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Several studies suggest the relevance of healthcare simulation to prepare future doctors to deliver bad news. A such, we designed a role-play workshop to train first-year residents enrolled in Lille University School of Medicine to break bad news. The objective of this work is to report on our experience of this training and to assess its educational value through its capacity to satisfy residents' expectations, to induce a feeling of ease towards bad news disclosure, and to change trainees' preconceptions regarding these situations. The training consisted of a 45-minute heuristic reflective activity, aimed at identifying residents' preconceptions regarding bad news disclosure, followed by 4 30-min role-plays in which they played the parts of the physician, the patient and/or their relatives. Trainees were asked to answer 2 questionnaires (pre- and post-training), exploring previous experiences, preconceived ideas regarding bad news disclosure and workshop satisfaction. Almost all residents felt very satisfied with the workshop, which they regarded as formative (91%) and not too stressful (89%). The majority felt "more capable" (53% vs. 83%) and "more comfortable" (27% vs. 62%) to deliver bad news, especially regarding "finding the right words" (12% vs. 22%). Trainees tended to overestimate their skills before the workshop and lowered their assessment of their performance after attending the training, especially when they played the role of a patient in the simulation. Healthcare role-play seems an interesting technique for training to breaking bad news. Placing residents in the role of patients or relatives is an active approach that encourages reflexivity. [ABSTRACT FROM AUTHOR]

Context and background: Post-graduate specialized training in psychiatry aims at acquiring knowledge and competencies. The acquisition of skills related to interviewing techniques is an important component. Among them, motivational interviewing is a specific interviewing technique that should be mastered during the internship. Objective: To report on the planning and preliminary assessment of the effects of a motivational interviewing training seminar for interns in the first year of their psychiatric specialty degree (DES). Methods: A two half-day seminar, including a theoretical part and practical teaching based on role-playing, was developed and implemented for first-year psychiatry interns at the University of Toulouse. Participants’ learning and satisfaction were evaluated using questionnaires administered before the seminar, after the seminar and three months after its end. Results: Eighteen interns participated in at least one of the two sessions. The average pass rates on the declarative knowledge test were respectively 45.4 %, 94.5 %, and 87.8% before the seminar, at the end of the seminar, and three months after the seminar, respectively. Three months after the seminar, 77.7%of the interns considered that they had used motivational interviewing often or very often in their current practice and 66.6%that the improvement in their level of interviewing skills had been important or very important. Conclusion: A short educational program, specifically dedicated to the teaching and learning of motivational interviewing, allowed for significant learning, by meeting the training expectations of the students concerned and by improving their sense of competence in motivational interviewing. [ABSTRACT FROM AUTHOR]

