Donald Hiscock | Articles | Health Service Journal
Making a drama out of a crisis might not seem the best advice when it comes to training, but for health care staff in the Newcastle-upon-Tyne area being dramatic is a positive part of their professional development.
Operating Theatre is a group of writers, health care professionals,
actors and educators who use stories, drama and writing to assist learning
on health matters. Currently chaired by Dr Dominic Slowie, the group focuses
on areas of learning where there may be complex emotional issues or communication
hurdles for both patients and staff.
The use of hot-seating exercises involving professional actors
is a way of training health workers to be more empathetic in their approach
to patients.
“For example, an actor will be in role and course participants
then ask that actor about their particular health issue,” explains Dr
Slowie. “Then we get the group to work on a first person monologue based
on what they have discovered, getting them to explore what it might feel like
to experience the issue for themselves.”
These monologues are performed and then discussed by the group.
For health practitioners it can give a valuable insight into living with a
particular condition and help them to establish the appropriate communication
skills needed in their jobs.
A new development for Operating Theatre has been the delivery
of training to a whole year group of over 200 students in medical education.
Using an arts-based approach to training doctors tends to be an option in
many universities but in Newcastle it is now being adopted as a vital element.
“If we really believe the issues that this type of training
raises are important then it shouldn’t be seen as an option,”
says Slowie.
A recent case launch lecture on adolescence saw Operating Theatre
perform an adaptation of Julia Darling’s radio play about anorexia,
‘Letters Home’. For Dominic Slowie the success of this approach
was the way in which the students were encouraged to reflect and empathise
with the actors who remained in role after the performance.
“The pieces we use are purposely written to be emotive,”
he says. “We give them a situation they may not have encountered and
when they are qualified they can refer back to it. The more emotive and vivid
the learning the more easily it is recalled.”
This is a view endorsed by first year medical student Lucy Holden:
“It was gripping and very moving. It allowed us to get inside the minds
of the characters and put a real life perspective on what we’re studying.”
Participants on the Operating Theatre sessions are encouraged
to respond to issues through their own creative writing. It is the engagement
with the creative process that is valued highly by those involved with training
health care professionals in Newcastle.
“You can ask how using theatre is better than questioning
a real patient,” says Dr Jane Macnaughton, director of the Centre for
Arts and Humanities in Health and Medicine at the university of Durham. “The
answer is that drama creates a safe and circumscribed environment in which
to explore very sensitive issues. You can also manipulate the situation with
an actor so that particular teaching points can be made.”
The idea that one’s own imagination is a valuable tool
for learning is extremely important when it comes to how training is delivered
to health workers.
“As a teacher it has been very useful and something I
have applied to my own work as a general practitioner,” says Dr Rachel
Lunney, course director for medicine in the community at Newcastle.
Dr Lunney was involved in a pain workshop with other GPs and
those from related health disciplines. The aim was to help people describe
their experience of pain using a creative approach. The workshop led to exploring
ideas such as encouraging patients to draw their pain and for those with a
chronic condition to write letters to it.
“As doctors we hear pre-programmed words from a patient
and one adjective can send us off down a particular diagnostic pathway,”
says Dr Lunney. “We are waiting for the key words, but patients don’t
work in the same way. Some people are more visual, so we need to be trained
to enter into a different way of describing pain.”
Using the arts to teach in the medical professions is certainly
taking off, but there is not much drama being played out in hospital training
rooms across the country. Although the positive feedback is strong, Dr Slowie
is aware that it shouldn’t be over-used.
“It shouldn’t be allowed to lose its impact,”
he says, “but as a training method it is still developing. We’ve
done workshops with physiotherapists and are planning to work with patients
with diabetes as part of their self-management of the condition.”
By exploring the inherent drama of medical encounters Operating Theatre is aiming to add empathy and understanding to the training mix.
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