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Reviewing Clinical Skills

Guest Blog Series: The Clinical Connection #5

Using Video Capture to Increase the Efficacy of Role-Play Practice

Post #5—November 2015

A wide range of related medical and educational fields rely heavily on the acquisition of a specific set of knowledge, skills, and dispositions in order for the pre-practice professional to become effective in his or her future role. To develop undergraduate and graduate students for roles as counselors, law enforcement agents, healthcare providers, teachers, coaches, and endless others, it takes a strategic scope and sequence of a curriculum delivered through a combination of classroom instruction, supervised rehearsal, and real-world practice. Many skills being facilitated are best learned through demonstration of and rehearsal with the specific behaviors, rather than hearing or reading about the “how-to” associated with the use of the skill. For example, learning how to interview another person can be spelled out in printed form, but it cannot be fully understood and mastered without simulated and real practice interviewing others. At the start of that learning process, it is not feasible or appropriate to have beginning students engaged with actual patients, clients, customers, etc. Role-play simulations are a widely-respected, evidence-based technique for learners to transition from classroom or textbook instruction into real-world application of targeted behaviors (Lorenzo, 2014; Lewsi, et al., 2013; Oh & Solomon, 2014; Lane, Hood, & Rollnick, 2008; Alkin & Christie, 2002; Nikendei, et al., 2005).

Role-play is just one technique in teaching and fits into a bigger category of simulation techniques (Alkin & Christie, 2002). Simulations can grow to be complex, layered, and lengthy. On the other hand, role-play (either on its own or within a more complete simulation activity or process) can be succinct, quick, and precise (Alkin & Christie, 2002). Role-play activity to target specific skills and behaviors makes learning interactive, responsive, and individualized. The most complete and effective use of role-play is facilitated by intentional use of the practice and includes a feedback component that is easily accomplished through the use of video capture and review of the rehearsal. Educators using role-play activity to heighten learning are encouraged to think more completely about this process so that the maximum advantage is obtained. The following comments and suggestions are offered to either get someone started with this process or to take professional use of role-play to the next level.

  1. Consider infusion of role-play tasks into traditionally-taught classroom topics. For example, if previous attention to something like the use of verbal contingencies to respond to patient/client/student behavior has been typically handled through a classroom lecture or textbook reading, redesign that lesson by adding role-play scenarios for the learners to use to actually apply contingencies while engaging with another person. Many skills cannot be efficiently or fully realized without actual application of the concept. Dig into course outcomes within the curriculum, or professional standards, to identify those topics and add role-play to the current teaching methodology and course requirements.
  2. Make a plan for the specifics associated with all role-play practice. Consider details such as:
    • Will it be spontaneous or scripted (with the learners outlining a script or an instructor-provided format)?
    • Will a prompt be provided or will it be open-ended?
    • How many individuals need to be involved?
    • Will the learner be paired with other learners or will “hired” practice partners be brought in?
    • How much, if any, “sabotage” will be inserted or applied by the role-play partner or instructor?
    • Are props/materials needed?
    • Will role-play practice be foreshadowed for students, or more impromptu in nature?
    • Will a time limit be set/needed? Will timing be displayed during the role-play?
    • Do you plan on offering a demonstration of the practice scenario to set a model, or will students be expected to complete rehearsal based on lecture- or textbook-based learning?
  3. Prior to and/or during the role-play, provide students with a guide, particularly focused on the desired outcome(s) of the practice. State what needs to be accomplished and provide any other specific instruction. Unless it is the desired intent of the role-play, do not leave students confused or guessing at the purpose of the practice or time will be lost and negative practice will occur.
  4. Pair role-play activities with video capture and review. While role-play can be used as a teaching-learning technique without video capture, it can fall dramatically short without this value-added component, especially if the educator is not available to give real-time feedback to the learner(s). Even in the case of online instructor observation of the role-play, without video capture and review, learners cannot benefit from seeing themselves in action, completing self-evaluation, and seeing positive examples of their peers in action. Furthermore, use of video capture allows the educator to compile a collection of footage of skills in action that can be used and reused during future classroom and clinical instruction.
  5. When conducting video review of performed role-plays, use an intentionally-structured feedback format. This can include oral notes, written narrative, rating scales, and checklists. Make sure to provide feedback calling attention to the positive or “correct” use of behaviors/skills. In addition, make sure constructive feedback includes instructor think-aloud statements (such as “When I see you sitting back in the chair like that with your arms folded, it makes me believe that you’re disinterested in what your patient has to say”) along with specific suggestions for change (such as “Next time, lean forward a bit more and fold your hands on your notepad or place your arms on the chair so that you send a more inviting signal”).
  6. Share the video capture of role-plays with the students and encourage their reflection and self-evaluation. As with instructor feedback, carefully design the manner in which you guide and receive these reflections and self-evaluations from students. Respond to their feedback so that you can confirm or offer suggestions associated with what they observed while watching the role-play.

Role-play work that is accompanied by video capture and review can strengthen the acquisition of critical knowledge, skills, and dispositions of learners across a wide range of training programs. This teaching practice can bring big rewards to many.

Alkin, M., and Christie, C. (2002). The use of role-play in teaching evaluation. American Journal of Evaluation, 23(2), 209-218.

Lane, C., Hood, K., and Rollnick, S. (2008). Teaching motivational interviewing: Using role play is as effective as using simulated patients. Medical Education.

Lewsi, D., O’Boyle-Duggan, M., Chapman, J., Dee, P., Sellner, K., and Gorman, S. (2013). Putting words into action project: Using role play in skills training. British Journal of Nursing, 22(11), 638-644.

Lorenzo, C.M. (2014). Teacher’s skill improvement by role-play and simulations on collaborative educational virtual worlds. Journal of Educational Computing Research, 50(3), 347-378.

Nikendei, C., Zeuch, A., Dieckmann, P., Roth, C., Schafer, S., Volkl, M., Schellberg, D., Herzog, W., and Junger, J. (2005). Role-playing for more realistic technical skills training. Medical Teacher, 27(2), 122-126.

Oh, H., and Solomon, P. (2014). Role-playing as a tool for hiring, training, and supervising peer providers. Journal of Behavioral Health Services and Research.