Communication skills for medical/dental students at the University of Pretoria: Lessons learnt from a two-year study using a forum theatre method

Background: This study describes the lessons learnt from using a novel method for teaching communication skills to second-year medical/dental students. Methods: Medical and drama teachers designed this action research project to serve the educational interests of second-year medical/dental and drama students. The drama students enacted problematic doctor-patient scenarios for their forum theatre course. The interactive enactment was done for groups of 60-70 medical/dental students. The latter interrupted the actors to suggest improved communication skills. The drama students then re-enacted the scenarios, incorporating the improvements. The medical/dental students' knowledge of communication skills was assessed before the enactment, three weeks later, and again four months after that. Their semi-structured feedback was analysed thematically. In the next year, the feedback was used to improve the methodology for the new second-year students. Results: In both years, the medical/dental students' knowledge showed a statistically significant improvement after the enactment, and this was sustained for four months. In year 1, the feedback revolved around language problems and disrespectful attitudes. In year 2, visual cue cards of the communication skills were displayed during the act, and the drama students emphasised these rather than attitudinal problems. However, feedback showed that caricaturing the doctors' attitudes still detracted attention from the desired focus on communication skills. Conclusions: Although the forum theatre method can transfer knowledge of communication skills, the focus of the acting should be on the demonstration of inappropriate communication skills rather than inappropriate attitudes. One limitation of this study is that assessment was limited to knowledge and did not progress to skills.