Drama Therapy: An Experimental Approach to Improving Communication Skills in Radiation Therapy Students

Abstract

Excellent communication skills are integral to the behaviours expected of all health care professionals. In addition, proficiency in communication builds positive relationships with staff, peers and patients, and enhances student confidence and performance. Every year there are a small number of radiation therapy students at the Michener Institute for Applied Health Sciences, who struggle with the clinical portion of the program because of challenges with communication and interpersonal skills. Although, for many of these students, English is not their first language, their vocabulary and accents are not the factors that limit performance. The larger obstacles that these students face are rooted in their expressions and/or their socio-cultural construct. In an effort to provide the students with the tools to maximize their chances for success in the clinical environment, we identified students who demonstrated significant communication challenges. We also invited the students to ‘self-identify’ if they felt that they were struggling to meet the basic communication competencies of the program. Specifically, the most common behaviours identified were timidity, lack of self-efficacy (confidence), lack of awareness of Western cultural norms, unclear speech, poor diction, and awkward expression/non-verbal communication. Traditional remedial approaches for communication issues were based upon repetition and modeling, but were largely ineffective in addressing these particular behavioural concerns. At the beginning of January 2006, ten students were identified by faculty as exhibiting lack of confidence and clarity in both verbal and non-verbal communication. Of the ten students, five spoke English as a second language. All ten students accepted our invitation to participate in an experimental program utilizing the dramatic arts. The goal of this program was to provide the students with the opportunity to focus on various aspects of communication (i.e., tone, volume, posture, and expression) in a safe, supportive, and fun environment. The course consisted of nine 1.5-hour sessions over a ten-week period. The first class was unique in its format as it employed a series of individual warm up exercises to “shake off ” the physical and mental tensions and distractions of the day. The following classes were comprised of a directed open reading (i.e., rehearsal) of the stage play Arsenic and Old Lace by Joseph Kesselring. This play was selected for the relative simplicity of the English language used, strong characters, humour, and a cast size that suited our needs. At the beginning of each session, an instructor would provide the students with a synopsis of the scene(s) to be studied. After selecting a character, the students would perform an unrehearsed oral reading or “cold read”. The pronunciation or meaning of any words, expressions or attitudes which were not familiar to the group were also explained. These conversations often led to discussions which highlighted the differences between the culture of the play and those of the students. Following the cold read, the students would read through the scene again “in character”. The focus of this second read was to encourage the students to build dynamic and expression into their character while continuing to work on pronunciation, clarity of speech and volume control. Instructors provided continuous encouragement and feedback. The movie version of each scene was also shown on video to the students which provided further insight into the plot and its characters. As the course progressed, we observed increased interaction and confidence amongst those students who appeared more reserved and hesitant when attempting to speak. At the completion of the course an evaluation was conducted. The following is some of the feedback that we received: