Teaching and Learning Forum 95 [ Contents ]

The use of drama in teaching and learning

Beverley O'Connell, Jenny McNae, Robin Watts,
Gerard McKelvie and Michel Burgum
School of Nursing
Curtin University

Recent Government initiatives demand that quality teaching remains a priority within the tertiary educational system. Each discipline, with its unique characteristics and body of knowledge, faces its own challenge in trying to achieve this goal. Concepts that are central to nursing, by their very nature and complexity, require different strategies of teaching. One strategy employed by Curtin University School of Nursing was the use of an artist-in-residence. It was envisioned that the introduction of theatre expertise would stimulate the creative abilities of academic staff. More importantly, it would enhance the quality of teaching.

The pedagogical issues that underpin this educational strategy are that:

Collaborative projects with the theatre professional included teaching death and dying in general and maternity settings and addressing the stereotypical image of nursing in a professional foundation unit. This production presents the use of drama in teaching and learning and reflective evaluation of this teaching strategy.

Background

The use of drama as a strategy for teaching and learning in nursing is relatively new. The idea for implementing this approach in the School of Nursing at Curtin University of Technology came from the Head of School who had experienced the artist-in-residence program at the Colorado University School of Nursing, USA. In this program, Marilyn Krysl spent a semester observing nurses caring for patients. She recorded her experiences in a memorable collection of poems published by the National League of Nurses in Midwives and Other Poems on Caring.

The idea of implementing a similar program in Perth was initially impeded due to a lack of funds, however a grant from the University was eventually obtained and an actor/director was employed. It was envisaged that the actor would work with staff members to enhance creativity in teaching.

The use of drama in teaching and learning

The French theatre great Jean Louis Barrault posed the question. "Is theatre a valuable phenomenon, individually as well as ethically?" (Cited in Hodgson, 1978). He came to the conclusion that drama can help in preparing for life, plays are ways of meeting aspects of life, theatre ought to entertain through educating and theatre is an escape to understanding and awareness. He also defined drama as "the art of the now a co-existence of sensations". Although videos can be obtained or commissioned on practically any topic, use of live presentation in lecture, conference or workshop is far more immediate and effective. Based on this premise two major projects developed. The first one was a strategy for teaching death and dying in both the general and midwifery programs and the second one was the portrayal of nursing stereotypes for the Professional Foundations of Nursing Unit.

Teaching death and dying

There is an abundance of literature that provides guidance on how to teach student nurses procedural skills. However, there is very little written about teaching death and dying. Experience gained from teaching this subject and anecdotes from the field suggest that "the traditional methods" of teaching were limited in that they failed to illustrate the substantive issues that needed to be addressed and to capture the true meaning of the message (the feelings involved) and more importantly did not help students to internalise this information and relate it to the context in which it applied. After experimenting with a few different teaching methods, drama was used.

The drama script was developed from excerpts of an interview with a patient who had a life threatening illness. The script centred around her thoughts, feelings and responses when she was hospitalised and diagnosed as having cancer. She discussed aspects of care that really stood out as being exemplary and incidences where the care left her feeling frightened and angry. It seemed a worthwhile exercise for students to view the experience of death and dying through the eyes of the patient. Using the script and liaising with academic staff, the actor produced a live presentation using students from the University's theatre-arts section. This presentation was used instead of a lecture to teach students about death and dying.

To assist the students to think about the major issues, an advanced organiser highlighting each major point was used. The students were given the advanced organiser before the drama session and asked to reflect and make brief notes on the various issues which were then enacted before them.

At the end of the drama the points on the advanced organiser were used to summarise the session and to integrate feelings, thoughts and the nursing actions. In addition some important sections of the script were illustrated on overheads and formed the basis for further discussions. For example, this particular part of the script was used to further explore nursing actions that promote healing.

Client
You've got warm hands -healing hands. (She holds nurse's eyes with her own) Do you believe in healing ?
Nurse
Yes, I do. But what's more important is, do you?
Client
(Still holding Nurse's eyes. After a moment) Yes, I do.

