Abstract
Dear Editor:
There is little documented literature on teaching interprofessional learners (house staff and nurses) as members of the same interdisciplinary team in the area of palliative care. Although the use of simulation labs is increasing, they are often costly and time consuming. Role playing has been used for other clinical scenarios. It is more easily implemented and is much less costly. Interdisciplinary teaching with role playing has not been described in the literature. The benefits of using role play to teach disciplines to work more closely together may be particularly important in the palliative care arena.
Objective
We conducted a pilot study to determine if the use of role playing with physicians and nurses would lead to an improvement in understanding of palliative care communication issues, and the recognition of the unique contribution of each team member.
Methods
Seven subjects participated in a scripted role play scenario, on a voluntary basis. These participants included two pediatric nurse practitioner students, one family practice nurse practitioner, three pediatric residents, and one neonatal fellow. Each participant completed an eight-question Likert scale assessment immediately before and after the project. These data were analyzed with the Wilcoxon signed-rank test, with a p value of<0.05 defined as significant. There was a post-project debriefing, which was coded by two of the participating facilitators for thematic content. These field notes were then reviewed by a third investigator, who was not involved in the role play, and then similarly coded for content and identification of key themes.
Results
There were significant improvements in five of the eight questions. There was improvement in comforting families (p=.020), collaborating with other disciplines (p=.020), ability to develop strategies to look after oneself (p=.030), understanding the benefits of role play (p=.008), and understanding the roles that other disciplines play in the care of these patients (p=.0001). The thematic analysis yielded several key concepts: (1) the essential use of flexibility during the role play, (2) greater appreciation for each other's roles, (3) the role of the facilitator to provide a “lifeline,” and (4) appreciation of different skill sets in the role play experience.
Conclusions
This project demonstrates the benefits of the use of role playing in teaching palliative care communication skills and the value of including multiple disciplines in this educational process. Role playing appears to be a promising intervention for teaching palliative care communication skills in an interdisciplinary setting. Future research should continue to explore this technique for teaching multiple skills in an interdisciplinary fashion.