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PubMed1993

The impact of unstructured games of fantasy and role playing on an inpatient unit for adolescents.

Games of fantasy and role playing such as Dungeons and Dragons (1983) have become increasingly popular among adolescents and young adults. This article reviews the negative impact of such games on an adolescent inpatient treatment setting. The unrestricted play of such games contributed to the disruption of a treatment setting, resistances to treatment, reinforcement of character pathology, disruption of individual treatments, and to the normalization of violence. When such games begin to be played on a psychiatric inpatient unit or are prominent in discussions of individual patients, treaters should examine them in the context of their potential to reinforce and foster resistance and maladaptive patterns of relating to the environment. Treaters are also encouraged to attempt to understand the meaning and risks of such games in the context of an individual patient's psychiatric difficulties and of group dynamics, both within the patient group and between patients and treaters.

Adolescent↗
PubMed2001

The organizational context of ethical dilemmas: a role-playing simulation for the intensive care unit.

The allocation of health care resources often requires decision makers to balance conflicting ethical principles. The resource-constrained intensive care unit (ICU) provides an ideal setting to study how decision makers go about their balancing act in a complex and dynamic environment. The author presents a role-playing simulation exercise which models ICU admission and discharge decision making. Designed for the class-room, the simulation engages a variety of ethical, managerial, and public policy issues including end-of-life decision making, triage, and rationing. The simulation is based on a sequence of scenarios or "decision rounds" delineating conditions in the ICU in terms of disposition of ICU patients, number of available ICU beds, prognoses of candidates for admission, and other physiological and organizational information. Students, playing the roles of attending physician, hospital administrator, nurse manager, triage officer, and ethics committee member, are challenged to reach consensus in the context of multiple power centers and conflicting goals. An organization theory perspective, incorporated into the simulation, provides insight on how decisions are actually made and stimulates discussion on how decision making might be improved.

Competency-Based Education↗
PubMed1984

Role-playing techniques: the differential effect of behavior simulation interventions of the readiness to inflict pain.

Investigated the differential effect of two kinds of behavior simulation (role-playing) interventions: The spontaneous and the mimetic-pretend, on the readiness and the responsibility attributions associated with delivering electric shocks to others (N = 25). Shocks were administered in a teaching situation using the Buss Aggression Machine in the "teacher-learner" paradigm. The results showed that the spontaneous Ss were more ego-oriented and more inhibited in administering shocks than the mimetic-pretend Ss. Unlike the latter Ss, who evinced task-oriented behavior and attributions, the spontaneous Ss assumed personal responsibility for their actions and evaluated the outcomes by minimizing their contribution. Implications for clinical use of role-playing are discussed.

Adult↗
PubMed2005

Use of cigarettes and alcohol by preschoolers while role-playing as adults: "Honey, have some smokes".

OBJECTIVE: To examine preschoolers' attitudes, expectations, and perceptions of tobacco and alcohol use. DESIGN: Structured observational study. Children used props and dolls to act out a social evening for adults. As part of the role play, each child selected items from a miniature grocery store stocked with 73 different products, including beer, wine, and cigarettes, for an evening with friends. SETTING: A behavioral laboratory at the Department of Psychological and Brain Sciences, Dartmouth College. PATIENTS: One hundred twenty children, 2 to 6 years old, participated individually in the role-playing. MAIN OUTCOME MEASURE: Whether or not a child purchased cigarettes or alcohol at the store. RESULTS: Children purchased a mean of 17 of the 73 products in the store. Thirty-four children (28.3%) bought cigarettes and 74 (61.7%) bought alcohol. Children were more likely to buy cigarettes if their parents smoked (adjusted odds ratio [OR], 3.90; 95% confidence interval [CI], 1.20-12.63). Children were more likely to buy beer or wine if their parents drank alcohol at least monthly (adjusted OR, 3.04; 95% CI, 1.02-9.10) or if they viewed PG-13- or R-rated movies (adjusted OR, 5.10; 95% CI, 1.14-22.90). Children's play behavior suggests that they are highly attentive to the use and enjoyment of alcohol and tobacco and have well-established expectations about how cigarettes and alcohol fit into social settings. CONCLUSIONS: The data suggest that observation of adult behavior, especially parental behavior, may influence preschool children to view smoking and drinking as appropriate or normative in social situations. These perceptions may relate to behaviors adopted later in life.

