspective should also occur, as it has for actors playing patients. [ABSTRACT FROM AUTHOR]

This is a case study of a conflict management intervention in two secondary schools in post-apartheid South Africa. The feature of the intervention that we examine is the use of play as an educational strategy. The literature attests that play can facilitate change by allowing learners freedom to change their behaviour and opportunities to explore their new identities. The context of the case revealed that conflicts had become deeply entrenched over time. The literature on conflict management suggests that such situations can change if approached in the right way. In the article we describe the intervention and evaluate it with the help of feedback received from participants and facilitators. In the evaluation we found that the participants were able to overcome prejudices and develop democratic approaches to conflict. The evaluation was repeated several months later, when it was found that the benefits of the workshop had been maintained, with the result that the participants were engaging in healthier relationships. [ABSTRACT FROM AUTHOR]

Drama is dialogic, offering multiple avenues for communication through the medium of questions that become sites for further action and inquiry. In this paper we explore the ethical considerations in the transmission of cultural `truths' within the context of Canadian drama education. How can we enable that transmission so that it supports rather than challenges a `boundary-less' world society when the majority of Canadian drama practitioners are not representative of our cultural diversity? The paper provides a theoretical framework for addressing these questions within the context of drama education generally and the training of pre- service drama teachers in Canada more specifically. The theoretical discussion is supported by a series of anecdotes drawn from the extensive drama practice of the authors. From each of these anecdotes a series of questions or challenges are raised to interrupt `thinking as usual' in order to enter the space that Norman Denzin describes as `that ethical moment when individuals are led into the troubling spaces once occupied by others'. [ABSTRACT FROM AUTHOR]

Abstract: The use of simulation and standardized patients in medical education is firmly established. In this “point–counterpoint” format we debate not their important function but the extent to which they are used to establish “evidence” for trainees’ empathic communication skills beyond their surface manifestations. We also question such issues as the power dynamics implicit in simulation when patients are not really worried or dependent but rather students who are under the evaluative surveillance gaze, often relying on formulaic and superficial behaviors associated with good communication. We offer educative experiences in narrative domains as opportunities to develop the habits of thinking and authentic feeling often absent in evaluative-based simulations. [Copyright &y& Elsevier]

Effective communication is recognised as a key professional skill for pharmacists. Pharmacy education has a relatively recent history of communication training. Content and methods vary widely and limited use is made of simulated patients (SPs). The purpose of this paper is to describe and evaluate a communication session that uses volunteer SPs to support the training of pre-registrant pharmacists (PRPs). The session enabled PRPs to interview an SP and observe their colleagues in different scenarios. Each group was facilitated by an experienced pharmacist. SPs, PRPs and tutors participated in feedback. Evaluation data was collected immediately after the session. Participants rated the session highly in terms of educational value. PRPs met learning objectives that focused on practice and reflection. Feedback on performance was highly valued. A volunteer SP session can support learning of PRPs. We do not know whether the benefits will have lasting value or translate into practice. Although we used volunteer SPs, scenarios with higher challenge are likely to require the use of professional SPs. Volunteer SPs provided an opportunity for direct involvement of users of health care services in health professional education. [ABSTRACT FROM AUTHOR]

Creating simulation-based learning experiences is a process. With tools such as the 2016 INACSL Standards of Best Practice: SimulationSM Simulation Design and theories to guide development, nurse faculty have the opportunity to create rich simulation-based learning experiences that promote student learning. The purpose of this article is to describe an innovative simulation-based experience that applies simulation design criteria in a non-manikin experience. Using a ShadowBox approach, novice nursing students were exposed to expert decision-making in a simulated environment. We describe this approach and how the simulation design criteria are applied. [ABSTRACT FROM AUTHOR]

Police hostage negotiations have traditionally been based upon the conception of “contain and negotiate.” A new school of communications researchers have recently challenged this approach. A role play is described in order to test each perspective. It is concluded that the traditional method works better in actual hostage situations. [ABSTRACT FROM PUBLISHER]

Objective: To determine the effectiveness of video role play with structured feedback in improving undergraduate communication skills and application of knowledge in genitourinary medicine.Design: A blind, randomised, controlled trial.Subjects and Setting: Fourth year undergraduates attending a 5 week attachment in genitourinary medicine during 1997 at a London medical school.Intervention: A randomly selected sample group of undergraduates were filmed in the role of a doctor interviewing a patient (played by an actor) presenting with a genitourinary (GU) problem. Structured feedback by a GU physician and an educational psychologist was given a week later. The control group of undergraduates did not receive this training intervention.Outcome Measures: Student performance in two stations of an objective structured clinical examination (OSCE), administered at the end of their attachment. This tested communication skills and knowledge in GU settings.Results: 132 undergraduates were assessed in the OSCE. 40 of these were in the sample group who received training using video role play with feedback and 92 were in the control group. The sample group scored significantly higher marks than the control group (p<0.001).Conclusions: Video role play with structured feedback is effective in improving undergraduate communication skills and application of knowledge in GU medicine settings. [ABSTRACT FROM AUTHOR]

Parents of hospitalized children need support to diminish their own fear and anxiety and provide safe and loving care for the child. Baccalaureate nursing students, who are rarely parents themselves, often find it difficult to understand the needs of parents. An innovative simulation strategy was created to enhance students’ understanding of the parent’s role and its effect on family-centered care. This article describes the development of pediatric simulation experiences that actively incorporate the role of a parent. Portraying the parent during the simulation increases students’ ability to be empathetic while providing safe family-centered care. [ABSTRACT FROM AUTHOR]

Abstract: The education–practice gap in the area of management, leadership, and communication for newly registered nurses contributes to nurse attrition. Faculty are increasingly using simulations that provide experiences for senior nursing students to facilitate transition into practice. This article describes scenarios that incorporate students, faculty, staff, and community volunteers who role-play situations that students may not encounter during clinical education, including staffing problems, staff conflicts, physician interactions, patient–faculty communications, and crisis interventions. Examples are illustrated through short videos. Feedback from students has been overwhelming positive. Faculty believe the simulations provide realistic opportunities that link education to practice. Volunteers enjoy and support these educational experiences. [Copyright &y& Elsevier]