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| ORIGINAL ARTICLE |
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| Year : 2023 | Volume
: 2
| Issue : 1 | Page : 27-31 |
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Perceptions of the undergraduate medical students about roleplay, a teaching/learning and training tool: A descriptive cross-sectional study
Rano Mal Piryani1, Suneel Piryani2, Nudrat Zeba1
1 Bilawal Medical College (BMC), Liaquat University of Medical and Health Sciences (LIMHS), Jamshoro, Sindh, Pakistan
2 Publich Health Professional, Karachi, Sindh, Pakistan
| Date of Submission | 30-May-2023 |
| Date of Decision | 08-Jun-2023 |
| Date of Acceptance | 08-Jun-2023 |
| Date of Web Publication | 21-Aug-2023 |
Correspondence Address:
Prof. Rano Mal Piryani
Bilawal Medical College, Liaquat University of Medical and Health Sciences, Jamshoro, Sindh
Pakistan
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/JIMPH.JIMPH_8_23
BACKGROUND: Roleplay is not commonly used as a tool for teaching/learning and training in the majority of medical schools in Pakistan. Bilawal Medical College, the newly established constituent college of Liaquat University of Medical and Health Sciences Jamshoro, Sindh, Pakistan, organized roleplay sessions for second-year undergraduate medical students and took feedback from them. The objective of this study was to assess the perceptions of students about roleplay as a teaching-learning/learning and training tool. MATERIALS AND METHODS: This descriptive cross-sectional study was conducted on June 2022 with a purposive sampling technique. The questionnaire comprised 10 closed-ended questions on a Likert scale of 1–5 (5=strongly agree, 4=agree, 3=to-some-extent agree, 2=disagree, and 1=strongly disagree) besides age and comments as open-ended questions. The validity was checked with pilot testing. The data were entered in Microsoft Excel and analysis was done in SPSS version 23. The frequency with the percentage of each item and median with interquartile range were calculated. The reliability of the questionnaire was calculated using Cronbach α. RESULTS: The reliability of the questionnaire was confirmed by Cronbach’s α, which was 0.75 falls within the acceptable level. The mean age of students was 20.057 ± 1.027 years. The perceptions of students are notable; the median value on nine statements (items) is 4 and one is 5, whereas the interquartile range of eight statements is 4–5 and 2 statements 3–5. CONCLUSION: The perceptions of medical students were positive regarding the role of roleplay in teaching/learning and training learners. A remarkable percentage of students strongly agreed to agree on all 10 items related to the cognitive, skills, and attitude domain of learning. Keywords: Feedback, learning, medical students, perceptions, roleplay, teaching/training
How to cite this article:
Piryani RM, Piryani S, Zeba N. Perceptions of the undergraduate medical students about roleplay, a teaching/learning and training tool: A descriptive cross-sectional study. J Integr Med Public Health 2023;2:27-31 |
How to cite this URL:
Piryani RM, Piryani S, Zeba N. Perceptions of the undergraduate medical students about roleplay, a teaching/learning and training tool: A descriptive cross-sectional study. J Integr Med Public Health [serial online] 2023 [cited 2023 Sep 21];2:27-31. Available from: http://www.jimph.org/text.asp?2023/2/1/27/384124 |
| Introduction | |  |
Roleplay is one of the teaching, learning, and training methods in health professions education chosen as per need, whether the learning objective addresses knowledge, skills, and attitude.[1],[2],[3],[4] Roleplay as a tool is used in a varied discipline both in basic and clinical sciences.[1] Roleplay is one of the simulation methods, fosters active learning among learners, and follows Knowles’ adult learning principles.[1],[3],[4],[5],[6] It is among the cost-effective simulation methods to involve students in active learning.[7]
Roleplay is an effective method used for educating learners in managing workplace conflict[7]; in enhancing critical-thinking skills[4],[6] in developing certain soft skills such as understanding, empathy, and communication skills both verbal and non-verbal especially in difficult situations like breaking bad news,[4],[5],[7],[8]; in boosting professionalism[5]; in understanding doctor-patient relationship[8]; and in enriching learner’s capacities to face with related situations in clinical practice.[9]
Roleplay activities can be played in diverse ways.[1],[10] The students can play the role, for example, of the patient or of the caregiver or both, or community members or family members, etc., and the process can involve interactions between two individuals or among a larger group.[1],[10] There can be fully scripted roleplay where all players act from exact scripts or partially scripted roleplay where players have certain prompts or incite––often an opening line or theme.[1]
Roleplay as a method of teaching/learning and training is underutilized in most of the medical colleges in Pakistan and very few studies have been conducted in Pakistan regarding feedback from the students about roleplay as a teaching/learning and training tool in medical education. Bilawal Medical College (BMC), a recently established constituent college of Liaquat University of Medical and Health Sciences (LUMHS) Jamshoro, Sindh, Pakistan, conducted roleplay sessions for second-year third batch undergraduate medical students and took feedback from them. The objective of the study was to assess the perceptions of the students about the role of roleplay as a teaching/learning and training tool.
