Appendix B Communication role plays

The objectives of a role play are to:

1. Enable you to learn and practice effective communication skills that allow you to facilitate therapeutic relationships and decision making with a child and family
2. Facilitate difficult conversations and break bad news to children and the family in a safe environment without upsetting patients.

Role play uses real life situations, but provides opportunities for participants to practice in a simulated situation.

Instructions for the communication role plays

Role play 1 – Basic communication skills

1. Read through the scenarios together as a group.
2. The group facilitator will hand out the communication assessment tool and self-reflection tool and read through it with the group.
3. The group will be divided into subgroups of three people each. Two people will be the role players and the third will be the peer assessor who will complete the communication assessment tool.
4. Each person will take a turn at being the assessor, the patient and the professional healthcare worker conducting the communication session.
5. Only the healthcare professional will need to be assessed with each role play conducted.
6. The role play can be stopped frequently by the assessor, either for discussion of an interesting point or if the assessor detects that one of the players is having difficulties.
7. Once each role play is complete the assessor should get feedback from the role players on how well they thought the discussion went. The healthcare professional role player can use the self-reflection tool to guide the discussion as to what went well and what didn’t go well for themselves.
8. The assessor will then give positive feedback from the communication assessment tool to the healthcare professional only (not the patient) on how they conducted the conversation with the patient. When the positive feedback has been discussed, the assessor asks the role players if there is anything they feel that they could have done better.
9. Once the role play has been completed, the role players must ‘de-role’. This is the process of separating who they are as a person from the role that they just played. There are several ways to carry out this important part of a role play. One of these is to have the role players say their own name and say that they are not the character name they have been role playing.
10. Once the role players have ‘de-roled’ they will swop around and the same process will take place until all three participants have had a turn at being the assessor, healthcare professional and patient.

Scenario:

Thandi is 5-years-old. She has been receiv­ing treatment for leukaemia for 3 months. Thandi is normally a very upbeat and smiley child but this week she is very with­drawn. As part of the treating team who has the best relationship with Thandi, you have been asked to go and chat with her.

Role players:

• Thandi
• The healthcare professional (nurse, doctor or social worker).

Roleplay the following situation:

Thandi is sitting on her bed with her back towards the door. Her favourite things – colouring book, crayons and her teddy – are on the side-table behind her. Role play how you would approach Thandi and find out what is bothering her.

Role play 2 – Breaking bad news

(Based on case study 4 in Chapter 3)

The group facilitator should ask for five volunteers to role play in front of the group. The remaining group members will assess the role play individually on the communication assessment tool they were each given. The group facilitator will lead the feedback session.

When conducting the role play in this manner it is important to remember that:

1. The role play can be stopped frequently by the facilitator, either for discussion of an interesting point or if the facilitator detects that one of the players is having difficulties.
2. The group facilitator will conduct the feedback session as discussed in points seven and eight in role play 1. Once the role players and the group facilitator have given their feedback the group facilitator can ask the group members to give their feedback. Firstly, on what went well and then what they think could have been done better.
3. It is very important that the role player’s ‘de-role’ as discussed in point nine in role play 1.

Scenario:

Devon is a 9-year-old who has suffered a severe head injury and may not survive. He is currently admitted to the ICU on a ventilator. His parents and 16-year-old sister, Tamara, are at his bedside. The family have been very active on social media asking that people pray for Devon. This has resulted in thousands of people following his progress online and encouraging his family to expect a miraculous recovery.

Role players:

• Two healthcare professionals (doctor, nurse and/or social worker)
• Devon’s mother
• Devon’s father
• Tamara.

Role play the following situation:

Devon’s parents and his sister are at his bedside in a busy ICU ward. His mother is comforting Tamara, who is crying softly. Devon’s condition has stabilised for the moment but the prognosis for a recovery remains poor. Role play how you would break this distressing news to his parents and to Tamara.