09 January 2018
Jo Odell, FoNS Practice Development Facilitator
Last week we featured an improvement insight from a hospice project team that used a number of forum theatre events to help nurses learn how to have difficult conversations about patients’ choices at end of life.
This reminded me of a project that I had led on several years ago where I used forum theatre as a interactive learning event for nurses who were developing their skills and confidence as champions for older people in acute care settings. When I started the project, I knew I wanted to take a very creative approach and started looking for theatre companies to achieve this aim. That’s when I came across forum theatre.
I commissioned a small theatre company to develop a piece of theatre around the care of older people which they set in a care facility in the future (space age!). We wanted the theatre to be light-hearted and slightly removed from ‘real life’ but also for the audience to be able to relate to the interventions and behaviours (both helpful and unhelpful) of staff taken from real life scenarios. The piece of theatre they devised lasted approximately 15 minutes long and told the story of three different residents with different conditions and struggles (one lady with a severe cognitive impairment, one gentleman who wanted to go home, but was physically in need of help and one lady recovering from a surgical operation) in the care facility and the different interactions they had with one member of staff. Bearing in mind there were only two actors, there were a few scene changes and many changes of makeshift costumes! Once run, the theatre was repeated but this time the actor who was the staff member acted as a facilitator and interacted with the audience. He explained that they were going to re run the piece of theatre but if at any point any person in the audience wanted to suggest a different interaction based on their own experience, all they had to do was shout “stop” and then come up and show the actor the different intervention, as a film director might do. If that felt too difficult for people to do in front of an audience, they could direct the actor from their chair by “phoning in” their suggestion. So, let’s be clear this is not role play – this is sharing suggestions of things to say or do, based on their own experience, which they feel will be benefit the patient and staff member.
Intially, I used the forum theatre with a small number of people but the feedback we received was so positive, we took this out to a larger hospital audience to raise awareness of caring for older people and to share interventions that really helped. The benefits of using the forum theatre approach was that the audience could see and witness the interventions and behaviours, as well as outcomes and crucially, choose whether to try them in their own practice. It moved away from a telling or teaching approach and led to a much more powerful learning experience.
I was fortunate; I had a budget to commission and work with a theatre company.
So, what if you want to run with this idea, but have no budget? Then I would suggest keeping the concept small. What is it you want to achieve and what do you want people to explore and learn from in practice? What internal resources are available to you? All you need is two enthusiastic people prepared to visualise a scenario (you could be one) and then facilitate some interactive discussion around different interventions and try these out and see what effect they have. Another alternative would be to show a short video instead of a real-life scenario and then facilitate some discussion around different interventions that you could try out between you.
The key aspects of forum theatre are visualisation of interventions and behaviours within a scenario and creating a safe atmosphere where the audience feels able to interact. You could consider creating ground rules or ways of working to help people feel safe quickly. And trying out different interventions and learning from each other’s experiences about the outcomes these may achieve for both the patient and the staff member involved. For example: Your scenario maybe caring for an older person with a cognitive impairment who is agitated and scared and wants to leave the ward/area. However, they are unsteady on their feet and you are concerned they will fall and injure themselves. One intervention might be to constantly remind the older person to stay sitting, but does this help the person with their agitation? Another intervention may be to assist the older person with a short walk, or is there a ‘job’ that needs doing, or some sort of distraction technique? By trying out these interventions you can see what is the most effective. I am sure there are many other interventions you could try!
If you have used forum theatre or another creative method to help people learn in and from practice, please share you experiences and ideas with us here so we can learn from each other.