| Materials and Methods | | |
This descriptive cross-sectional study was conducted at Bilawal Medical College (BMC) for Boys, Liaquat University of Medical and Health Sciences (LUMHS) Jamshoro, Sindh, Pakistan with the objective to assess the perceptions of the students about the role of roleplay as a teaching/learning and training tool. The roleplay session for the students of second-year MBBS (third batch) was organized and conducted on June 6, 2022 for 2 h between 10.00 AM and 12.00 PM in second-year lecture hall. The objective of this session was to educate the students about the role of roleplay in medical education.
The students were informed about the session in advance through notification. Five days ahead of role-plays session on June 1, 2002, students were briefly oriented about the session. During orientation, three group leaders for leading each group were selected on voluntarily basis. Subsequently, three groups (1, 2, and 3) of students were constituted on voluntarily basis with a plan that each group plays one roleplay at the beginning of role-plays session. The theme for roleplay was allocated randomly to each group.
Role play 1
Group of three students visited community for creating awareness about monkeypox disease and felt resistance from the community (Group 2).
Role play 2
Student interacted during the conversation between salesman at medical store and customer (father of 5year old son) who has come to purchase tablet for the son having fever (Group 1).
Role play 3
Students seen an adult who is falling down in the street and become unconscious, what student has to do (act) (Group 3).
Instructions regarding required members in group, script writing and rehearsal shared with students. Students groups wrote script by themselves and did a rehearsal on its own within their groups. Time allocated for each roleplay was 20 min; 10 min for roleplay and 10 min for reflections, discussion and learning points. This information was also shared on their WhatsApp group.
The session started on June 6, 2022 on time. The principal author briefed about the process of role-plays session. Students developed ground rules to follow during the entire session. Students group performed roleplay in a sequence. Each group leader introduced himself and team members, then shared the theme, title of the role and name of member who plays the particular role before proceedings of role play. Group leader ensured for the completion process within time. Each of the students of each group after performing roleplay reflected on his character. Other students who observed the roleplay shared their views and faculty provided their input after each roleplay. After completion of the role-play exercise Principal author discussed learning points of each roleplay with logic. He also shared his presentation on roleplay focused on definition of roleplay, purpose of roleplay, uses of roleplay, elements of successful roleplay, and types of role play.
The third author facilitated the session and took feedback from the students in writing on the feedback questionnaire. Fifty-seven students and 12 faculty members attended the session. The feedback questionnaire was comprised of 10 items (statements or questions) on Likert scale 1–5 (5=strongly agree. 4=agree, 3=to-some-extent agree, 2=disagree and 1=strongly disagree). The age of the student and any other comments were also sought from the students. The questionnaire was designed by the principal author who is medical educationist having 2-Year FAIMER (Foundation for Advancement for International Medical Education and Research) fellowship in medical education. Subsequently, the pilot test was done with 5 students of same class who were allowed to participate as observers in the roleplay session.
Bilawal Medical College only admits male students. The sample was purposive; “the participants who consented to give feedback were included in the study” and those who refused to provide consent were excluded.
Informed consent was taken from the participant students and study was approved by the Principal of BMC.