As part of the learning it was necessary to get students to think about their approach to care and how they would advise relatives that their loved ones had died. It was also important for them to understand how their own emotions and thoughts influence their actions. Role play was used to illustrate this point. The setting was in a ward area where the doctor had just certified a patient's death and the novice nurse had to inform a relative that her husband had died. This same situation was then re enacted by an experienced nurse who used a different and more expert approach.

The novice nurse was fearful, anxious and unsure of how to respond appropriately to the situation. The expert nurse having dealt with this situation before was able to respond professionally.

At this stage the students were asked to review the two different approaches and discuss important issues.

The educational intent of the role play was to illustrate to students that their education would not always prepare them to manage every situation they encountered and that it was natural to have feelings that were negative and could initially impair their performance. However, they had to try and learn from every experience; and turn negative experiences into positive learning outcomes.

Evaluation of the session

A formal evaluation of the session was conducted a week later using a questionnaire with open ended questions. Some of the students comments are listed below:

"Very necessary for nursing practice -most of us have not experienced death and dying"
"I found all issues of death and dying were covered effectively and this was an effective teaching tool"
"I felt the session was very well presented and an excellent idea and I felt I benefited greatly from it"

Overall the evaluation indicated that:

On reflection this was an all embracing teaching strategy which promoted experiential learning within the psychomotor, cognitive and affective domains (it was o.k. to cry). Furthermore, it created an educational milieu which encouraged the exploration of the students' perceptions, feelings, beliefs and values. The students commented that they would always remember the learning experience and relate the information to their practice.

Portrayal of nursing stereotypes

Another project undertaken was the portrayal of nursing stereotypes for the Professional Foundations of Nursing Unit. This came very early in the student's education and was intended to stimulate examination of the steps nursing has taken to reach its current status, possible reasons for stereo-typing (and media perpetuation of these stereotypes) and appraisal of personal aims and motives by each student in the course. Laughter is a powerful conveyor of message so comic extremes were used to highlight the style of the ministering angel, the battle-axe, the gay male, the handmaiden and the whore. Much laughter was elicited by the team of Theatre Arts students at the lecture performance and much lively discussion was reported back from the follow-up tutorials.

Care of the families experiencing bereavement in child birth

This teaching strategy was also used for the a group of postgraduate midwifery students. A series of role-plays interspersed with mime was used to portray key aspects of bereavement in childbirth. Students were given an outline of how the session would be structured and a copy of session objectives. Students were asked to write their feelings as they observed the drama. They were asked to discuss issues as they were enacted. The feedback was once again positive and was as follows:

"The live acting made it a very real experience"
"Made us feel we could talk about our feelings or write our feelings down but not have to discuss them with everybody"
"It helped me reflect and think how I could approach these situations in the real world very, very helpful to prepare us for the future"
"My sister has had three stillbirths, made me realise what she had endured"

In summary, drama provided students with real experiences which provoked feelings that they were allowed to express within a protective environment.

Conclusion

Employing the actor and the use of drama stimulated thinking about alternative methods of teaching and learning. Out of this experience a Creative Teaching Special Interest Group was developed for nursing academic staff. It is envisaged that this group will develop into a university wide network.

Student feedback was overwhelmingly positive, both immediate and long term. One of the outcomes has been the lasting effects it has had on the students, particularly at the affective level. Students, for example, indicated how the classroom experience helped them in a clinical situation some considerable time later. These instances are raised in debriefing sessions within clinical settings or students have discussed an experience with the teacher. It has also stimulated students to search for sources of information other than texts and discuss the issues raised with others in their lives.

'Increasing links' is a good way to summarise the benefits of drama in teaching and learning: linking students to the realities of practice, linking students to the ones experiencing care, linking students and staff to other sources of learning, and strengthening the links between learner and teacher.

References

Hodgson, J., (ed.), (1978). The uses of drama. Acting as a social and educational force. London: Eyre Metheun Ltd.

Please cite as: O'Connell, B., McNae, J., Watts, R., McKelvie, G. and Burgum, M. (1995). The use of drama in teaching and learning. In Summers, L. (Ed), A Focus on Learning, p190-193. Proceedings of the 4th Annual Teaching Learning Forum, Edith Cowan University, February 1995. Perth: Edith Cowan University. http://lsn.curtin.edu.au/tlf/tlf1995/oconnell.html


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