
| Education for Health (WHO, 1988, 261 pages) |
| Chapter 5: Health education with groups |
Role-playing consists of the acting-out of real-life situations and problems.
In a role-play, the player receives a description of the character he or she is to play. From the description, the player makes up the action and dialogue as the role-play progresses. The player tries to behave in the way that the character might behave when faced with a given situation or problem.
The participants simply behave in a natural way, so that their roles and the action develop as the play goes along.
In a role-play, people volunteer to play the parts. Other people watch carefully and may even offer suggestions to the players. Some of those watching might decide to join in the play.
After the play, players and watchers always discuss it and their reactions to it. Here, you have the important task of guiding the discussion. Ask the players questions like these: How did you feel? Are you happy with the way the situation you were acting worked out? Could you have done anything different to get better results? Then ask the audience to give their views. This discussion helps people to learn something from the play.
Purpose
By acting out a real-life situation, people can better understand the causes of their problems and the results of their own behavior. Role-playing can help an individual explore ways of improving his or her relationships with other people, and of gaining other people's support in efforts to live more healthily.
Another purpose of role-playing is to give people experience in communication, planning, and decision-making. Finally, it helps people to reconsider attitudes and values. We learn about our own behavior during a role-play. We can discover how our attitudes and values encourage cooperation and problem-solving or, how our attitudes and values create problems.
Group size
Role-playing is usually done with small groups. A role-play can be done with a health worker and one or two other people. Someone may come to a health worker in private. The health worker may ask the person to act out their own problem. The health worker would play the part of someone important in the other's life.
Time
A role-play should last about 20 minutes. If the action is lively and the audience is interested, allow the play to continue. But you should stop the play if (a) the players have solved the problem; or (b) if the players are getting confused and cannot solve the problem; or (c) if the audience looks bored.
Allow another 20-30 minutes for discussion. Discussion helps people focus on the important issues in the play. If the discussion is lively, allow it to continue longer. You may suggest a repeat of the play to try out the suggestions that have resulted from the discussion.
Other concerns
Role-playing works best when people know and trust each other. Before using role-playing with an individual, be sure you have established a good relationship with that person. If a group is involved, be sure that the members have already met a few times so that they know each other.
Role-playing involves some risk. Since we do not know the outcome, players are taking a chance when they act in a role play. Do not ask people to take parts that might embarrass them. Some people may not be interested or may be very afraid to speak out in a group. Do not force such people to take part. Let them watch role-plays a few times to see if they become less timid or more interested.
A sample role-play
Mrs Debo is a community nurse. She has organized a mother's club in one village. The club meets once a month at the district health centre to discuss ideas about raising children, and to learn new skills. One day three of the mothers came to see Mrs Debo. They asked if the club could meet at the local primary school that month. They said that the school was closer to where most mothers lived. Mrs Debo saw from their eyes that there were probably other reasons for the change of place. She decided not to ask any questions at that moment and agreed to the change. When the club met at the school, they told Mrs Debo their problems. They said that the staff at the health centre were not nice to them. Sometimes the record clerks kept the mothers waiting a long time. If the mothers asked about their cards, the clerks would be rude and tell them to go home if they did not want to wait. The mothers claimed that the nurses yelled at them if their children were not gaining enough weight. The nurses only gave orders, they never explained anything. If a mother asked for an explanation, the nurse would say she was too busy. Finally, the staff at the dispensary also kept the mothers waiting. The dispensers would have drugs for their friends ready within five minutes, but many mothers would have to wait an hour. Then when they got the drugs, there would be only half the recommended dose. If they complained, they were told to buy the drugs elsewhere.Now Mrs Debo knew why the mothers wanted to meet at the school. They were afraid of the health centre staff. They did not want to make their complaints where someone would overhear them.
Mrs Debo decided to use role-playing to help the mothers and herself learn more about the problem. She told the mothers what a role-play was and asked if they would like to try it. They all agreed they would. She started with the problems with the record clerks. The health centre had two clerks, so she asked two mothers to volunteer to play the clerks. Then she asked the rest of the mothers to play themselves. They moved some tables together and pretended to be in the records office. Then the play started.