The data was entered in Microsoft Excel and analysis done in SPSS V 23. The frequency and central tendency were computed. Cronbach’s α was measured for the reliability (internal consistency) of questionnaire containing 10 questions on Likert scale 1–5.
| Results | | |
Fifty-three out of 57 students consented to give written feedback; the response rate was 93%. The reliability (internal consistency) of questionnaire was confirmed by Cronbach’s α which was 0.75. This falls within the acceptable level which is considered to be between 0.7 and 0.8.[11]
The mean age of the participant students was 20.057 ± 1.0269 years with range 18–22 years.
The frequency of student’s response on individual item (statement) is given in [Table 1].
The median with interquartile range of the student’s response on individual item (statement) is mentioned in [Table 2]. | Table 2: The median with interquartile range of the student’s response on individual item (statements)
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Comments of students
Out of 53 participants, 13 (24.53) had written comments in open-ended question. Seven participants documented that such type of roleplay must be organized frequently. Some of the comments need worth mentioning.
“Good opportunity to learn and shine our skills”
“Very interesting, glad to be part of it”
“Waiting for next roleplay session”
“This activity should be promoted more among medical students”
“Absolutely it makes medical person perfect to face real-life situation in current circumstances, it improves skills and motivates for self-directed learning”
| Discussion | | |
Role-plays have been recognized as one of the effective methods of teaching-learning in health professions education as role-plays strengthen bonds between learners and educators.[2]
This study assessed the perceptions of the undergraduate medical students about role of roleplay as a teaching/learning and training tool on 10 items (statements) related to three domains of learning that is, cognitive, skills and attitude. The perceptions of participant students in this study are notable; the median value on 9 statements is 4 and one is 5, whereas interquartile range of 8 statements is 4–5 and 2 statements 3–5 (Likert scale: strongly agree = 5, agree = 4, to-some-extent agree = 3, disagree = 2 and strongly-disagree = 1).
More than 90% participant students in this study agreed to strongly agreed on “Roleplay is one of the effective methods of learning.” This finding is consistent with the findings of study conducted by Manzoor et al. They reported majority of undergraduate medical students agreed roleplay promotes adult learning.[2] In another study conducted by Ma, majority of the participants students of age 18 and above found roleplay valuable tool for learning.[6] Khan and Sheikh in their study documented that more than 96% of students agreed roleplay promote learning in small group and roleplay is an interesting mode of learning stated by the 90% students.[7]
Around 80% students agreed to strongly agreed that “Roleplay helps in understanding the real-life situation” in our study. Khan et al. in their study cited students’ perception related to facing patients in real-life situation. They mentioned more than 50% students agreed that roleplay helps in dealing real patients better.[3]
In the present study approximately 85% agreed to strongly agreed on “Roleplay helps in improving communication skills.” The study done by Manzoor et al. mentioned 99% of students agreed roleplay enhanced their communication skills.[2] More than 97% participant students of study done by Khan and Sheikh documented that roleplay improves communication skills.[7] Roleplay improves communication skills was the feedback of students in study conducted by Khan et al.[3] Around 89% students strongly agreed and agreed that roleplay updates communication skills reported in the study done by Nair.[8] A significant number of participant students of study of Khan and Jamil et al. cited that roleplay improves communication.[4]
More than 77% students agreed to strongly agreed that Roleplay helps in improving critical-thinking skills in this study. Majority of the students of study done by Ma documented that roleplay enhances critical thinking.[6] More than 76% participant students in the study conducted by Manzoor et al. revealed that roleplay incite critical thinking.[2] Notable percentage of students in the study done by Khan and Jamil et al. documented that roleplay improves critical-thinking skills.[4]
Nearly 80% of students of this study agreed to strongly agreed on “Roleplay helps in improving decision-making skills.” Eighty-six percent of students of study conducted by Khan and Sheikh have mentioned that roleplay helps in decision making and analytical skills.[7]
More than 77% agreed to strongly agreed that “Roleplay helps in developing psychomotor skills” in our study. Deepa Rao and Ieva Stupans in their study mentioned that roleplay develops practical skills of students in small group settings.[12]
In the present study, more than 70% agreed to strongly agreed on “Roleplay promotes self-directed learning.” Khan and Jamil et al. cited in their study positive effect on self-directed learning feedback given by the students.[4]
More than 80% agreed to strongly agreed “Roleplay promotes group (team) learning” in this study. Khan et al. in their study mentioned around 60% students believes roleplay shapes teamwork.[3]
More than 77% agreed to strongly agreed that “Roleplay promotes peers learning” in our study.
