title: The educational value of improvisational actors to teach communication and relational skills: perspectives of interprofessional learners, faculty, and actors.
abstract: OBJECTIVE
  To assess the educational value of improvisational actors in difficult conversation simulations to teach communication and relational skills to interprofessional learners.
  
  
  METHODS
  Surveys of 192 interprofessional health care professionals, and 33 teaching faculty, and semi-structured interviews of 10 actors. Descriptive statistics, Fisher's exact test and chi-square test were used for quantitative analyses, and the Crabtree and Miller approach was used for qualitative analyses.
  
  
  RESULTS
  191/192 (99.5%) interprofessional learners (L), and 31/33 (94%) teaching faculty (F) responded to surveys. All 10/10 actors completed interviews. Nearly all participants found the actors realistic (98%L, 96%F), and valuable to the learning (97%L, 100%F). Most felt that role-play with another clinician would not have been as valuable as learning with actors (80%L, 97%F). There were no statistically significant differences in perceived value between learners who participated in the simulations (47%) versus those who observed (53%), or between doctors, nurses, or psychosocial professionals. Qualitative assessment yielded five actor value themes: Realism, Actor Feedback, Layperson Perspective, Depth of Emotion, and Role of Improvisation in Education. Actors independently identified similar themes as goals of their work.
  
  
  CONCLUSIONS
  The value attributed to actors was nearly universal among interprofessional learners and faculty, and independent of enactment participation versus observation. Authenticity, feedback from actors, patient/family perspectives, emotion, and improvisation were key educational elements.
authors: Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA; Institute for Professionalism and Ethical Practice, Boston Children's Hospital, Harvard Medical School, Boston, USA. Electronic address: Sbell1@bidmc.harvard.edu.
authors: Sigall K
authors: SK
authors: Bell
authors: Critical Care Medicine and Perioperative Anesthesia, Departments of Critical Care Medicine and Anesthesia, Boston Children's Hospital, Harvard Medical School, Boston, USA.
authors: Robert
authors: R
authors: Pascucci
authors: Institute for Professionalism and Ethical Practice, Boston Children's Hospital, Harvard Medical School, Boston, USA.
authors: Kristina
authors: K
authors: Fancy
authors: Institute for Professionalism and Ethical Practice, Boston Children's Hospital, Harvard Medical School, Boston, USA.
authors: Kelliann
authors: K
authors: Coleman
authors: Department of Anesthesia and Director of Biostatistics for the Departments of Anesthesia and Surgery, Boston Children's Hospital, Harvard Medical School, Boston, USA.
authors: David
authors: D
authors: Zurakowski
authors: Department of Psychiatry, and Director, Institute for Professionalism and Ethical Practice, Both at Boston Children's Hospital, Harvard Medical School, Boston, USA.
authors: Elaine C
authors: EC
authors: Meyer
mesh_terms: D003142:Communication; D004521:Educational Measurement; D005178:Faculty; D005246:Feedback; D006801:Humans; D007396:Internship and Residency; D007400:Interprofessional Relations; D007407:Interviews as Topic; D007858:Learning; D009726:Nurses; D016544:Patient Simulation; D010820:Physicians
keywords: Actors; Communication; Education; Interprofessional; Simulation