JMIR Publications

ABSTRACT

Background:

Effective physician-patient communication is crucial to positive health outcomes for patients with chronic disease. However, current methods of physician education in communication are often insufficient in helping physicians understand how patient actions are influenced by the contexts within which they live. An arts-based participatory theater approach can provide a necessary health equity framing to address this deficiency by engaging physicians in interactive modules designed to provide tools for improving communication with patients in a disease specific context.

Objective:

The purpose of the present study was to develop, pilot, and conduct a formative evaluation of an interactive arts-based communication skills intervention for graduate level medical trainees grounded in a narrative representative of the experience of patients with SLE.

Methods:

We hypothesized that the delivery of interactive communication modules through a participatory theater approach, would lead to changes in both attitudes and capacity to act on those attitudes among participants in four conceptual categories related to patient communication (understanding social determinants of health, expressing empathy, shared decision-making and concordance). We conducted a formative evaluation by collecting qualitative focus group feedback to evaluate the implementation of our modules and through a quantitative survey using a pre- and post-test method to assess shift in participant attitudes and capacity to act on those attitudes.

Results:

Our qualitative data suggest that the participatory theater approach and the design of the modules added value to participant learning experience by facilitating interconnection of the four communication concepts. Our survey data suggest that in all conceptual categories, participants (physician) attitudes and capacity to act on those attitudes with regard to patient communication shifted in the intended direction.

Conclusions:

Our findings from this formative evaluation of communication modules suggest that participatory theater is an effective method for framing physician education with a health equity lens, though considerations in the realms of functional demands of healthcare providers and use of structural competency as a framing concept are needed. The integration of social and structural context into the delivery of this communication skills intervention may be important for uptake of these skills by intervention participants. Participatory theater provided an opportunity for dynamic interactivity among participants and facilitated greater engagement with the communication skills content.