Practical Training in Clinical Ethics Consultation Using Immersive Role-play

Although the need for clinical ethics consultation (CEC) is widely recognized, Japan still lacks proper functioning of effective CECs. One of the reasons for this is the lack of a practical training system for CEC. Although seminars on clinical ethics have been held in Japan, unfortunately, none of them provide training in the ability to respond flexibly in clinical settings, which is essential for CEC. Furthermore, given the current situation in Japan, where even large hospitals receive only a few CEC requests per year, it is difficult to shadow learn CEC provided by experienced clinical ethics consultants on the site. Therefore, we developed “Immersive Role-play (IR)” to ensure practical training opportunities on CEC. The IR is the application of a new theater technique, immersive theater, to role-play learning, characterized by the high fidelity use of studios and actors and the dynamic realism of its scenario progression, which deepens the immersive experience. We designed the IR to enable learners to gain experiential learning of practical CEC points, such as (a) importance of narrative, (b) fragmentation of information, (c) variability of information, and (d) importance of communication through IR.We conducted a seminar on CEC, including IR, for healthcare professionals during 2016–2019. A questionnaire was administered to the attendees regarding the educational effectiveness of IR after the completion of all annual seminars. The responses were recorded anonymously, using a 4-point Likert scale to answer questions about their satisfaction with IR and their perception of learning effectiveness. They were also asked about the effectiveness of IR and areas for improvement.The questionnaire showed positive responses in all areas of usefulness, satisfaction, understanding, and interest. Furthermore, compared to conventional role-play learning, the overall response to IR was good. In particular, “realism,” “seriousness,” “understanding the importance of communication skills,” and “understanding the diversity of narratives” were rated very highly. Moreover, the free-text responses indicated that many learners learned about practical procedures; the IR “audience system” was also shown to be effective. These results indicate that IR is a practical program with sufficient educational effects.