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Analysis of role-play in medical communication training using a theatrical device the fourth wall.

Jacobsen T, Baerheim A, Lepp MR, Schei E - BMC Med Educ (2006)

Bottom Line: The analysis of the empirical material revealed three main locations of the fourth wall as it moved and changed qualities during the learning session: 1) A traditional theatre location, where the wall was transparent for the audience, but opaque for the participants in the fiction. 2) A "timeout/reflection" location, where the wall was doubly opaque, for the patient on the one side and the moderator, the doctor and the audience on the other side and 3) an "interviewing the character" location where the wall enclosed everybody in the room.The theatrical concept 'the fourth wall' may present an additional tool for new understanding of fiction based communication training.Increased understanding of such an activity may help medical teachers/course organizers in planning and evaluating communication training courses.

View Article: PubMed Central - HTML - PubMed

Affiliation: Section for General Practice, Department of Public Health and Primary Health Care, University of Bergen, Kalfarveien 31, Bergen, Norway. torild.jacobsen@isf.uib.no

ABSTRACT

Background: Communication training is a central part of medical education. The aim of this article is to explore the positions and didactic functions of the fourth wall in medical communication training, using a role-play model basically similar to a theatrical performance.

Method: The empirical data stem from a communication training model demonstrated at an international workshop for medical teachers and course organizers. The model involves an actress playing a patient, students alternating in the role of the doctor, and a teacher who moderates. The workshop was videotaped and analyzed qualitatively.

Results: The analysis of the empirical material revealed three main locations of the fourth wall as it moved and changed qualities during the learning session: 1) A traditional theatre location, where the wall was transparent for the audience, but opaque for the participants in the fiction. 2) A "timeout/reflection" location, where the wall was doubly opaque, for the patient on the one side and the moderator, the doctor and the audience on the other side and 3) an "interviewing the character" location where the wall enclosed everybody in the room. All three locations may contribute to the learning process.

Conclusion: The theatrical concept 'the fourth wall' may present an additional tool for new understanding of fiction based communication training. Increased understanding of such an activity may help medical teachers/course organizers in planning and evaluating communication training courses.

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Location 3. The remove of the fourth wall opens up for a possible communication between everybody in the room.
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Figure 3: Location 3. The remove of the fourth wall opens up for a possible communication between everybody in the room.

Mentions: At some point in the process of the consultation the moderator stopped the ongoing fiction, not by taking timeout, but by informing the audience that everyone had the possibility to pose questions directly to the patient from their places. Hence everybody in the room were verbally and emotionally involved in the fictional context. The framing was 'a doctor's office' and the audience was a kind of multi-headed doctor. There was no wall separating fiction and reality because the fictional and the real contexts had melted into one, and the wall was standing as "un mur" enclosing the fiction in the classroom (Figure 3).


Analysis of role-play in medical communication training using a theatrical device the fourth wall.

Jacobsen T, Baerheim A, Lepp MR, Schei E - BMC Med Educ (2006)

Location 3. The remove of the fourth wall opens up for a possible communication between everybody in the room.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC1621062&req=5

Figure 3: Location 3. The remove of the fourth wall opens up for a possible communication between everybody in the room.
Mentions: At some point in the process of the consultation the moderator stopped the ongoing fiction, not by taking timeout, but by informing the audience that everyone had the possibility to pose questions directly to the patient from their places. Hence everybody in the room were verbally and emotionally involved in the fictional context. The framing was 'a doctor's office' and the audience was a kind of multi-headed doctor. There was no wall separating fiction and reality because the fictional and the real contexts had melted into one, and the wall was standing as "un mur" enclosing the fiction in the classroom (Figure 3).

Bottom Line: The analysis of the empirical material revealed three main locations of the fourth wall as it moved and changed qualities during the learning session: 1) A traditional theatre location, where the wall was transparent for the audience, but opaque for the participants in the fiction. 2) A "timeout/reflection" location, where the wall was doubly opaque, for the patient on the one side and the moderator, the doctor and the audience on the other side and 3) an "interviewing the character" location where the wall enclosed everybody in the room.The theatrical concept 'the fourth wall' may present an additional tool for new understanding of fiction based communication training.Increased understanding of such an activity may help medical teachers/course organizers in planning and evaluating communication training courses.

View Article: PubMed Central - HTML - PubMed

Affiliation: Section for General Practice, Department of Public Health and Primary Health Care, University of Bergen, Kalfarveien 31, Bergen, Norway. torild.jacobsen@isf.uib.no

ABSTRACT

Background: Communication training is a central part of medical education. The aim of this article is to explore the positions and didactic functions of the fourth wall in medical communication training, using a role-play model basically similar to a theatrical performance.

Method: The empirical data stem from a communication training model demonstrated at an international workshop for medical teachers and course organizers. The model involves an actress playing a patient, students alternating in the role of the doctor, and a teacher who moderates. The workshop was videotaped and analyzed qualitatively.

Results: The analysis of the empirical material revealed three main locations of the fourth wall as it moved and changed qualities during the learning session: 1) A traditional theatre location, where the wall was transparent for the audience, but opaque for the participants in the fiction. 2) A "timeout/reflection" location, where the wall was doubly opaque, for the patient on the one side and the moderator, the doctor and the audience on the other side and 3) an "interviewing the character" location where the wall enclosed everybody in the room. All three locations may contribute to the learning process.

Conclusion: The theatrical concept 'the fourth wall' may present an additional tool for new understanding of fiction based communication training. Increased understanding of such an activity may help medical teachers/course organizers in planning and evaluating communication training courses.

Show MeSH