Volume 63 - Spring 1996	Download

Role playing as a method for teaching and evaluating the affective domain by Benna Boutty, MA, MT(ASCP) Vice Chariman, PARC

Programs are often cited for lack of compliance to the NAACLS Standards related to a curriculum component or objectives pertaining to the affective domain.

Several program directors have requested that we suggest ways to incorporate this aspect of training into the curriculum. Since the affective domain is composed of internalized values, emotional reactions, moral character and other "invisible" traits, it is often difficult to assess. Some programs have submitted impressive check lists of "professional behaviors" without any systematic plan to provide measurable observations. We know that situations involving irate patients, malfunctioning equipment and unhappy family members happen to phlebotomists daily. But for some reason, they rarely occur while an instructor is observing a student. The rating scales for honesty, respect for patients, communication skills, etc. are of no real value if the instructor can only guess at a student's actions when students are involved in these circumstances.

In our phlebotomy program, we have used role-playing as both a teaching method and an evaluation tool for the affective domain. Some traits covered have included: self-confidence (do they stay calm during interruptions?); respect for patient dignity (do they cover unclothed patients?), and honesty (do they admit mistakes?)

Role-playing situations usually involve several students playing the parts of patient, nurse, visitors and other staff members. Each is given a brief outline of a role in the scene. The student phlebotomist is told only to simulate the collection of specific samples from the patient. The "patient's" instructions may include directions to be verbally abusive, to refuse, to cry, to pretend a lack of understanding language or to ask detailed questions about the tests or the doctor. "Visitors" may be told to hover over the patient, to complain or even to overturn the collection tray. The patient may not have proper patient identification yet a nurse insists the sample be drawn anyway.

The role-playing situations are discussed by the whole class, which measures "reaction to constructive criticism" (do they learn from it or resent it?). Concepts such as "body language, " "active listening, " "medical ethics, " "zone of comfort, " "professional behavior, " and "stress management" are explained and related to the duties of blood collection before these simulations occur.

Role-playing can help a student develop confidence and an ability to adapt to unpleasant or unexpected situations. It can provide the instructor with an objective method of evaluation. Try it!

Ms. Boutty is an Instructor of Blood Collection at Florida Hospital in Orlando, Florida and Vice Chairman of the Programs Approval Review Committee.

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