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Christina Kowalchuk is an American-born, Oxford-based actor, singer-songwriter and educator. Here she discusses her role as a simulated patient for the Communication Skills course and how she has developed new role-play material to help students talk about gender.

Portrait headshot of Christina Kowalchuk

I have been acting as a simulated patient for the University’s high-calibre Communication Skills programme for a number of years. Recently I’ve had the pleasure of helping Ruth Wilson develop a new role for the course, informed by the wonderful LGBTQ+ learning session that included presentations by Jack Amiry and Steph Clark.

The aim of the new role play is to help the student explore vocabulary around gender fluidity and sexual identity. Additionally, it encourages the student to discuss sex in an unembarrassed way, using appropriate, unambiguous vocabulary. The character in this role-play has a lifestyle and partners that defy traditional definition in concrete, binary terms. The student is challenged to speak frankly, as well as to ascertain what actually matters most in taking a sexual history. Language and culture are evolving. Like everyone else, doctors need additional communication skills in their “tool kit” to enable them to explore patients’ self-identifications (and related concerns).  

Several lifetimes ago, I earned a Master’s degree in Education from Stanford University, and went on to teach public school in California. I headed my department, teaching English, history, and (my personal favourite) sex education. Currently, I lead writing workshops and retreats, assisting people in finding their authentic voices. As a member of the queer community (and trustee for Young Women’s Music Project), I am acutely aware of the importance of this role and the discussions it provokes. The learning process in Communication Skills sessions is dynamic and invaluable. Through a collaborative effort between the students, the tutor and the simulated patient, deeper understanding and sensitivity are unlocked and assimilated.

The new role-play has recently been introduced as a pilot in the “Talking About Sex” session. So far we are receiving positive feedback from all quarters. The great advantage of this role-play is the opportunity it gives students to be curious, to make mistakes from which they can learn, and to question their own assumptions. At its heart, the doctor-patient relationship is about a human connection. communication skills sessions give students the opportunity to practise developing these connections in a safe, supportive context.

Here is some feedback on the new role-play: 


“The pilot went well. It allowed students to consider areas they hadn’t thought about—we had really good discussions. Especially around the patient pronouns, the doctor pronouns— how to ask about gender assigned at birth. We concluded that in a supportive and compassionate environment you can explore anything with your patients and that it is always ok to reverse (apologise, correct and reframe if needed)”.
- Dr Suzanne Stewart, Communication Skills Tutor

I think the scenario is invaluable, enabling students to be comfortable with terminology and asking somewhat intimate details in a factual, unembarrassed way. It also seems to open up their confidence with the other scenarios.
Karen Fanning, Patient Simulator

Opinions expressed are those of the author/s and not of the University of Oxford. Readers' comments will be moderated - see our guidelines for further information.