More than 85% of students cited that roleplay promotes peers learning acknowledged by Khan and Sheikh in their study.[7]
In this study more than 77% agreed to strongly agreed on Roleplay usually brings positive change in attitude. More than 76% of students agreed to strongly agreed that roleplay has brought positive change in their attitude towards patient’s problems reported by Nair BT.[8]
Limitations
This study has certain limitations. The participants were only male students as BMC admits only male students in its MBBS program. The script for each roleplay was prepared by students’ group on given theme and executed by themselves not directed by any of the faculty members. This feedback was just perceptions (immediate reaction) of the students taken after completion of roleplay session, so comparison of gain in knowledge and understanding could not be possible to measure. The sample was purposive and number of participant was 57 comparably less sample size. The study was conducted only in one medical school.
| Conclusion | | |
The perceptions of undergraduate medical students were positive regarding role of roleplay in teaching/learning and training of learners. Remarkable percentage of students were strongly-agreed to agree on all 10 items related to cognitive, skills and attitude domain of learning.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
Ethical considerations
The study is approved by Principal of BMC. Informed consent was taken from the participant students.
| References | | |
| 1. | Nestel D, Tierny T. Role-play for medical students learning about communication: Guidelines for maximising benefits. BMC Med Educ BioMed Central 2007;7:3. doi:10.1186/1472-6920-7-3.  |
| 2. | Manzoor I, Fatima Mukhtar F, Hashmi NR. Medical students’ perspective about role-plays as a teaching strategy in community medicine. J College Phys Surg Pak 2012;22:222-5. https://pubmed.ncbi.nlm.nih.gov/22482377/ |
| 3. | Khan AS, Khawaja R, Hakeem J, Soliman M, Balaes J, Labaniego R. Illustration of different modalities of role-play for medical communication skills at undergraduate level. Int J Psychol Educ Stud 2019;6:59-65. doi:10.17220/ijpes.2019.02.006. |
| 4. | Khan JUA, Jamil B, Ahmed F, Khan UA, Qaisar A. Role play as a learning and teaching modality and its effectiveness in improving the communication and critical thinking skills of medical students. J Med Sci 2020;28:154-7. https://jmedsci.com/index.php/Jmedsci/article/view/997/659 |
| 5. | Westmoreland KD, Banda FM, Steenhoff AP, Lowenthal ED, Isaksson E, Fassl BA. A standardized low-cost peer role- playing training intervention improves medical student competency in communicating bad news to patients in Botswana. Palliat Support Care 2019;17:60-5. doi:10.1017/S1478951518000627. |
| 6. | Ma ZF. Role play as a teaching method to improve student learning experience of a bachelor degree programme in a transnational context: An action research study. Compass: J Learn Teach 2020;13:1-10. https://journals.gre.ac.uk/index.php/compass/article/view/1035/pdf |
| 7. | Khan HS, Sheikh NS. Role-play: A simulated teaching technique in physiology. Pak J Physiol 2021;17:46-50. http://www.pps.org.pk/PJP/17-4/Saeed.pdf |
| 8. | Nair BT. Role play: An effective tool to teach communication skills in pediatrics to medical undergraduates. J Edu Health Promot 2019;8:18. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6383693 |
| 9. | Gelis A, Sophie C, Romain R, Guy L, Philippe L, Nicolas F, et al. Peer role-play for training communication skills. Simul Healthcare 2022;15:106-11. doi:10.1097/SIH.0000000000000412. |
| 10. | Mcllvried DE, Prucka SK, Herbst M, Barger C, Robin NH. The use of role-play to enhance medical student understanding of genetic counseling. Genet Med 2008;10:739-44. doi:10.1097/GIM.0b013e318187762e. |
| 11. | Vakili MM, Jahangiri N. Content validity and reliability of the measurement tools in educational, behavioral, and health sciences research. J Med Educ Dev 2018;10:106-18. doi:10.29252/edcj.10.28.106. |
| 12. | Rao D, Stupans L. Exploring the potential of role play in higher education: Development of a typology and teacher guidelines. Innov Educ Teach Int 2012;49:427-36. doi:10.1080/14703297.2012.728879. |
[Table 1], [Table 2]
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