Le personnage du clown a fait sa première apparition à l'hôpital au sein des unités pédiatriques où les effets positifs de son action sont largement reconnus. Cette « activité clown » est néanmoins encore très peu répandue dans les services de psychiatrie où les patients, qui parfois ont du mal à accéder à l'humour, ou qui sont aux prises avec des émotions fortes qu'ils ne parviennent pas à exprimer, pourraient bénéficier de ses vertus cathartiques. Dans cet article, nous présentons dans un premier temps les résultats d'une mini-revue de la littérature portant sur la place et le rôle du clown dans la démarche de soins en psychiatrie. Dans la seconde partie de l'article, nous présentons les résultats de notre étude dont l'objectif était de mesurer le sentiment de bien-être des patients psychiatriques par une échelle visuelle analogique (EVA) après deux semaines de participation à l'atelier clown. Il s'agit d'une étude pilote de faisabilité ouverte, prospective et monocentrique qui s'est déroulée de juin 2015 à décembre 2016 à l'Unité d'Hospitalisation Temps Plein (UHTP) du site de l'EPS Ville-Évrard à Saint-Denis, Pôle 93G03. Cinquante-neuf patients ont été inclus dans l'étude après recrutement par un médecin investigateur chargé de vérifier les critères d'inclusion et de non-inclusion. L'analyse des articles recensés dans la mini-revue souligne les gains des patients en termes de capacité de communication et de gestion des émotions. Par ailleurs, les résultats de notre étude n'ont pas montré de différence statistiquement significative (p < 0,7). Bien que notre étude n'ait pas montré de différence significative, elle a mis en évidence la faisabilité de ce type d'atelier au sein d'un service de psychiatrie et fournit des arguments en faveur de la poursuite de cette activité sur une plus longue période et au sein de structures telles que l'HDJ ou le CATTP. In psychiatry, we often talk about therapeutic mediation, used in many group and individual therapies. We use a wide variety of mediating objects, cultural means and even people, their roles and the image they project, including the character of the clown. The word clown immediately sends us back the image of a comedian working in the circus world or in the royal courts. Yet, modern clowns are now taking different places. The 1980s marked the beginning of the era of "Doctor Clowns" in hospitals. The character of the clown made his first appearance in hospital in pediatric units where the positive effects of his action are widely recognized. This "clown activity" is nevertheless still not very widespread in psychiatric services where patients, who sometimes have difficulty accessing humor, or who are struggling with strong emotions that they cannot express, could benefit from its cathartic virtues. In this article, we first present the results of a mini-literature review on the place and role of the clown in the psychiatric care process. In the second part of the article, we present the results of our study whose objective was to measure the feeling of well-being of psychiatric patients by a visual analog scale (VAS) after two weeks of participation in the clown workshop. For the conduct of the research of scientific articles, we have chosen the databases according to their relevance in scientific, psychiatric and psychological research. These are the following areas: PubMed, PsycInfo, ScienceDirect, LiSSa... No time limit has been set given the low availability of articles in this area and its recent development. For the same reason, all types of scientific papers, as well as some books have been considered. We have selected the articles in French and English. Furthermore, our study is an open, prospective and monocenter pilot feasibility study that took place from June 2015 to December 2016 at the Full Time Hospitalization Unit of the EPS Ville-Évrard site in Saint-Denis, pole 93G03. Fifty-nine patients were included in the study after recruitment by an investigating physician responsible for verifying the inclusion and non-inclusion criteria. The aim was to offer hospital patients in psychiatry a group activity around the theme of humor. This mediation was coordinated by a professional clown with previous experience of hospitalized patients. The activity was 2 hours long, with 8 participants maximum. Description of a session: 1/Time to put on the "clown's outfit" (hat, red nose, wigs...). 2/Relaxation with breathing exercises. 3/Self-presentation through games. 4/The "clown" time which is articulated in two passages on stage, one individual and the other with several people. 5/The conclusion when everyone expresses their feelings about what they have experienced. The main endpoint, namely the participants' sense of well-being, was measured by a Visual Analogue State (VAS) before and after each clown workshop (D0 and D15), i.e. after two weeks of participation in the clown workshop. Analysis of the articles reviewed highlights patients' gains in terms of communication skills and emotion management. Furthermore, the results of our study did not show a statistically significant difference (P < 0.7). Although the results did not show a statistically significant difference, this study highlighted the feasibility of this type of workshop within a psychiatric department. There was no worsening of the clinical condition of the patients during the protocol and no behavioral disorder caused a disruption of the sessions or their premature termination. In fact, all the sessions could be carried out. The patients who participated in the first session were also present during the second one 15 days later. It can be noted that in terms of feasibility, the patients were complacent and joined the group well. They cooperated in this foray into the imagination created by the character of the clown, allowed emotions to be expressed that they did not show during formal interviews. In conclusion, this study provides arguments in favor of the continuation of this activity over a longer period and within structures such as day hospital or part-time therapeutic activity center. [ABSTRACT FROM AUTHOR]

Reflection on professional practices by professionals themselves in collective discussions allows them to improve their understanding of work activities, and to develop reflexivity skills. In the educational field, one challenge is to offer new interpretive frameworks allowing professionals to perceive their activity in a new light and enhance reflection on practices in collective discussion. The goal of this paper is to present a new interpretive framework that can be used to study professional practices that take place through linguistic interactions. This framework includes models, theories, concepts and methodologies taken from language sciences and the psychology of communication. The issue in this paper is to study how this framework contributes to the process of training lawyers and notaries in civil and commercial mediation. The training system uses: (i) the role-play technique, (ii) the results of the analysis of verbal productions voiced during role-play (analysis based on the framework), (iii) a collective discussion consecutive to the role-play and (iv) a discussion in allo-confrontation, during which the results of the analysis are presented. From this study, we can see that the restitution of the results of the role play analysis based on the framework clarifies the communicational activity from viewpoints that are not immediately accessible to the trainees. It also makes it possible to revise dysfunctions/phenomena that have so far gone unnoticed. Above all, it provides conceptual tools for a reflexivity that might be useful in the optimization of professional practice. [ABSTRACT FROM AUTHOR]

