Healthcare Professionals’ Perception of Learning as Staff from “Diabetes Theater”, a Drama-based Educational Program

Background: Patient empowerment is considered to be crucial for healthcare professionals (HCPs) in diabetes.  However, it is yet unclear how to learn this concept and how to use it in daily diabetes care.  Thus we developed a drama-based educational workshop, Diabetes Theater (DT), to teach HCPs the philosophy of patient empowerment.  Participants reflect on their own practice by watching a play based on common misunderstandings between patients and HCPs in a clinical practice, and then discussing by focusing on the good points and areas for practice improvement in the drama.  We have held this program over 60 times across the country since 2009.

Aims:  The aim of our study was to investigate the effect of DT on staff members' (not audience) perception of their learning and attitudes toward diabetes care. 

Method:  We conducted a quantitative study with a questionnaire and a qualitative study with a focus group with 11 HCPs two months after DT.  All of them were engaged in one DT titled “I can’t stop eating big flan!” held in Kobe, Japan, in 2012 as staff members by writing the scenario and/or appearing as actors.  We asked them to answer a questionnaire and to share their opinions at the focus group.  The focus group was semi-structured group interview for 1.5 hours.  The transcripts of the focus group discussion were recorded after obtaining the written consent of the interviewees and analyzed combining qualitative data analysis and theoretical coding.   

Results:  The participants were 5 nurses, 3 doctors, 2 dietitians, and 1 clinical laboratory technician working in the same university hospital.  All but one were female.  Their mean experience of diabetes care was 3.9 years.  The original questionnaire using Likert scales with 1=strongly disagree and 5=strongly agree showed that after the DT, “I came to listen to the patients’ feeling more” (mean 4.2); “The interaction between my patients and me got better” (mean 4.4).  The main categories of their learning from DT identified were such as 1) reflection effect, e.g. ”It was a great opportunity to joining the transcript writing to look back on my own daily diabetes care with my patients”; 2) realization of the improvement of their own communication skill, e.g. “I was able to draw out the patient’s mind, voice of the patient’s heart,” “It became possible to obtain important information through conversation with a patient” ; 3) team-building effect, e.g. “Through the collaborative work of making a drama, we got to understand each other well and it became easier to consult in daily practice” ; and 4) empowerment practice, e.g. “I began to think of solutions that respect patient’s thoughts together”, “I put more focus on what my patient want to be and to do,” “Now I can wait until the patient speaks even though silence time flows”.
  
Discussion: In conclusion, HCPs on the staff of DT showed an enhanced awareness of value of reflection, communication skill, team building, and empowerment practice.  This finding suggests that DT might be a unique and useful method not only for audience but for staff to improve their attitudes in diabetes care in terms of the empowerment and interprofessional collaboration.

Healthcare professionals’ perception of learning as staff from “diabetes theater”, a drama-based educational program