Acting the part

Nursing and theatre students collaborate on training exercise for both

by Chuck Wasserstrom

Taylor is a 17-year-old with a history of asthma that has become increasingly troublesome. She's in the examination room with a cough, and it's getting harder and harder for her to breathe.

Chanda Okyere is asking questions, trying to figure out the triggers that have caused Taylor's latest issue. The situation is getting serious.

But Taylor's lying. Well, not exactly lying. Acting.

There are four Taylors on four different examination room tables in the University of Tennessee at Chattanooga's School of Nursing. Each is a UTC undergraduate theatre major participating in a simulation collaboration with students in the nurse practitioner program.

Having the students pretend to be patients in emergency situations gives nurse practitioner students a chance to practice the steps needed in such situations without someone's life on the line, says Amber Roaché, coordinator for the nurse practitioner program in the School of Nursing. Simulations utilizing theatre students have been taking place at various points throughout the year.

"One of the biggest changes we've made to our graduate program is having the simulated patient actors come in and portray real patients for our students," Roaché says. "They are able to get the hands-on training and do everything they need to do with a patient in a safe, controlled environment, and we can provide feedback immediately so they know what they’re doing well or where they may need some improvement.

Okyere knew her Taylor—theatre student Maegan Whitlock—wasn't really in respiratory distress, but it sure felt like it. They both were using a script, yet both were improvising, Okyere explains. Neither knew what the other person would say, just like an actual examination room.

"She was thinking through what you were asking her," says Okyere. "As I was doing the simulation, it helped me to get a realistic flow of everything. It was good to work with an actual person versus using a mannequin because the responses were real.

"Not knowing what the next answer is going to be, in my head I'm running a couple of different scenarios. Based on what she tells me, I can move on. Anything I asked, she answered right away. And she was very believable, so I didn't feel like it was an actor. I felt like I had a real patient."

Nursing student Chanda Okyere examines theatre major Maegan Whitlock in the nurse practicitioner simulation lab. This nontraditional collaboration between the nurse practitioners and theatre programs allows nursing students to simulate real patient care and exposes theatre students to alternate career pathways and improvisation practice.

Roaché says seeds for the partnership were planted a couple of years ago after having a difficult conversation with one of her patients about a diagnosis. She shared the story of having a student with her in the room and asking the student to leave because of the rapport she possessed with her long-time patient.

"I realized after we got out that it was such a disservice to the student; at that point, until they get into practice, they weren't getting experience having some of these difficult conversations with patients or experiencing some of these things," Roaché says.

Having previously met Laurie Melnik Allen, executive director of the Arts Based Collaborative at UTC, Roaché reached out to her with an idea of mixing nursing and acting.

Allen jumped at the chance. She has utilized the services of community actors in other collaborations, saying that she is always looking for ways to use theatre for nontraditional purposes.

"Roleplay is something that helps a lot of professions helping to contextualize experience and prepare," she says. "Along with that, there is the opportunity for students in theatre to understand career pathways that may not be visible to them yet. Seeing how their craft can be utilized in different ways beyond just performing a role in a play is huge.

"For the performer, they're utilizing so many of their skills: Improvisation, thinking on their feet, responding in the moment, being true to their character. Authenticity is still really important because it has to be as real-world as possible to make this a rich learning experience for the nurse practitioner students, but also the theatre students as well."

During the nursing simulations, each actor went through four or five rounds playing Taylor, with examinations taking about 20 minutes. Faculty, including Roaché and Allen, observed from behind a glass window.

Combining healthcare and theatre might seem a little odd, "but once you get into it and you start seeing how theatre and some improv really plays well into being a simulated patient actor, the students really get into it," Roaché says.

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KRAUSE AND COREY STANDARDIZED PATIENT CENTER OPENS

Through her gift this summer, Dr. Rebecca Corey MSN '99, DNP '12 honored her longtime friend and mentor Dr. Richard A. Krause by funding the Krause and Corey Standardized Patient Center.

Krause served the medical community for more than 40 years as a gastroenterologist. He was an advocate for both patients and nurse practitioners, hiring the first nurse practitioner in gastroenterology in the Chattanooga area—Rebecca Corey.

The Krause and Corey Standardized Patient Center is located in a newly renovated area in Davenport Hall on the University of Tennessee at Chattanooga campus. Four patient exam rooms are fully outfitted for nurse practitioner students who will have UTC and Chattanooga actors portraying patients who are "experiencing" various medical complaints. Students will assess them and develop a plan of care.

In this standardized, controlled experience each “patient” works from a script and each student who evaluates them is graded on the same skills and interventions.

“This is not role-playing, this is truly acting,” said Chris Smith, director of the UTC School of Nursing. “Each standardized patient receives rigorous training to maintain a consistent, highly realistic portrayal.

"They’re also prepared to give feedback to the students on communication and interpersonal skills, which is a plus. The students learn immediately what went well from the patient’s perspective. We are now fortunate to have a space dedicated to this highly effective teaching modality.”

Rebecca Corey

Richard A. Krause