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1st mother: |
(walks up to clerks' office) I need my card, my child is very
sick. He's been vomiting since yesterday. |
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1st clerk: |
If the child is so sick why didn't you bring him yesterday? Wait,
I'll get the card (both clerks walk away). |
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2nd mother: |
(walks up, sees no-one at desk) Hey? Anyone here? My baby is sick,
I need my card. |
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2nd clerk: |
(yells from back of office) Can't you people wait? We're looking
for the other woman's card. |
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2nd mother: |
So it takes two grown men to find one small card? |
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1st clerk: |
You can go home if you can't wait. |
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1st mother: |
I've been waiting too long already. The government pays you a good
salary. You should work for it. I wish my husband had a job that paid as much as
that. |
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2nd clerk: |
It's not my fault you married a poor man. |
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1st clerk: |
(finally brings the cardfor which a small piece of paper can be
used) Here, take this (lets the card drop to the floor in front of the
table). |
The play continued like this for a while with a few more mothers coming up to get their cards. Their words were similar to those of the first two mothers. Then Mrs Debo stopped the play so that everyone could discuss what they saw. The discussion went like this:
Discussion of the role-play
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Mrs Debo: |
Would the mothers who acted the clerks tell us how it felt to be a
clerk? |
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2nd clerk: |
I was not too happy with the job. The second mother was not very
polite. I did not feel like finding her card. |
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2nd mother: |
Why should I be polite to those clerks? They are all younger than
me. They are paid a good salary for doing their work. |
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Nurse: |
Is it necessary to be polite only to older
people? |
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3rd mother: |
I was always taught by my mother to be polite to everyone. You
never know where you will meet people in this life. It pays to be
polite. |
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1st mother: |
But shouldn't the clerks be polite to us first? Neither of them
said good-morning or asked how our children were. |
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1st clerk: |
I guess we were busy and forgot to greet you, but you did not have
to insult us. Your attitude suggested we were stupid when we did not find the
card quickly. |
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4th mother: |
I think that all of you were insulting each other. I think we can
behave better than that. If we wait for someone else to be polite first, we may
have to wait a long time. We should make an effort to be friendly and polite.
Maybe that will teach the clerks a lesson on how they should
behave. |
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Mrs Debo: |
What do you all think of this last comment? |
The women nodded their heads in agreement; some of them said 'Yes. That's right.'
Through role-playing, it is possible to portray positive or negative types of behavior and to show their impact For instance, patients will be more likely to take their medicines properly if they receive a careful explanation (as in the top drawing) than if the drugs are handed to them casually (as in the bottom drawing).As the discussion continued, the mothers agreed to try to be more polite to the clerks, even if the clerks did not say anything nice to them first.
They repeated the role-play with different volunteers. Everything went much better the second time when the mothers tried to be polite.
One issue still remained. The mothers said that the clerks started being rude some years ago. Because of this the mothers had become ruder themselves. They wished that someone would talk to the clerks about this problem. Mrs Debo agreed to see the clerks. They decided to wait until the next meeting before discussing the problems with the dispensers and nurses. If there was an improvement with the clerks, then they would try to solve the other problems.
Mrs Debo kept her promise and met the clerks. She did not tell them directly about the mothers' feelings. That might have made them angry. She simply talked to them about their jobs. Were they happy? What did they like about their jobs? What problems did they have?
The two clerks said that the job was not bad compared with other government jobs, but they had difficulty supporting their families on the small salary. They complained that many of the patients demanded too much. The clerks felt that the local people did not like them because they were from another district.
Mrs Debo found out a number of things that day. She knew that the mothers and the clerks did not understand each other very well. For example, the mothers felt that the clerks were rich because they worked for the government. The clerks felt that the mothers did not like them because they came from another district. Mrs Debo asked the clerks if they would like to try a role-play to learn how they could handle the patients better. They agreed. Mrs Debo pretended she was a mother. She behaved in the way the mothers had behaved in their role-play. Then she asked one of the clerks to pretend that he was a mother. After the play and discussion, the clerks came to understand the problem better. They realized that they could be more polite. They also realized that when a mother is worried about her sick child, she sometimes forgets to be polite.
When the mothers had their next meeting, they thanked Mrs Debo. They said that they had seen a big improvement in the clerks. One mother said that when she became friendly with them, she learned that one clerk was married to a relation of hers. She had since invited the clerk and his family to her house. The clerks also told Mrs Debo that they had seen a big improvement in the patients.
By using role-play, this community nurse had helped mothers and clerks change their attitudes and learn new skills for communicating with other people, thereby changing their behavior.
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Get together with some other health and community workers. Decide
on a problem and make up a role-ploy. It do" not necessarily have to be a
personal problem of your own. It could be a problem in the village in general.
Get volunteers to play the different parts. Practise several times to get the
'feel' of what a role-play should be. After practicing with a group of people
you know, try to use role-playing with a patient or a community group.
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