Adult↗
PubMed2006

Senior veterinary students' perceptions of using role play to learn communication skills.

Recent studies of veterinary practice have suggested a correlation between well-developed communication skills and job satisfaction, career retention, customer satisfaction, decreased lawsuits, and financial remuneration for veterinarians. Veterinary educators are under growing pressure to teach functional communication skills to veterinary students; however, the methods employed have not been well evaluated. In this study we have evaluated veterinary student's attitudes to learning communication skills by participating in role play. The study indicates that experiential learning modalities such as role play are perceived as effective by students, despite reluctance to participate and some discomfort surrounding participation.

Adult↗
PubMed2003

The influence of information and role-playing experiences on children's attitudes toward peers who use AAC.

A school-based intervention designed to increase the positive nature of children's attitudes toward peers who use AAC is described. Small groups of children were given only information about AAC or they were given information about AAC and the opportunity to role-play being nonspeaking. Results indicated a greater positive effect of the information plus role-play experience compared to the effects of being given information alone for older children and boys. Clinical implications and suggestions for future research are discussed.

Attitude↗
PubMed2006

Teaching engineering ethics using role-playing in a culturally diverse student group.

The use of role-playing ("active learning") as a teaching tool has been reported in areas as diverse as social psychology, history and analytical chemistry. Its use as a tool in the teaching of engineering ethics and professionalism is also not new, but the approach develops new perspectives when used in a college class of exceptionally wide cultural diversity. York University is a large urban university (40,000 undergraduates) that draws its enrolment primarily from the Greater Toronto Area, arguably one of the most culturally diverse cities in the world, embracing the largest percentage of Canada's immigration. Among the area's five million inhabitants, 50% identify themselves as a visible minority born outside Canada, while over 100 languages and dialects are spoken daily. Although students admitted from this international pool have usually been exposed to western attitudes during secondary education and are rapidly assimilated into Canadian culture, responses to specific ethical issues are strongly influenced by their prior culture. Two and three-part scripts for case studies based on NSF or original scenarios were written to illustrate issues such as gifts, attitudes towards women and ethnic minorities, conflict of interest, whistle-blowing, sexual harassment, individual rights, privacy, environment, intellectual property, and others. Following the presentation, the actors lead group discussion based on previously specified questions. Once the initial shyness and reluctance of some cultures has been overcome through the building of rapport, students have written original scripts based on hypothetical or prior personal situations. The method is now being adopted in a short course format to assist the professional integration of foreign trained engineers.

Canada↗
PubMed1996

Using live theatre combined with role playing and discussion to examine what at-risk adolescents think about substance abuse, its consequences, and prevention.

Live theater is used as a means of stimulating thought and discussion among adolescents on topics related to the effects of substance abuse in their lives. A thirty-minute professional and contemporary live musical play, Captain Clean, was performed at three Chicago high schools (grades 9-12). In general, students in these schools had been judged to be at risk for drug problems by school administrators and by the Illinois Criminal Justice Information Authority. Students' responses to issues highlighted in the play were examined through ethnographic procedures used during role playing and discussion immediately following the performance. In addition, written comments were collected from the students two weeks after viewing. The amount of interaction and level of student response indicate that live theater is an effective means for stimulating both thought and discussion pertaining to the effects of drugs in the lives of adolescents. In addition, analysis of the students' responses reveals: (1) an unmet need for individual counseling; (2) a pervasive ignorance of the legal consequences of drug use; (3) the importance of family as a source of information and support; and (4) an expressed concern for their own futures as well as those of their peers.

Adolescent↗
PubMed1992

[The use of role-playing with actors and video in teaching clinical interviews to medical students].

OBJECTIVE: To describe the use of the technique of role-play, using actors and recorded on video, in teaching clinical interviews to medical students; and the latters' evaluation of the methodology used. DESIGN: Prospective and observational controlled study. SITE. The Faculty of Medicine in Granada. PATIENTS AND OTHER PARTICIPANTS: The study was carried out with a group of 32 students doing the last year of Medicine. MAIN MEASUREMENTS AND RESULTS: Two actors, ten students as interviewers and two teachers were involved. The programme consisted of: a theoretical setting-out of the contents of the clinical interview; a description of the group analysis method; filming simulated interviews on video; group analysis of the material filmed; and evaluation by means of a questionnaire. The choice of interviews gave rise to no problems. The actors assumed with ease the roles they had to play. In the group work, students actively participated and made constructive contributions all the time. In the assessment the items referring to Interest, Teaching Method and Relevance and Originality were high (4.49 out of 5 points). Only that referring to documentation obtained a lower score (3.87 out of 5). CONCLUSIONS: Role-play technique, using actors and video, are excellent educational methods for teaching the clinical interview in undergraduate training.

Education, Medical, Undergraduate↗
PubMed1993

[Observation of the effects of warming-up and role-playing in psychodrama in terms of mood rating].

The purpose is to make an appropriate list of terms that describe person's moment-to-moment changes in moods during psychodrama sessions. Seventy nurse students participated in a series of psychodrama sessions, consisting of a session of warming-up and two sessions of role playing. They rated their moods at the beginning of the sessions and after each session, on a five-point scale for each of the 55 terms, which were supposed to cover all kinds of moods during psychodrama sessions. After analyzing variations (using factor analyses) of subjects' ratings, three factors were found to be sufficient for describing their moods, and the terms in the list were eventually reduced to sixteen. Changes of moods analyzed through the ratings of sixteen scales were related significantly with subjects' performances of warming-up and role playing.

Adult↗
PubMed1994

Involvement and role playing.

Three studies focused on involvement as a function of type and content of the role play, experimenter behaviors, and proportion of time in scenario roles. Several measures of involvement were obtained. Generally, there was a low correlation between involvement estimated by observers and self-reported involvement; subjective involvement also was related more consistently to other variables.

Adult↗
PubMed2004

[Apoptosis: mitochondrial membrane permeabilization and the role played by Bcl-2 family proteins].

The crucial role of mitochondria in the initiation of apoptosis is well established. The metabolic consequences of mitochondrial membrane permeabilization as well as the leakage of apoptogenic factors normally confined to mitochondria determines the catabolic features of cell death. Here we attempt to summarize the current view of the mechanisms that lead to the efflux of many proteins from mitochondria during apoptosis and the role played by Bcl-2 family proteins in these events.

Adenosine Triphosphate↗
PubMed1999

Scripted role play: a technique for teaching sexual history taking.

Many inexperienced physicians are uncertain as to how to go about gathering a sexual history. They have had courses in basic history taking, but they do not know how to go about obtaining the information in a nonthreatening way. Their opportunities for interaction with real patients have typically been limited. Scripted role play is a very effective method for providing residents with an opportunity to enhance their sexual-history-taking skills. This article describes scripted role play as a teaching method; explains why it is effective for teaching sexual history taking; presents general guidelines for script writing for this purpose; details how to organize a teaching session; and provides some tips for the session facilitator.

Counseling↗
PubMedDate not supplied

Pain, role play, and videotape. Pain management staff development in a community hospital.

Videotaped role play was an effective staff development strategy used as an initial exercise in a five-part class to update the pain management skills of experienced nurses. It engaged the participants in learning and stimulated discussion and provided concrete feedback of current clinical practices for comparison with the Agency for Health Care Policy and Research pain management guidelines (Acute Pain Management Guideline Panel, 1992).

Clinical Competence↗
PubMed1996

Development of the role-play inventory of situations and coping strategies for parents of children with cystic fibrosis.