There is considerable variation in the implementation of role-play activities in second language (L2)/foreign language (FL) classroom settings, and little information is available about how students actually manage them, particularly with regards to overcoming their L2 deficits. This study examines the preparation of role-plays by university students in an intermediate Spanish class. When confronted with challenging aspects of the L2, they employed a variety of strategies, such as asking classmates, consulting reference materials, and modifying their original ideas to manage the task. This analysis of students' strategy use provides insights into how teachers might implement role-play activities more effectively into second and foreign language classes. [ABSTRACT FROM AUTHOR]

Abstract: Drawing on the story of events surrounding the hospitalization of a patient named Mr. B., the authors try to reconstruct what, from the non-symbolized past of this patient, is going to be replayed during this regressive period. Observation and decoding of the institutional mise-en-scene that the patient evokes in the hospital environment do reveal him as a “user” of the place he uses, often without him knowing, by producing a singular reconfiguration of what is established and constituted as a template for welcome and care. Consequently, the authors review this reconfiguration of the medical institution through observation of various times when a specific interactive dynamics is put into effect between the patient and the other patients but also with the nursing body and its hierarchy. They suggest the idea of deploying a primary fantasy scenario peculiar to the patient and perceptible in the movements and feelings of the professionals, in the actions of this patient and in his statements during dual conversations. The known traumatic elements of the patient''s life are put into correspondence with the scenes produced in the institutional space. These mappings show how the hospital can be the theater of a simple repetition of the traumatisms or become a convenient space for their partial elaboration. [Copyright &y& Elsevier]

This article discusses the use of computer games in cybercartography and how computer game characteristics can enhance the design of cybercartographic products. We focus on investigating multiple perspectives through role play in a geospatial virtual environment. The ways in which literature and film support multiple perspectives can guide us in our design efforts for developing cybercartographic atlases. We explore the potential of games for presenting multiple points of view in an environmental context through the modification of an existing computer game that includes quest narratives and character interaction as well as role play. Active engagement with different characters and the environment in role-playing games encourages exploration and learning, and these interactions give a player the opportunity to discover diverse points of view and develop different ways of solving problems. Multiple points of view in cybercartography can offer a plurality of voices on critical issues. In particular, information presented in maps can stimulate ideas and encourage critical thinking. This leads us to conclude that the engaging and emotional dimensions of computer games can be combined with the multiple perspectives they offer to attract new atlas users and to provide them with a more critical perspective on geographic and environmental information. [ABSTRACT FROM AUTHOR]

Contexte/problématique : L'utilisation d'une notation à un jeu de rôle est parfois proposée comme système d'évaluation de la prestation. Nous avons voulu savoir si la formation préalable du notateur influençait son évaluation. Méthodes : Une session de jeux de rôle a été organisée dans le cadre d'une formation master, elle avait pour thème la gestion d'une relation difficile avec les patients Les apprenants, tous professionnels de santé confirmés, devaient annoncer cette nouvelle aux membres d'une famille représentée par des comédiens Ces derniers avaient reçu au préalable une description de la situation et avaient pu se faire expliquer toutes les questions techniques Les apprenants ont reçu l'exposé juste avant le jeu de rôle qu'ils avaient à mener. Le jeu de rôle était filmé pour les spectateurs (apprenants et comédiens) Cinq questions ont été posées aux spectateurs qu'ils soient apprenants (AS) ou comédiens (CS) ainsi qu'aux comédiens acteurs (CA) : Q1 : La situation a été clairement saisie par l'apprenant Q2 : La nouvelle a été annoncée de manière satisfaisante Q3 : Les causes du problème ont été clairement expliquées Q4 : Une perspective a été fournie pour la suite Q5 : Le comportement de l'apprenant a été correct L'adhésion à chacune des affirmations a été cotée de 1 (désaccord total) à 6 (accord total). L'analyse statistique a utilisé le logiciel Stat EL et des tests non paramétriques. Résultats : Dix réponses ont été obtenues pour chacune des 6 situations. En regroupant les réponses aux 5 questions, le ressenti était différent entre les groupes (p = 0,002 Kruskal- Wallis), en particulier entre les AS et les CS (p = 0,001 Mann- Whitney) La stratification par questions a montré que ce sont surtout pour les questions 1 et 2 que s'exprimaient ces différences (Q1 p = 0,009, Q2 p = 0,01 Mann-Withney). Conclusion : L'analyse du résultat de l'évaluation d'une prestation lors d'un jeu de rôle est significativement influencée par la formation préalable des notateurs [ABSTRACT FROM AUTHOR]