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The role of role-play: managing activity ambiguities in simulated doctor consultation in medical education.

机译：角色扮演的角色：在医学教育中模拟医生咨询中管理活动歧义。

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摘要

This paper is concerned with simulated consultations between medical students and real patients, focusing in particular on multiple framings as they lead to activity-specific ambiguities. In these simulated consultations the misalignment of expectations between medical students and patients becomes evident in the opening and closing sequences in particular, which provides the rationale for focusing on these phases of the encounter. Transcribed video recordings were drawn from a Norwegian empirical study of simulated consultations in medical education. The analytic framework derives from a dynamic notion of activity type in conjunction with framing and hybridity. The data illustrate that agenda questions, targeted at the patient's reason for seeing the doctor, frame situations where the students had to manage ambiguities at different levels. While the medical students strive to negotiate the multi-layered frames at an implicit level, the patients negotiate the frames in a more explicit manner. There is uncertainty as to whether the role-play should be perceived as an authentic consultation, which seems to be the student's aspiration, or whether it is to be regarded as a training situation, which appears to be the patient's perception. The paper concludes by raising some issues about the role of role-play in medical education, with particular reference to communication skills training.
机译：本文关注的是医学生与真实患者之间的模拟咨询，尤其关注多个框架，因为它们会导致特定于活动的歧义。在这些模拟的咨询中，医科学生与患者之间期望的错位在打开和关闭序列中尤其明显，这为关注相遇的这些阶段提供了理由。转录的录像来自挪威医学教育中模拟咨询的经验研究。分析框架源自活动类型的动态概念以及框架和混合性。数据表明，针对患者就医原因的日程安排问题构成了学生必须在不同层次上处理歧义的情况。当医学生努力地在一个隐含的水平上协商多层框架时，病人以一种更明确的方式来协商框架。是否应该将角色扮演视为真正的咨询，这似乎是学生的愿望，还是应该将其视为训练的情况，似乎是患者的看法，因此尚不确定。本文最后提出了一些角色扮演在医学教育中的作用的问题，特别是关于沟通技能培训的参考。

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