Training physicians in communication skills with adolescents using teenage actors as simulated patients Daniel Hardoff 1 & Shifra Schonmann 2 1 Role-play exercises with simulated patients may serve the purpose of training professionals to develop appropriate communication skills with adolescents. Authentic adolescent responses toward the physicians may be achieved by actors who themselves are in their teenage years. We describe our experience in continu- ing medical education programmes for primary care physicians aimed at improving their skills in commu- nicating with adolescents, using simulation methodo- logy with teenage actors. Eight 16±17-year-old actors from the drama department of a high school for the arts were trained to simulate 20 cases with characteristic adolescent medical problems, as well as con®dentiality issues and home and school problems. The actors performed in front of large groups of 20±30 paediatri- cians, family practitioners, or gynaecologists in con- tinuing medical education. Diagnostic issues as well as therapeutic and management approaches were dis- cussed, while the actors provided feedback to the train- ees about their understanding and their feeling regarding the issues raised during the exercises. Normally, smaller learning groups are more suitable for such training purposes; nevertheless the participants could appreciate learning the principles of careful listening, a non-judgmental approach and assuring con®dentiality. A collaboration of medical schools and postgraduate programmes with high schools which have drama departments may be fruitful in the teach- ing of adolescent medicine with special emphasis on communication skills with teenagers. Keywords Adolescence; communication; education, medical, continuing; education, medical, under- graduate; *physician patient relations; role playing. Medical Education 2001;35:206±210 Introduction The doctor±patient relationship remains at the core of the art of medicine. In addition to demonstrating clinical acuity, physicians ought to possess the necessary skills to assess patients' emotional needs and to display clear and effective responses to these needs. 1 Lack of skill in the doctor±patient relationship may result in failure to reach the appropriate diagnosis, as well as to secure follow-up visits and compliance. 2 A visit to the doctor is often upsetting and anxiety-producing, 2 especially for adolescents who often experience dif®culties in expressing their concerns, and are reluctant to share feelings and con®dential matters with adults. 3 The ability to create trustful relationships with adolescents in need of directed medical attention, together with success in obtaining useful information from them, demands special communication skills. Health professionals are under an obligation to serve as the adolescents' advocates, even when encountering rejection and hostility. In order to avoid expression of attitudes which may adversely affect the health interest of the adolescent patient, the health professional's feelings sometimes need to be carefully masked 1 and acting can thus be the ultimate salvation for the caring physician. 4 Communication skills are taught in most medical schools, allowing students to rehearse and to experiment, often by the use of simulation methods, including medi-drama where physicians also play the role of the patients, 5,6 and by videotape scene analysis. 7±9 Simulation exercises role-played by adult professional actors are accepted methods for both teaching and evaluation of clinical competence in medical schools worldwide. 10±17 The use of adolescent actors in training professionals has not yet been reported. 1 Division of Adolescent Medicine, Department of Paediatrics, Bnai Zion Medical Center, The Faculty of Medicine, Technion, Haifa, Israel 2 The Laboratory for Research in Theatre/Drama Education, The Faculty of Education, Haifa University, Haifa, Israel Correspondence: D Hardoff, Director, Division of Adolescent Medi- cine, Department of Paediatrics, Bnai Zion Medical Center, P.O. Box 4940, Haifa, Israel Communication skills 206 Ó Blackwell Science Ltd MEDICAL EDUCATION 2001;35:206±210