‘Applied Drama and ‘sympathetic presence’ in person-centred care: a case of interdisciplinary pedagogy with Nursing and Drama’

Development of an interactive model of creative play and critical reflection to advance ‘sympathetic presence’ in Nursing practice: a case of interdisciplinary pedagogy with Nursing and Drama.Dr Matt Jennings, Lecturer in Drama, School of Creative Arts, Ulster University, mj.jennings@ulster.ac.ukPat Deeny, Senior Lecturer, School of Nursing, Ulster, University PG.Deeny@ulster.ac.ukKey Words: Empathy, Sympathetic Presence, Nursing, Applied Drama, Critical Reflection, Pedagogy. In the wake of critical reports on the National Health Service, there is a fresh drive to create a culture of care that delivers a dignified and empowered patient experience (O’Neill, 2013). Models such as Person-Centred Nursing (PCN) (McCormack and McCance, 2010) have emerged as frameworks for strategic direction in this area. One of the key features of PCN is the concept of ‘sympathetic presence’, which deepens the notion of empathy to a point that involves the nurse being available to the patient ‘in the moment’ (McCormack and McCance, 2010, p 104). In fact, the model of ‘sympathetic presence’ represents a critique of the limitations of empathy, suggesting that it is neither desirable nor possible ‘to fully comprehend another individual’s particular experience’ (McCormack and McCance, 2010, p 102). Similarly, political and applied theatre practitioners have challenged Aristotelian dramaturgical concepts of ‘empathy’ and ‘identification’ as ‘coercive’ and detrimental to the capacity for rational thought and social action (Boal 1998; Brecht 1978).Research has shown that Applied Drama can lead to positive outcomes in Nursing pedagogy (Boggs et al, 2007; McGarry and Aubeeluck, 2013; Bates, 2013; Lee et al, 2014). There have been calls to use such methods to deepen empathy in relation to patient experience (Arveklev et al, 2015), yet ‘sympathetic presence’ has not yet been explored as an alternative approach to framing applied drama practice in medical simulation.This case study examines the incorporation of approaches to applied drama and actor training into the delivery of a work-based learning module in Clinical Practice at Ulster University from September to December 2015. Mental Health and Adult Nursing students (n=200) were introduced to Theatre of the Oppressed techniques such as Image Theatre and Forum Theatre (Boal 1979), as well as some aspects of Stanislavski’s Method of Physical Action (Benedetti, 1998). These supported the Nursing students’ assessment, whereby they were engaged in a series of role play scenarios based on ‘real world’ clinical encounters. Student assessment also involved a reflective account of the experience, using a framework of critical reflection derived from Asadoorian et al (2011). A small group of Drama students also devised and delivered a piece of Forum Theatre, based on the reported experiences of Nursing students during their clinical placements. This was performed to the Nursing cohort as a whole, who engaged with the performance as interactive ‘spect-actors’ (Boal, 1998). Most Nursing students felt they advanced in understanding of ‘sympathetic presence’ and gained new insights into the patient experience. Students stated that they gained new skills and understanding of agency, person-centred engagement and ‘presence’. While this remains work in progress, it can be inferred that is possible to use Applied Drama as form of creative play to support critical reflection and professional development, through an interactive model that advances ‘sympathetic presence’ in the nurse-patient relationship. This paper explores the potential for interdisciplinary collaboration in applied drama and Nursing pedagogy to develop a set of practical approaches for developing ‘sympathetic presence’ as a specific technique, beyond empathy and towards creative agency.References: Arveklev, S.H., Wigert, H., Berg, L., Burton, B., Lepp, M. 2015 The use and application of drama in nursing education - An integrative review of the literature Nurse Education Today 35(7), e12-e17Asadoorian, J., Schönwetter, D, J. and Lavigne, S, E. 2011 Developing Reflective Health Care Practitioners: Learning from Experience in Dental Hygiene Education. Journal of Dental Education 75(4), 472-484Bates, K. (2013) Drama in the classroom: Fitness to practise. Practising Midwife, 16(1), 23-25. Benedetti, J.( 1998) Stanislavski and the Actor. London: MethuenBoal, A. 1998. Theatre of the Oppressed. Trans. Charles A. and Maria-Odilia Leal McBride. London: Pluto Press.Boggs, J, Mickel, A, and Holtom, B.2007. 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