Critiqued previous conceptual and methodological approaches to the measurement of stress and coping. Applied Goldfried and D'Zurilla's behavior-analytic model to create a context-specific measure of problematic situations and coping strategies for parents of school-age children with cystic fibrosis (CF). The sample was stratified by child's gender and illness severity. Forty-seven families (46 mothers, 32 fathers) and 8 health care professionals completed structured interviews or daily diaries to obtain the widest range of problematic situations; 1,725 situations were elicited across all participants and then content-analyzed into 97 nonredundant categories in 11 domains (e.g., Discipline, Medical Care). Few differences were found in problem frequency or difficulty as a function of either gender or illness severity. Using empirical criteria, the most frequent and difficult problem situations were selected and developed into role-play vignettes that include relevant contextual, developmental, and interactional details. The Role-Play Inventory of Situations and Coping Strategies (RISCS) consists of 31 audiotaped vignettes designed to elicit and evaluate the coping strategies used by parents of children with CF.

Adaptation, Psychological↗
PubMed2006

Massively multiplayer online role-playing game-induced seizures: a neglected health problem in Internet addiction.

As the Internet has become rapidly and widely integrated into society, Internet addiction has become a growing psychosocial problem. However, epileptic seizure, another out-of-the-ordinary health problem, is often neglected in this regard. Ten patients who experienced epileptic seizures while playing the newest genre of electronic games -- Massively Multiplayer Online Role-Playing Games (MMORPGs) -- were investigated. Patients were predominantly male young adults, and most of the events were generalized tonic-clonic seizures, myoclonic seizures, and absences. These patients should be categorized into idiopathic generalized epilepsies. Even though photosensitivity was an important factor, behavioral and higher mental activities also seemed to be significant seizure precipitants. Results demonstrated that MMORPG-induced seizures were not analogous to the ordinary video game-induced seizures. Significantly, an epileptic seizure warning did not always appear on the websites of MMORPGs and instructions for the software. While the prevalence of MMORPG-induced seizures remains unknown, it may exceed our expectations and impact our society. Not only for clinical neurologists but also for the primary physicians, educators, sociologists, and global online game publishers, there should be an awareness of this special form of reflex seizures in order to provide an appropriate health warning to MMORPG players.

Adolescent↗
PubMed2003

Using role playing to increase residents' awareness of medical student mistreatment.

The teacher-learner relationship is subject to both internal and external influences that may lead to mistreatment and harassment of the student. The student who is mistreated may mistreat students when he or she becomes a teacher. The author describes an experiential program for residents at Brown Medical School from 1999 to 2002 in which residents, through role playing, helped produce teaching videotapes on medical student mistreatment. Fourteen residents had participated in the program to date. They reported that they had benefited from an increased awareness of the effects of student mistreatment and had learned how to handle mistreatment more effectively. They also reported increased sensitivity to others and improved self-awareness, qualities that they planned to incorporate into their professional identities and that should help them avoid mistreatment of students and residents later in their careers. Because preventing mistreatment from being transmitted to the next generation is an important way to increase medical professionalism, the author recommends that role-playing exercises dealing with mistreatment be a part of all residency education.

Awareness↗
PubMed2000

Minor role played by type I tumour necrosis factor receptor in the control of Mycobacterium avium proliferation in infected mice.

Control of mycobacterial growth depends on the concerted activity of different cytokines acting in different stages of the development of innate and adaptive immune responses. Tumour necrosis factor-alpha (TNF-alpha) has been shown to play a protective role in Mycobacterium avium infections. Here we assessed the growth of this mycobacterial species in wild-type mice and in mice with a genetically engineered disruption of the type I receptor for TNF-alpha (p55-KO mice). p55-KO mice infected with a low-virulence strain of M. avium exhibited a slightly delayed capacity to eliminate the micro-organisms from the liver as compared with wild-type animals. However, either the growth of this strain in the other organs studied (spleen and lung) or the growth of two other strains of M. avium with intermediate or high virulence, failed to be affected by mutation of the TNF-alpha receptor. p55-KO mice were also as protected by the administration of recombinant interleukin-12 as the heterozygous p55 +/- mice. We conclude that signalling through the type I TNF receptor plays a small role in vivo in the induction of mycobacteriostasis during M. avium infection but may improve survival during infection with virulent mycobacteria, independently of the extent of their proliferation.

Animals↗