THE SCENE looks for all the world like any modern hospital ward. Some cubicles have curtains drawn across them as patients and medical staff consult on courses of treatment and progress to date. There is a nurses’ station in one corner, bedside lockers next to each patient and charts hanging from some of the beds.
In one corner, Laura Pauwels, who goes by the name Jacinta, is sitting on a bed and concerned that vocal nodules are making her increasingly ill. Each sentence is followed by a dry, aggravated cough. She works as a singing teacher and her career is in jeopardy because of her throat problems.
Seated beside her are two trainee speech and language therapists, Shinann Buckley O’Sullivan and Yvonne McEvoy, who take turns in outlining the various courses of treatment available to Pauwels.
“My voice is my life and I need it,” Pauwels says, before inquiring, “With the therapy thing, would it be once a week?”
McEvoy answers her directly: “We usually start with a block of six treatments at a time that suits you.”
Pauwels has more questions: “Will this take them completely away or just reduce them? And is there a chance they could come back, now that I’ve had them once?” She waits for an answer, but neither of the speech and language students responds immediately.
Having suffered with vocal nodules more than a decade ago, I feel like jumping in to offer my own advice and experience. McEvoy looks to Buckley O’Sullivan and when neither of them seems confident of the answer, she shouts “pause”, and everyone stops.
It’s like a scene from The Truman Show, when you suddenly realise that the reality being presented is in fact a construct. Each scenario being played out here involves drama students playing patients and students from the Department of Speech and Hearing Sciences putting what they’ve learned in class into practice.
While simulated wards have been used in the training of medical and nursing students for decades, University College Cork believes this is the first time speech and language students in Ireland have benefited from this type of practical experience.
It helps that UCC also has a School of Music and Theatre, so that students from both the medical and the drama departments can benefit. Before each scene is set up, the drama students are sent a detailed brief about their characters, including details on the particular condition they have and what kind of emotional responses they should give.
It is this level of detail and advance preparation that makes the simulated ward seem so incredibly real. Pauwels, who played the patient with the vocal problem, takes the role as seriously as she would any other. “It is a great opportunity for us to show that drama is not just for fun,” she says.
“It teaches us also to stay in character and really believe in what we are doing. I prep the role the same as I would any other. I got a description of the character in advance and I watched videos on vocal nodules and how they impact on patients. I did hours of research for this role. We are pioneering this, so it is an honour to be part of it.”
Buckley O’Sullivan says that the level of detail the drama students go into helps prepare her for when she will encounter actual patients for the first time. “It doesn’t feel fake and you never think this is only an actress,” she says. “You really think this is a real patient who thinks they could have cancer or some other ailment.”
A few weeks ago during an initial simulation, all the participants found themselves becoming emotionally involved during a particularly difficult scene when they had to tell a male “patient” he had a life-threatening illness. “We had to tell him we may not be able to make him speak properly again and it was actually very emotional,” says McEvoy.
The first time they tried a scene with Pauwels though, things didn’t go exactly according to plan. “I had her terrified,” says Buckley O’Sullivan. “I mentioned surgery and I used medical terms instead of language we would use for the patient.”
The drama students are all paid for their efforts, and there are plans to roll out simulations on a larger scale in the coming years, as well as to assess the impact it has on speech and language therapy students when they go out on work experience in hospital wards.
This project has recently won a prestigious UCC President’s Award for innovative teaching methods for the pioneering way it is imparting essential clinical skills to students.
“The difference between this and regular role playing is that we find with the drama student involved we can really push the emotional side of it,” says Nicole Kennedy from the Department of Speech and Hearing Sciences.
“We can have someone play a patient who is told their speech will get worse and they will break down and start to cry. Our speech and language therapy students have to deal with that. As a result, when they go out on work experience they are better prepared.
“On placement, this type of exposure doesn’t even happen as probably the trained therapist would be mindful of not exposing patients or student to emotional situations. This allows us do that in a controlled environment. That doesn’t make it feel less real for those involved though.”
