The lone actor

Back in that old life, where we brushed past people and shook hands, all without a second thought, actors gathered early for free coffee. We caught up with who did and didn’t have any auditions looming, many of us having relinquished that path now revelling in playing real people, in realistic ways, for immediate rewards, as simulated patients for Communications Skills training. The busy GP tutors would rush in from appointments elsewhere to calibrate our levels of anxiety/anger/distress, (forgetting their own!), in supportive preparation for the actual encounters with medical students. Students arrived in a buzz of friendship groups and there was time to swap smiles before we split into our tutorial groups and sideswiped them with emotion. At the end of sessions there were always moments to whisper encouragement, to a student who had struggled, or heap praise on another.

So, in the new age of lone actor, lone trainer and the students arriving singularly to Teams/Zoom from their various backdrops of: postulant cell, palatial parents’ sitting rooms, or chaotic house shares, it has been difficult to share those small important moments. Concentrating on the technicalities of logging on, mute or unmute, the moment of meeting can be fraught. Even when trainers sensitively enable ‘arrival’ and indeed ‘departure’ in the shared space, there is no doubt we are not sharing space as we used to - ‘alongside each other’. The screen boundaries exclude those peripheral opportunities of spotting body language cues of nervousness/inattention from students and students miss out on actors using the full range of angry body language, up close and far too personal! Most importantly, both parties in the consultation miss those visceral moments of human connection, from the safe proffer of a tissue, to the comforting touch of a “doctor’s” hand: the feeling in that teaching room of magic happening.

Having said that, simulated online consultations have sometimes provided a greater potency of experience, with only one student and simulated patient interacting on screen at one time. Equally valuable, has been the trainer appearing beside us on screen, dissolving this intensity and enabling both student and actor to retreat and re-group. Personally, the device of coming off camera whilst not in role is useful to delineate characters (albeit from the waist up!) and gives time to write feedback notes with more specific detail than was possible in the face-to-face setting. Also, one-on-one time with our GP trainer before and after the session is an invaluable chance discuss and reframe the session with lessons learned from shared experience, further strengthening the actor/trainer relationship.

So which do I prefer – both, for different reasons, so possibly a blend of the two?!